Summerson Carr | University of Chicago (original) (raw)

Books by Summerson Carr

University of Chicago Press, 2023

http://www.luminosoa.org/site/books/detail/15/scale/

Scripting Addiction takes readers into the highly ritualized world of mainstream American addicti... more Scripting Addiction takes readers into the highly ritualized world of mainstream American addiction treatment. It is a world where clinical practitioners evaluate how drug users speak about themselves and their problems, and where the ideal of "healthy" talk is explicitly promoted, carefully monitored, and identified as the primary sign of therapeutic progress. The book explores the puzzling question: why do addiction counselors dedicate themselves to reconciling drug users' relationship to language in order to reconfigure their relationship to drugs?

To answer this question, anthropologist Summerson Carr traces the charged interactions between counselors, clients, and case managers at "Fresh Beginnings," an addiction treatment program for homeless women in the midwestern United States. She shows that shelter, food, and even the custody of children hang in the balance of everyday therapeutic exchanges, such as clinical assessments, individual therapy sessions, and self-help meetings. Acutely aware of the high stakes of self-representation, experienced clients analyze and learn to effectively perform prescribed ways of speaking, a mimetic practice they call "flipping the script."

As a clinical ethnography, Scripting Addiction examines how decades of clinical theorizing about addiction, language, self-knowledge, and sobriety is manifested in interactions between counselors and clients. As an ethnography of the contemporary United States, the book demonstrates the complex cultural roots of the powerful clinical ideas that shape therapeutic transactions--and by extension administrative routines and institutional dynamics--at sites such as "Fresh Beginnings."

Papers by Summerson Carr

Legitimzing Evidence: The Trans-institutional Life of Evidence-Based Practice, 2022

Evidence-based practice (EBP) has become a dominant paradigm in North American behavioral health ... more Evidence-based practice (EBP) has become a dominant paradigm in North American behavioral health and social service provision. Once a model of expert decision-making that asked practitioners to search through the "best available evidence" to inform their clinical decisions and select interventions, EBP is now better understood as a complex system of legitimation that designates particular methods and-by extension-their practitioners as "evidence-based." While critics worry that EBP forecloses professional discretion by imposing particular epistemic virtues of intervention science, this ethnographic case demonstrates that 1) EBP legitimates professional actors, methods, and organizations at least as much as it hampers them and 2) a wide range of "extrascientific" actors are involved in producing and legitimating the evidence of evidence-based practice, including policy makers, public and private insurers, state agencies, charitable foundations, registries and clearinghouses, health and human service organizations, and helping professionals themselves. Once we recognize the range of actors and institutions involved in basing and legitimating evidence, and the rhetorical work of tethering scientific terms to resonant political and economic discourses, we learn that there is nothing self-evident about evidence-based practice. Drawing on the social scientific study of expertise and focusing empirically on how one behavioral intervention earns and retains its status as an EBP, this study traces the trans-institutional life of evidence and the continual need to legitimate it as a base for behavioral health practice.

American Anthropologist, 2021

Motivational interviewing (MI) is an American behavioral health intervention that has spread dram... more Motivational interviewing (MI) is an American behavioral health intervention that has spread dramatically across professional fields, including counseling psychology, corrections, dentistry, nursing, nutrition,primary-care medicine, safe-water interventions, and social work. This article explores how the central methodological principles of American pragmatism—if understood and learned as MI—take root among a group of contemporary American helping professionals. More specifically, the article shows how professional training in MI inculcates: (1)a steadfast focus on the immediate consequences of one’s acts rather than floating or abstract conceptions of the true, the good, or the right; and (2) an investment in a highly reflexive mode of knowledge acquisition, which relinquishes the certainty of positivist explanations and embraces doubt. Indeed, learning how not to know is part and parcel of becoming an American pragmatist, and this article details the labor, costs, and rewards of adopting a pragmatic, or (in)expert, sensibility. [expertise, pragmatism, professionals, knowledge, United States]

In the first place, I wish to lay before you a particular, plain statement, touching the living b... more In the first place, I wish to lay before you a particular, plain statement, touching the living bulk of this leviathan, whose skeleton we are briefly to exhibit. Such a statement may prove useful here. According to a careful calculation I have made, and which I partly base upon Captain Scoresby's estimate, of seventy tons for the largest sized Green-land whale of sixty feet in length; according to my careful calculation, I say, a Sperm Whale of the largest magnitude, between eighty-five and ninety feet in length, and something less than forty feet in its fullest circumference, such a whale will weigh at least ninety tons; so that, reckoning thirteen men to a ton, he would considerably outweigh the combined population of a whole village of one thousand one hundred inhabitants. Think you not then that brains, like yoked cattle, should be put to this leviathan, to make him at all budge to any landsman's imagination?

