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The Dreamwork of the Symptom: Reading Structural Racism and Family History in a Drug Addiction

Proudfoot, Jesse

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Abstract

A key tenet of critical health research is that individual symptoms must be considered in light of the social and political contexts that shape or, in some cases, produce them. Precisely how oppressive social forces give rise to individual symptoms, however, remains challenging to theorize. This article contributes to debates over the interpretation of symptoms through a close reading of the case of Leon, an African American man struggling with an addiction to crack cocaine. Leon presented a complex illness narrative in which his addiction was clearly a product of structural racism, but also the result of dynamics within his family. Drawing on critical reevaluations of Freud’s concept of the dreamwork, I call attention to the surface elements of Leon’s narrative—what I term the surface of the symptom—and to the formal mechanisms by which latent contents (such as the social, the political, and the personal) are transformed into the manifest form of his symptom. This formal mode of reading offers a productive way of approaching questions of demystification and interpretation, one that holds in tension the register of social causation with the singularities of individuals and their symptoms.

Citation

Proudfoot, J. (2023). The Dreamwork of the Symptom: Reading Structural Racism and Family History in a Drug Addiction. Culture, Medicine and Psychiatry, 47(4), 961-981. https://doi.org/10.1007/s11013-023-09820-w

Journal Article Type Article
Acceptance Date Mar 7, 2023
Online Publication Date Apr 6, 2023
Publication Date Dec 1, 2023
Deposit Date Jan 19, 2023
Publicly Available Date Mar 29, 2024
Journal Culture, Medicine, and Psychiatry
Print ISSN 0165-005X
Electronic ISSN 1573-076X
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 47
Issue 4
Pages 961-981
DOI https://doi.org/10.1007/s11013-023-09820-w
Keywords Addiction, Illness narratives, Racism, Psychoanalysis, Structural violence
Public URL https://durham-repository.worktribe.com/output/1183160

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http://creativecommons.org/licenses/by/4.0/

Copyright Statement
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.





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