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Seeing Addiction: Ethnography and the Visibility of the Addict

Nick Catt

In 1937, the first sympathetic account of addiction in America was published. Ironically it was published in Shanghai. Chinese sociologist Bingham Dai, who had earned his doctorate from the University of Chicago, decided to show that opium addiction was not just a Chinese problem, and to explain addiction from the addict’s point of view. To do both he turned to ethnography—and wrote Opium Addiction in Chicago.


Some seventy years later, in 2009, two medical anthropologists, Philippe Bourgois and Jeff Schonberg, published Righteous Dopefiend, the culmination of over a decade of research on a community of addicts they call the Edgewater homeless. They too recognized an urgent need to make this community visible. As their book tells us, “They survive in perpetual crisis. Their everyday physical and psychic pain should not be allowed to remain invisible.”[1]


We encounter addiction every day, yet it remains largely unseen. And even when the suffering of addicts is in plain sight, it is often ignored. On one level they’re right in front of us, on another they live in the shadows. To understand opiate addiction one must first understand the addict. And to do that, one must make the addict visible.


Both Opium Addiction in Chicago, written in 1937, and Righteous Dopefiend, written in 2009, use ethnography to allow their audience to see addiction. Yet what do they want us to see? Dai wants to show that addicts come from diverse backgrounds and are a cross-section of America. He interviews doctors, professionals, pimps, prostitutes, criminals, performers—and shows them as not so different from anyone else. His ethnography carries an implicit message, ‘This could happen to you.’ By contrast, Bourgois and Schonberg focus on a community whose members are some of the most socially marginalized. The photographs added to Righteous Dopefiend are often shocking. They bring their audience face-to-face with unfathomable destitution, pain, and trauma. The authors show an uncomfortable reality that exists, quite possibly, down the street or under a bridge. Both works however, share a common thread. They want their audience to see addicts as vulnerable, as human beings silently suffering. The shared message is that this pain and suffering is a social problem that must be seen.


Dai feels existing studies were inherently flawed by understanding addiction as an isolated phenomenon and the addict as removed from society and culture. “If the addict is taken into account at all,” he writes, “he is usually looked upon by the law-enforcement officers, physicians and the general public as an individual with a diseased body, or a weak will-power, or a defective mentality, or still a psychopathic personality.”[2] Dai emphasizes a new approach: “[I]t may be said that every human individual, be he a holy man or an opium addict, is invariably a social as well as a cultural being,” he writes, in attempting to humanize the addict.[3]


Dai wants to understand social situations as they appear to addicts. As a result, he gains an intimacy into their emotional lives. A man interviewed at a shelter, for instance, tells Dai that he had lost both his parents by age eight and became familiar with the underworld by age twelve. Surrounded by gamblers and prostitutes he quit school, deciding that, “it does not take brains to make money.”[4] By eighteen he was living with an opium-addicted prostitute as her pimp. When she left, he had to fend for himself as an addict. “I felt the bottom had dropped out of everything,” he declares, “I did not know where to go…I did not know what to do…It was as if the world had stopped and all of us were flying around hellbent for some place.”[5] As he explains, If all the ‘junkers’ had mothers to whom they could go to, they would not be ‘junkers’ for long, ‘cause if a fellow knows someone who cares, he will try his damnedest. But what is the use of bucking the world, when one is lonesome and none of the rest of the world gives a damn if you come or go? Why take the cure? Why live at all, in fact, except to use more of the stuff and wonder what it is all about? If I had a mother I would be a different man today.[6]


Here Dai allows us to see a life shaped by trauma and loss. This man is flawed as all humans are flawed. Dai relates his story to human needs for family, love, care, and a place in the world. He makes this man’s pain visible to those who would never have seen it.


Many of Dai’s interviews expose a vulnerability that humanizes his subjects. He recognizes that drug use is not merely the manifestation of some predetermination toward vice. Many individuals he interviews were introduced to opiates from a doctor prescribing painkillers—a situation all too common today. One man became addicted after receiving a spinal injury when performing with a circus. Some months later he realized he was an addict, but by then he saw no other way to live. As he tells Dai, “thoughts born of hopelessness and incurability of the habit is one great contributing factor…that it is futile to attempt to quit.”[7] Dai sympathizes with addicts, presenting them as multi-dimensional. None wish to stay addicted. The strength and originality of this 1937 work came from allowing addicts to speak for themselves.


Righteous Dopefiend rests on many tenets of Dai’s work but writing seventy years later, Bourgois and Schonberg no longer need to convince their audience that addicts are indeed human. However, they reveal the humanity of the Edgewater homeless in much the same way—that is, by presenting moments of vulnerability and personal strife—and by letting addicts speak. These moments generate sympathy even when describing criminal activity or interpersonal betrayal. Bourgois and Schonberg state that, “Our challenge is to portray the full details of the agony and the ecstasy of surviving on the street as a heroin injector without beautifying or making a spectacle of the individuals involved, and without reifying the larger forces enveloping them.”[8]


Bourgois and Schonberg focus especially on Tina, who in one encounter creates an “imaginary household” with dolls scavenged from a nearby dumpster. She gives the dolls the names of her real-life daughters and tells stories of her family. But eventually the play becomes too much for her, and she tells him:


