Like Foucault and those who have followed him, I am interested in the “how” of power. This form of power is played out both between and within individuals, and it is made necessary and rendered visible by the irreducible materiality of psychopharmaceutical technologies. Revealing and tracing these inter- and intra-personal technologies is a crucial first step towards the articulation of a biopolitics that enables and, indeed, requires attention to difference. Drugs are experienced in as many ways as there are human beings who take them. Thus “totalizing discourses” which either reduce the biopolitics of drugs to the homogenizing determinism of biology (except biology is not itself homogeneous) or economics (and neither is economics itself), or those which sublimate all biopolitics to the consciousness of the self-producing individual, result in the erasure of the individual voices who are the real sites of neurochemical intervention. Of course, it is also essential to acknowledge that these “totalizing discourses” also influence the way in which individuals discover, approach, and engage with these technologies.
The process by which people “come off” psychiatric drugs reveals a tremendous diversity of understandings about what it means to “be on” those drugs. But across this tremendous diversity, a common theme emerges. The process of detaching oneself from a cognitive prosthetic such as psychiatric drugs inevitably involves a negotiation, both between the individual seeking to get away from those drugs and the psychiatric discourses in which they are implicated, as well as between medicated and unmedicated selves. Biopolitical negotiations, as well as the politics of difference so elegantly articulated by feminist scientists and social theorists, take place within the minds of individuals as much as within communities of those individuals.
But with all this attention to difference, how can we account for sameness? From the bottom up, that is, when we pay attention to individual articulations of illness, we see overlapping multiplicities of agencies and perspectives. But when we look from the top down, so to speak, we see a very different picture emerge. From the perspective of states, hospitals, disciplines, schools, and other institutions, we see populations instead of people. Instead of difference, we encounter sameness. While biological science has left us with no credible causal explanations for how psychiatric illness appears, we possess a wealth of statistical knowledge that points to such entities as “regularities,” “trends,” and “influences.” While two individuals may have dramatically different experiences of illness, and although they may have very different conceptions of the causal origins of their illness, they may respond very similarly to a given medication. Our bodies may be different in a variety of ways, but we have much—perhaps most—in common. It would seem, therefore, that we must also ask the question: “How can we still take regularities seriously?”
We must first ask: “What are regularities?” Regularities appear to real entities, things that we can touch and use in the form of graphs, categories, and predictions. Regularities are things that are used. An irrelevant regularity (“the sun always comes up”) is understood as a poetic or metaphoric statement, particularly when compared to the articulation of a relevant regularity (“the tide goes out every 12 hours”). To believe otherwise is to believe that any knowledge is really, truly produced solely for the sake of knowledge. It then follows that regularities are things that are used by people. Or, more precisely, by anything that acts in the social world. These people are accountants, pharmacists, software, computer programmers, astronomers, clocks, surfers, philosophers, consumers, engines, and carpenters. At the most quotidian scale, we use regularities to make decisions about where to shop, how to build, when to eat, and whether to carry an umbrella. Institutions use regularities to carry out every conceivable administrative task. Regularities are used by specific people, specific things, specific institutions. Who uses them and why matters a great deal.
It seems, then, that regularities are not to be found above, beyond, or outside the context of their use. Regularity is not the other side of irregularity, and sameness is not the other side of difference. There is only difference, there is only relation. The question of how to take regularities seriously becomes a question of whether we should take regularities seriously. Of course, this does not mean that regularities as practices do not guide thought and action—they do, and they are ubiquitous. But sameness is not an explanation; it does not tell us how things happen outside the spaces in which they are material practices.
By removing sameness and regularity from our field of view, we therefore do not deny their realness in specific contexts. But in doing so, we have opened up the possibilities for understanding the experience of individuals, groups, and things for whom sameness is not a relevant biopolitical entity. Understanding sameness therefore brings us right back to difference, and to the endless diversity of agencies and orientations with which we began.
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