“Learning how to deal with feelings differently”: Psychotropic medications as vehicles of socialization in adolescence Suparna Choudhury a, b, * , Kelly A. McKinney c , Laurence J. Kirmayer a, b a Division of Social and Transcultural Psychiatry, McGill University,1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada b Culture and Mental Health Research Unit, Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste Catherine Rd., Montreal, H3T 1E4 QC, Canada c Department of Humanities, Philosophy and Religion, John Abbott College, 21275 Lakeshore Road, Sainte-Anne-de-Bellevue, H9X 3L9 QC, Canada article info Article history: Available online xxx Keywords: Canada Adolescence Psychiatric medications Mental health Teenage brain abstract Drawing from ethnographic research among clinicians working with adolescents at a hospital psychiatric emergency department and outpatient clinic, and with interviews with adolescent psychiatric patients and their parents, we examine how psychiatric medicines function as socializing agents. Although psychiatric medications are thought to exert their main effects through direct biological action on neural circuitry, in fact, their use mobilizes specific kinds of moral discourse and social positioning that may have profound effects on sense of self, personhood, and psychological development. Specifically, our data reveal how clinical discourse around medications aims to enlist adolescents in becoming responsible, emotionally intelligent selves through learning to manage their medications. Among doctors, adolescents and their families, talk about psychiatric medications intertwines narratives of ‘growing up’ and ‘getting well’. Our analysis of case studies from the clinic thus demonstrates that while psychiatric medications are explicitly designed to influence behavior by acting directly on the brain, they also act to structure adolescents' selves and social worlds through indirect, rather than direct causal pathways to the brain. Crown Copyright © 2015 Published by Elsevier Ltd. All rights reserved. 1. Introduction Among the various technologies of the new brain sciences, psychopharmaceuticals have been most widely and pervasively integrated into everyday life and consequently, are perhaps, most influential in transforming our everyday notions of normality, ex- planations for behavior, modes of self-regulation, and sense of identity (Rose and Abi-Rached, 2013). In this paper, we focus on the experience of adolescents receiving psychiatric medications for mood, anxiety and attention disorders. Our aim is to explore how psychopharmaceuticals, although deployed as biological in- terventions, also work indirectly within psychiatric discourse and practice as socializing vehicles, encouraging adolescents to adopt specific modes of understanding, experiencing, and managing the self. This study is part of a larger, ongoing research program on the “neurological adolescent,” a social construct emerging with the increasing popularity of brain-based discourses and interventions on adolescent mental health and development (Choudhury et al., 2012). Adolescence has long been an important time for mental health interventions reflecting the developmental challenges of maturation and individuation, and the fact more than 50% of adult disorders first appear in adolescence (Kessler et al., 2005). With the emergence of developmental cognitive neuroscience, neuro- imaging techniques have been used to chart brain maturation from childhood through adulthood, documenting the plasticity and distinct modes of functioning of the “adolescent brain”. The popular model of the “teen brain” not only offers a new scientific expla- nation of developmental challenges but also provides a new vo- cabulary and set of metaphors that may be used by adults and young people themselves to frame and interpret developmental challenges arising from normal development as well as illness. The appeal of the neurobiology of adolescent development for trans- lational applications is increasingly evident in areas of education (Ansari et al., 2012), psychiatry (Insel and Quirion, 2005) and, though controversial (Bonnie and Scott, 2013; Johnson et al., 2009) has been influential at the level of the US Supreme Court in the law (Steinberg, 2013). In most of these applications, there is a more or less explicit assumption that describing the effects of * Corresponding author. Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada. E-mail address: suparna.choudhury@mcgill.ca (S. Choudhury). Contents lists available at ScienceDirect Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed http://dx.doi.org/10.1016/j.socscimed.2015.02.034 0277-9536/Crown Copyright © 2015 Published by Elsevier Ltd. All rights reserved. Social Science & Medicine xxx (2015) 1e9 Please cite this article in press as: Choudhury, S., et al., “Learning how to deal with feelings differently”: Psychotropic medications as vehicles of socialization in adolescence, Social Science & Medicine (2015), http://dx.doi.org/10.1016/j.socscimed.2015.02.034