Governing Habits: Treating Alcoholism in the Post-Soviet Clinic

by Eugene Raikhel

Overview

Critics of narcology—as addiction medicine is called in Russia—decry it as being "backward," hopelessly behind contemporary global medical practices in relation to addiction and substance abuse, and assume that its practitioners lack both professionalism and expertise. On the basis of his research in a range of clinical institutions managing substance abuse in St. Petersburg, Eugene Raikhel increasingly came to understand that these assumptions and critiques obscured more than they revealed. Governing Habits is an ethnography of extraordinary sensitivity and awareness that shows how therapeutic practice and expertise is expressed in the highly specific, yet rapidly transforming milieu of hospitals, clinics, and rehabilitation centers in post Soviet Russia. Rather than interpreting narcology as a Soviet survival or a local clinical world on the wane in the face of globalizing evidence-based medicine, Raikhel examines the transformation of the medical management of alcoholism in Russia over the past twenty years.

Raikhel's book is more than a story about the treatment of alcoholism. It is also a gripping analysis of the many cultural, institutional, political, and social transformations taking place in the postSoviet world, particularly in Putin's Russia. Governing Habits will appeal to a wide range of readers, from medical anthropologists, clinicians, to scholars of post-Soviet Russia, to students of institutions and organizational change, to those interested in therapies and treatments of substance abuse, addiction, and alcoholism.

Product Details

ISBN-13:	9781501707056
Publisher:	Cornell University Press
Publication date:	10/19/2016
Series:	Expertise: Cultures and Technologies of Knowledge
Sold by:	Barnes & Noble
Format:	eBook
Pages:	248
Sales rank:	834,762
File size:	946 KB
Age Range:	18 Years

About the Author

Eugene Raikhel is Assistant Professor in the Department of Comparative Human Development at the University of Chicago. He is coeditor of Addiction Trajectories as well as founder and editor of Somatosphere, an online forum for medical anthropology.

What People are Saying About This

Adriana Petryna

With vivid portrayals of how clinicians harness broad social forces in the quest for patient sobriety, Governing Habits engages foundational questions at the unruly nexus of clinical authority and legitimate care. The story of the social crafting of medical efficacy now has a new, groundbreaking account.

Michele Rivkin-Fish

Calling narcology a 'domain of knowledge, ethics, and intervention,' Eugene Raikhel raises a series of fascinating and significant questions regarding the place of truth and ethics, responsibility, personal autonomy, beneficence, and obligation in the processes that compose this domain.

Nancy D. Campbell

This brave book presents new material and interpretation of the treatment of alcoholism and drug addiction in post-Soviet Russia. Governing Habits will set the stage for new conversations about the cultural specificity of medicine and biomedicalization, as well as concepts of alcoholism and addiction that begin to open new avenues for thinking beyond the currently dominant paradigm of brain-based disorder. This is the best that medical anthropology can provide—a deeply historicized and richly contextualized account of the meaning, value, and significance of present practice.

Editorial Reviews

"Highly nuanced and innovative.... It is on the topic of efficacy and clinical practice that Raikhel makes his most original contribution. The author offers a nuanced and ultimately sympathetic take on the state of contemporary Soviet narcology.... Governing Habits offers a highly convincing defense of the principled refusal of its author to take familiar, sweeping positions and instead focus on the fascinating particularities of the post-Soviet narcological practices and epistemological commitments.... Governing Habits makes an important contribution to the anthropology of medicine through its vivid exploration of a history of medicalization that radically diverge from the 'two minds' of American psychiatry (Luhrmann 2001) and, by extension, the practice of addiction medicine in North America."

PoLAR: Political and Legal Anthropology Review

Raikhel's book does valuable work both at the level of medical anthropologies of addiction, as well as at the level of anthropologies of Russia. By keeping the question of efficacy open, Raikhel enables readers to dive deeply into a different modality of treatment, offering a valuable comparative lens with which to view it, as well as the ontology of addiction itself.

Ethos

Raikhel has written a fine book that places Russia's treatment of alcohol use disorder in historical context, from nineteenth century Tsarist Russia, through the Soviet era, to the present postSoviet times....Governing Habits is one of the few books written by an anthropologist that details therapeutic interventions from the point of view of both physicians and patients within the larger economic, social, and cultural context.