This chapter chronicles the highly mediated event of the migration of a dock—unmoored by the Grea... more This chapter chronicles the highly mediated event of the migration of a dock—unmoored by the Great East Earthquake and Tsunami from a small, Northern Japanese town where it was originally located—to Agate Beach, Oregon. The displaced dock awed most everybody who encountered it, from ecologists to public officials, marine biologists to local tourists. As the dock’s interlocutors (inter)scaled its heaviness, its height, its travel from afar, the enormity of the natural disaster that sent it on its way, and the foreign species attached to it, the dock came to project the awe of the unknown and portend the threat of a disastrous future. As a result, the dock served a variety of expert and bureaucratic projects, including a quintessentially neoliberal form of risk management. At the same time, many who encountered the dock claimed to have experienced intimate, sensorial connections with and through it, suggesting a scalar dynamic that we call de-escalation. Documenting the many socialities emerging from the prolifically scaled dock, the chapter shows that that scaling is a practice that can spawn a sense of intimacy and an ethic of interrelatedness at the very same time it serves projects that can differentially authorize, individuate and alienate.

This paper draws on fieldwork with American social workers, whose primary charge is to engage wha... more This paper draws on fieldwork with American social workers, whose primary charge is to engage what they view as particularly recalcitrant human problems and populations. All the while, these workers find themselves in intensive engagements with bedbugs, which have recently infested the American imaginary, as well as the most destitute sites of American social work. As every professional effort at elimination is met with bedbugs' seeming multiplication, eradicating bedbugs comes to be understood as both professional responsibility and practical impossibility—yet another example that the magnitude of the problems with which social workers are charged exceed their abilities to resolve them. And yet these professionals neither succumb to “burnout” nor suffer a sustained sense of futility. Rather bedbugs help them cultivate a sustaining occupational ethic, one that resonates with American systems theories and American Pragmatism. More specifically, human-bedbug engagements inspire a working formulation of agency, which acknowledges the efficacies of non-human actors, understands human intention as framing of, rather than fuel for what actually happens, and privileges the means over the ends of (professional) labor. With a focus on how human-bedbug engagements contribute to the development of folk theories of agency, this paper demonstrates the fluidity with which social actors think about the possibilities for effective, meaningful (re)action and thereby contributes to the anthropology of agency.

Annual Review of Anthropology

Every society recognizes expertise, and anthropologists have long documented the culturally and h... more Every society recognizes expertise, and anthropologists have long documented the culturally and historically specific practices that constitute it. The anthropology of expertise focuses on what people do rather than what people possess, even in the many circumstances where the former is naturalized as the latter. Across its many domains, expertise is both inherently interactional, involving the participation of objects, producers, and consumers of knowledge, and inescapably ideological, implicated in the evolving hierarchies of value that legitimate particular ways of knowing as “expert.” This review focuses on the semiotics of expertise, highlighting four constitutive processes: socialization practices through which people establish intimacy with classes of cultural objects and learn to communicate that familiarity; evaluation, or the establishment
of asymmetries among people and between people and objects;
institutionalization, wherein ways of knowing are organized and authorized; and naturalization, or the essentialization of expert enactments as bodies of knowledge.

Journal of the Royal Anthropological Institute

How is it that confession – a highly ritualized, dialogically structured speech act – appears to ... more How is it that confession – a highly ritualized, dialogically structured speech act – appears to transparently reflect and reveal the inner states of confessants? This article explores this question by closely engaging select post-Vatican II defences of the Sacrament of Penance, which lay out the requirements of ‘modern’ confession in striking detail. A close reading of these theological texts demonstrates that felicitous confession is the product of three correlated (meta-)semiotic processes: (1) the figuration of the pentinent memory as a storehouse for sin; (2) the management of ritual time into discrete stages of ‘private’ meaning-making and ‘public’ pronouncement; and (3) the erasure of the social scenery of the confessional utterance. In concert, these processes render indexical signs as iconic ones and, in so doing, naturalize confession as the cathartic revelation of inner truths, already constituted as such.

