Cosmetic psychopharmacology, selfhood and the underdetermination of our being by our bodies…

The cultural hype about designer drugs, like that of designer babies, deserves analysis. But while cultural representations may be of “designer moods,” what is sold to the patient is a dream of control. Take control of your moods, treat anxieties that are the symptoms of illness, feel like yourself again, get your life back: these are the hopes, and the narratives, that mobilize the relations between the drug companies, the prescribers, and the consumers of psychiatric drugs.

Indeed, despite the worries that this is an ethic that offers happiness without requiring an exertion of the will, getting your life back is seldom framed as a simple matter of taking a pill. A rapid trip around the websites for depression, for example, shows that the restoration of the self requires work. The subject must engage in self-analysis of the ebbs and flows of mood, thought, and emotion. The subject must learn new ways of self-reflection, self-assessment, and insight. These forms of self-scrutiny are often materialized in the form of questionnaires to complete or diaries to maintain, meticulously charting the variations in feelings, moods, behaviour, and thoughts in different situations. Frequently the subject is recommended to engage in other forms of therapy, for example cognitive therapy, which requires that thought works on thought itself. Here, as elsewhere, we are obliged to work on ourselves to make ourselves what we really are.

Nikolas Rose, The Politics of Life Itself, Pg 101

This gap between cultural representations of cosmetic psychopharmacology and the clinical reality  undoubtedly stems, in part, from the information ecology of late capitalism (i.e. the tendency towards hyperbolic simplification which results from content producers in the media being impelled to generate ever more copy with ever fewer resources) and the economic interests implicated in the subject matter (i.e. building hype around forthcoming products to ensure the buoyancy of market capitalization). Nonetheless, there is more to it than this. The promise of control Rose suggests functions as the level of both marketing strategy and consumer reception. The idea that we can escape from the Reflexive Imperative (the need to conduct internal conversations in order to determine a course of action, given our objective circumstances and our subjective concerns) in our attempts to negotiate a rapidly changing social world is tied up with a desire to escape our corporeality. As reflexivity becomes ever more imperative, it is generative of reflexive pathologies (failures of self-management  in the broadest sense of the term) which can manifest themselves as escaping behaviours e.g. compulsions, addictions, obsessions.

However the successful exercise of reflexivity over the life-course is also generative of existential tensions from which we seek to escape. The more successfully we exercise control over ourselves, using our deliberative capacities to negotiate a path through the world which meets our moral needs and shaping a life which reflects what we want to do and who we want to be, the more we run up against the limits of human capacities. One such limit is our corporeality. We can exercise agency over our bodies and, in many cases, this can produce the effects we desire. Yet our control can only ever be partial and fallible. Maximising this control can be a life strategy in its own right but it is one  which is endless (e.g. the concept of ‘health’ has no natural end target, one can always be healthier) and, in many cases, can produce pathologies of its own. Conversely, even when we exercise this control successfully, there is always a lag. At any given moment, we act in a setting which is constrained and enabled by our bodily characteristics. Even those most-committed to corporeal self-discipline can never achieve an immediate mastery over their own body, such that it is subjugated to our reflexive projects and the promise of the resurgent Cartesianism which Rose and others detect in contemporary cultural can be fulfilled. The body always exceeds our capacity to control it and, within a society which valorises individualism and instrumental rationality, it can be profoundly difficult to accept this. Hence the attraction of the ‘dream of control’ sold by over-eager advocates of transhumanism and technological self-enhancement (not to mention big pharma).

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