Nobody tell me a damn thing. I’m hard headed. But it’s no excuse, because I put myself in this position. And I pray to God that he help me along the way. Okay? I don’t wanna talk anymore, Jeff. Let me smoke this crack. It frees my brain. I don’t think about nothin’. I don’t want to think about all this, what I shared with you…my children, my kids.[9]


Tina’s words speak volumes. As her life spiraled out-of-control drug use became a means of survival—a symptom and a cause of her misfortune. Like Dai, Bourgois and Schonberg reveal a vulnerability in addicts that reinforces their humanity. While readers may not relate to Tina’s struggles with substance abuse, they can understand her desire to escape reality and trauma. Photographs add another means of representation to Righteous Dopefiend. By including visual evidence, Bourgois and Schonberg allow their audience to literally see what their writing can only take so far. As one reviewer stated, the “photographs depict a squalid reality that is difficult to grasp relying on the text alone.”[10] In fact, they do not allow us to look away. Their ethnographic narrative is strengthened by the photographs but, as the same reviewer noted, they do run the risk of turning Righteous Dopefiend into a “voyeuristic pornography of suffering.” [11] The authors are willing to take that risk to provide visceral evidence of pain and suffering. While photographs add a dimension of visibility that the text lacks, sometimes it is the field notes that truly allow us to see. For example, in one scene, they insist that we see, in gruesome detail, a man self-lancing one of his many abscesses:


He slowly inserts a pair of manicure scissors into the center of the inflammation, pushing one of the blades all the way up to the handle. He then slowly swirls the blade around to loosen the flesh. Pus flows out of the gash like a weeping eye. He finally pulls the scissors out and, with slow deliberation, squeezes the gash between his two thumbs to “drain it.” After ten or twenty seconds of grimacing and squeezing, he pokes a toenail clipper into the center of the abscess, using it as tweezers. He pulls out some sort of black gunk and, satisfied, holds it up for me to photograph: “This is the poison causing my pain.” [12]


While in the text the Edgewater homeless are given pseudonyms, their faces are boldly shown in photographs. Bourgois and Schonberg justify this with an anecdote from their field work. When asking a woman how she felt about them including a picture of her cooking heroin she replied, “If you can’t see the face, you can’t see the misery.”[13]


Both Opium Addiction in Chicago and Righteous Dopefiend use ethnography to make visible the invisible. They humanize addicts by allowing them to speak on their own terms without passing judgement. They provide intimate accounts of personal strife and struggle to survive in a world that seems to not care. They show addicts as vulnerable people with rich emotional lives and a complex personhood all their own. These works differ, however, in the way they step back and analyze their evidence. Dai writes as a trained psychoanalyst while Bourgois and Schonberg use social theory to decipher their material. Their work makes visible the effects of invisible impersonal forces upon human bodies, such as the dynamics of state power, the economic and political policies and practices of neoliberalism, as well as racism, sexism, homophobia, and classism. Although they often step back, they inevitably jump right back in with captivating stories that force the reader to see addiction.


Drug addicts are already marginalized in some way, whether homeless or not. By law, their everyday existence is criminalized. On the extreme side of the spectrum, homeless addicts represent the dark side of American excess and wealth. Their struggles are silenced, however, not just by legal threats but also by shame and guilt, leaving them largely invisible. How then can we then see addiction? Dai, Bourgois, and Schonberg turn to ethnography as a strategic decision to answer this question. As a genre, ethnography seeks to capture the unfamiliar. It allows us to see new realities. They do not merely tell us these stories on the behalf of their informants; instead, they allow them to speak for themselves. As Tina tells Bourgois and Schonberg, “I’ll let y’all know why I’m like this. Let me tell my story.” [14]


Notes


[1] Philippe Bourgois and Jeff Schonberg, Righteous Dopefiend (California: University of California Press), 15.


[2] Bingham Dai, Opium Addiction in Chicago (New Jersey: Patterson Press, 1970), 9-10.


[3] Ibid., 10.


[4] Ibid., 141.


[5] Ibid.


[6] Ibid., 141-2.


[7] Ibid., 112.


[8] Bourgois and Schonberg, Righteous Dopefiend, 5.


[9] Ibid., 207.


[10] Chad Farrell, “Righteous Dopefiend,” Review of Righteous Dopefiend, by Philippe Bourgois and Jeff Schonberg, City & Community 14, no. 4 (December 2011), 339-440.


[11] Ibid.


[12] Bourgois and Schonberg, Righteous Dopefiend, 102.


[13] Ibid., 11.


[14] Ibid., 48.


Bibliography


Bourgois, Philippe, and Jeff Schonberg. Righteous Dopefiend. California: University of

California Press, 2009.


Dai, Bingham. Opium Addiction in Chicago. New Jersey: Patterson Smith, 1970.


Farrell, Chad. R. “Righteous Dopefiend.” Review of Righteous Dopefiend, by Philippe Bourgois and Jeff Schonberg. City & Community 14, no. 4 (December 2011).


Biography


Nick Catt was raised in Whittier, California.  He earned his B.A. in American Studies at California State University, Fullerton, in 2011 and is currently a graduate student in CSUF’s American Studies Department.

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