Culture, Medicine, and Psychiatry

Motivational interviewing (MI) is an increasingly prominent behavioral therapy that draws from an... more Motivational interviewing (MI) is an increasingly prominent behavioral therapy that draws from and claims to synthesize two American therapeutic traditions long thought to be antithetical—“client-centered” and “directive” approaches. This paper proposes that MI achieves its hallmark “client-centered directiveness” through the aesthetic management of the therapeutic encounter, and more particularly, through MI practitioners’ marked use of silence. Drawing on data collected during the ethnographic study of MI trainings and the formal analysis of video-recorded MI sessions that are commonly used as models in such trainings, we identify three patterns of pause that regularly fall at specific grammatical junctures within seasoned MI practitioners’ turns-at-talk. We demonstrate how these pauses allow MI practitioners to subtly direct the conversation while simultaneously displaying unequivocal signs of client-centeredness. In other words, we show how and explain why the poetics of pause matter to MI. In presenting this case, we more generally highlight practice poetics—that is, the aesthetic management of the style and delivery of a professional message with a particular practical aim in mind—suggesting that this is a central if under-appreciated aspect of therapeutic practices.

American Ethnologist, 2009

Rather than simply silencing or excluding actors, contemporary U.S. institutions commonly assign ... more Rather than simply silencing or excluding actors, contemporary U.S. institutions commonly assign ways of speaking to the identities they forge and, therefore, preestablish ways of hearing the people who have come to inhabit them. Although institutional power is thereby reinscribed when “subalterns speak,” people can also inhabit such identities, and speak from these designated locales, in politically efficacious ways. Examining the rhetorical practices of clients and social workers at one institutional site, I highlight the process of anticipatory interpellation—reading how one is hailed as a particular kind of institutional subject and responding as such. [anticipatory interpellation, language, performativity, politics, representation, social work]

Qualitative Social Work, 2010

As a methodological proposal, this article proposes an approach to interview analysis that conne... more As a methodological proposal, this article proposes an
approach to interview analysis that connects the content of
interview data with (1) the immediate context of the interview,
(2) the way context emerges and changes during an
interview, (3) the relationship between the interviewee, the
interviewer, and other less immediate parties who elicit and
evaluate what said, and (4) the cultural conventions that
shape what counts as a meaningful speech in the first place.
The article continues on to delineate the importance of
accounting for (5) the relationship of the interview to
previous occasions of speaking, and (6) the relevant stakes
of speaking and interests of speakers. The potential import
of each principle is illustrated in reference to methodological
challenges encountered during an ethnographic study of
an intensive outpatient drug treatment program, a multimethod
evaluation of the same program, and relevant
practice experiences. In conclusion, the paper discusses how
to make the most of data collected in ‘interview intensive’
(Padgett, 2008) qualitative social work research.

Language in Society, 2006

This article demonstrates how cultural ideologies of language, and the semiotic processes that mo... more This article demonstrates how cultural ideologies of language, and the semiotic processes that mobilize them, manifest in contemporary American drug treatment. Drawing from an ethnographic study of an outpatient program in the Midwestern United States, it focuses on therapists' claims about what constitutes “healthy language.” It is argued that these claims both stem from and actively reproduce an “ideology of inner reference,” which presumes that “healthy” language refers to preexisting phenomena, and that the phenomena to which it refers are internal to speakers. By formally discouraging talk that could point outside the parameters of the individual psyche, the treatment program effectively insulates itself from clients' critiques and challenges. A broad attempt is made to elucidate the connection between a language ideology that enjoys wide cultural circulation as well as significant currency in contemporary clinical practice, and a particular political effect called “institutional insulation.”

Book Reviews by Summerson Carr

American Anthropologist, 2007

Accelerating Possession: Global Future of Property and Personhood. Bill Maurer and Gabrielle Schw... more Accelerating Possession: Global Future of Property and Personhood. Bill Maurer and Gabrielle Schwab, eds. New York: Columbia University Press, 2006. 275 pp.

Social Service Review, 2006