Journal of the History of the Behavioral Sciences

An important contribution to the medical anthropology of therapeutic institutions and practices, offering new insights on the cultural specificity of biomedical and lay therapies of addiction. In Raikhel's careful account, authority, knowledge, and subjectivity are mutually transformed in the post-Soviet context. The book should be of broad use to those interested in the areas of post-Soviet healthcare, global health, and substance abuse treatment. It is also a vital contribution to the anthropology of medicine, psychiatry, addiction, institutions, and expertise.

Slavic Review

Highly nuanced and innovative. Governing Habits offers a highly convincing defense of the principled refusal of its author to take familiar, sweeping positions and instead focus on the fascinating particularities of the post-Soviet narcological practices and epistemological commitments. [The book] makes an important contribution to the anthropology of medicine through its vivid exploration of a history of medicalization that radically diverge from the 'two minds' of American psychiatry (Luhrmann 2001) and, by extension, the practice of addiction medicine in North America.

PoLAR: Political and Legal Anthropology Review

An important contribution to the medical anthropology of therapeutic institutions and practices, offering new insights on the cultural specificity of biomedical and lay therapies of addiction. In Raikhel's careful account, authority, knowledge, and subjectivity are mutually transformed in the post-Soviet context. The book should be of broad use to those interested in the areas of post-Soviet healthcare, global health, and substance abuse treatment. It is also a vital contribution to the anthropology of medicine, psychiatry, addiction, institutions, and expertise.

-- "Slavic Review"

Highly nuanced and innovative. Governing Habits offers a highly convincing defense of the principled refusal of its author to take familiar, sweeping positions and instead focus on the fascinating particularities of the post-Soviet narcological practices and epistemological commitments. [The book] makes an important contribution to the anthropology of medicine through its vivid exploration of a history of medicalization that radically diverge from the 'two minds' of American psychiatry (Luhrmann 2001) and, by extension, the practice of addiction medicine in North America.

-- "PoLAR: Political and Legal Anthropology Review"

Raikhel has written a fine book that places Russia's treatment of alcohol use disorder in historical context, from nineteenth century Tsarist Russia, through the Soviet era, to the present postSoviet times....Governing Habits is one of the few books written by an anthropologist that details therapeutic interventions from the point of view of both physicians and patients within the larger economic, social, and cultural context.

-- "Journal of the History of the Behavioral Sciences"

Raikhel's book does valuable work both at the level of medical anthropologies of addiction, as well as at the level of anthropologies of Russia. By keeping the question of efficacy open, Raikhel enables readers to dive deeply into a different modality of treatment, offering a valuable comparative lens with which to view it, as well as the ontology of addiction itself.

-- "Ethos"

From the Publisher

"With vivid portrayals of how clinicians harness broad social forces in the quest for patient sobriety, Governing Habits engages foundational questions at the unruly nexus of clinical authority and legitimate care. The story of the social crafting of medical efficacy now has a new, groundbreaking account."

Adriana Petryna

"This brave book presents new material and interpretation of the treatment of alcoholism and drug addiction in post-Soviet Russia. Governing Habits will set the stage for new conversations about the cultural specificity of medicine and biomedicalization, as well as concepts of alcoholism and addiction that begin to open new avenues for thinking beyond the currently dominant paradigm of brain-based disorder. This is the best that medical anthropology can provide—a deeply historicized and richly contextualized account of the meaning, value, and significance of present practice."

Nancy D. Campbell

"Calling narcology a 'domain of knowledge, ethics, and intervention,' Eugene Raikhel raises a series of fascinating and significant questions regarding the place of truth and ethics, responsibility, personal autonomy, beneficence, and obligation in the processes that compose this domain."

Michele Rivkin-Fish

"Raikhel’s book is an important contribution to the medical anthropology of therapeutic institutions and practices, offering new insights on the cultural specificity of biomedical and lay therapies of addiction. In Raikhel’s careful account, authority, knowledge, and subjectivity are mutually transformed in the post-Soviet context. The book should be of broad use to those interested in the areas of post-Soviet healthcare, global health, and substance abuse treatment. It is also a vital contribution to the anthropology of medicine, psychiatry, addiction, institutions, and expertise."

SLAVIC REVIEW