Affective atmospheres and digital health

I have just submitted an essay for the special issue of Digital Health I am editing on the senses and digital health. In the essay I outline how the concept of affective atmospheres can be used to understand how and why people use or fail to take up digital health technologies, with a particular focus on the sensory and affective dimensions of these responses. The preprint version is available here, and the abstract is below.

The concept of affective atmospheres has recently emerged in cultural geography to refer to the feelings that are generated by the interactions and movements of human and nonhuman actors in specific spaces and places. Affective atmospheres can have profound effects on the ways in which people think and feel about and sense the spaces they inhabit and through which they move and the other actors in those spaces. Thus far, very little research has adopted this concept to explore the ways in which digital health technologies are used. As part of seeking to redress this lacuna, in this essay I draw on previously published literature on affective atmospheres to demonstrate and explain the implications of this scholarship for future theoretical and empirical scholarship about digital health practices that pays attention to their affective and sensory elements. The article is structured into six parts. The first part outlines the concepts and research practices underpinning affective atmospheres scholarship. In the second part, I review some of the research that looks at place, space and mobilities in relation to affective atmospheres. In the third part I go on to focus more specifically on the affective atmospheres of medical encounters, and then move on to digital technology use in the fourth part. I then address in the fifth part some relevant scholarship on digital health technologies. I end the essay with some reflections of directions in which future research taking up the concept of affective atmospheres in the context of digital health technologies can go. The key research question that these topics all work towards is that asking ‘How does digital health feel?’

Moving attachments: our emotional relationship with mobile digital media technologies

I recently read an article by Dave Beer in which he discussed the current lack of academic research and theorising about the emotional attachments users of the new mobile media develop with their devices. I agree that there is rather a dearth of writing about the ways in which we use and relate to new mobile media. I was frustrated, for example, to read a new edited book recently entitled Digital Cultures and the Politics of Emotion that focused on the topic of affect and digital technologies and to find that none of the contributions dealt with the affective dimensions of the technologies themselves. The focus, instead, was on the content produced via the technologies (their texts and images) and how affective states were reproduced and circulated online: for example, racist, violent and misogynistic material shared via social networks. While this book certainly provided interesting material on ‘digital structures of feeling’ there was little discussion of the ways in which digital technologies themselves as material objects and their embodied use are part of these structures.

This is a subject in which I have long had an interest. I have written extensively both on the topic of emotions, selfhood and embodiment (published in my book The Emotional Self ) and on the sociology of computer technologies. In the 1990s, I penned some articles on various aspects of the affective relationship we have with what were then emphatically ‘non-mobile’ digital technologies: the chunky desktop personal computer (PC). My argument was that using these PCs we developed a relationship with them that borders on the anthropomorphic.

One such piece was an essay entitled ‘The embodied computer/user’ (Lupton, 1995), where I explored the emotions that may be evoked by the PC not working or taking over one’s life, including  frustration, hostility and fear, and the tendency for users to describe their PCs as ‘friends’, ‘work companions’ or even ‘lovers’. With Greg Noble (Lupton and Noble, 1997) I then conducted some empirical research using interviews to address the ways in which the users of desktop computers incorporated their technologies in the context of the academic workplace. Our findings showed that PC users tended to evince an ambivalent position between seeing their PCs as humanoid and resisting this. Some people gave their PCs human names, or ascribed a gender or personality to them, describing them as spiteful, sexy, grumpy, intelligent or stupid. One person remarked that she saw her PC as ‘part of me’, ‘an extension of myself’.

I am still very interested in these dimensions of digital technology use (see here for a recent journal article and here, here and here for my blog posts on mHealth technologies and the quantified self). Digital technologies now have far more of a capacity to be intimately involved in our lives. Now, more than ever, as the new digital technologies become ever more mobile and wearable, as we carry them on our bodies throughout the day or even wear them at night (in the case of self-tracking headbands with embedded sensors designed to monitor sleep patterns): indeed as some can now be swallowed or stuck upon the skin as paper-thin patches to measure bodily functions, they are becoming even more a part of us, part of our bodies as prosthetics of the self, part of our identities as they store more data about our experiences, our social relationships and encounters and our bodily functioning.

There are moments when we become aware of our dependence on technologies, or find them annoying or difficult to use, or lose interest in them. As I have remarked in an earlier post on self-tracking technologies for health purposes, some people find wearable self-tracking devices not fashionable enough, or not water-proof enough, or too clunky or heavy, or not comfortable enough to wear, or find that they get destroyed in the washing machine when the user forgets to remove them from their clothing.

A blog post by designer Jennifer Darmour made similar observations, arguing that the aesthetic dimensions of wearable technologies have been little addressed. If these technologies remain too obvious, she argues, ‘bolting’ these devices to our bodies (an unlikely Frankenstein metaphor) and therefore obviously proclaiming ourselves as cyborgs will ‘distract, disrupt, and ultimately disengage us from others, ultimately degrading our human experience’. Darmour asserts that these objects need to be designed more carefully so that they may be ‘seamlessly’ integrated into the ‘fabric of our lives’. Her suggested ways of doing this include making them look more beautiful, like jewellery (broaches, necklaces, bracelets, rings), incorporating them into fashionable garments, making them peripheral and making them meaningful: using colours or vibrations rather than numbers to display data readings from these devices.

Another blogger has remarked upon the emotions that wearing digital self-tracking devices may provoke in people. Putting on a self-tracking device makes some people feel athletic, some fashionable, others fat and self-conscious about their bodies. Others feel safer and develop a greater sense of security about having their health monitored by these devices. Here again it was noted that the design of the device – its ‘look’, its conspicuousness or lack thereof  – may be integral to how people feel when they wear it.

Researching and theorising the affective dimensions of the configuration of user/mobile device potentially brings together the literatures on affect and emotion, embodiment, actor-network theory, media and cultural studies, the anthropology of material culture, digital cultures, digital sociology, digital anthropology and social computing. One way forward is to tap into the literature on the domestication of technologies emerging from media and cultural studies. This perspective is interested in how we ‘domesticate’ or ‘appropriate’ the technologies we use: that is, incorporate them into our everyday lives. I drew upon some of this work in my earlier research described above, and think that it still has much to offer in relation to understanding our affective attachments to our new digital technologies.

The material culture literature is also relevant to understanding how things in our lives are appropriated, incorporated and domesticated, how meaning and significance is invested in objects, and what the affective dimensions of this may be (see, for example, Miller’s The Comfort of Things and Turkle’s Evocative Objects, and my chapter on ‘emotion, things and places’ in The Emotional Self). So too, the work of Bourdieu, particularly his writings on the habitus, or the habitual practices of everyday life as they contribute to embodiment and subjectivity, may usefully be applied to understanding the interaction of bodies/selves with technologies. The actor-network approach to theorising the ways in which material objects join with fleshly bodies, other people’s bodies, other living things, ideas and practices to configure dynamic assemblages can potentially contribute to theorising and researching the affective dimensions of digital object use.

Computer science is well ahead of sociology when it comes to exploring what is termed in that field ‘social computing’ or ‘human-computer interaction’. The focus for computer scientists is in recognising that users interact with computerised technologies in often emotional ways (sometimes described as the subfield of ‘affective computing’), and to incorporate that recognition into designing systems and technologies that are accepted by users as useful, meaningful and a positive rather than frustrating experience.

Much remains to be explored, including the following questions: What does it feel like to carry, wear and use a mobile digital device? How much does their appearance and size matter? How are these devices incorporated into the habits and practices of everyday life (the habitus)? What are the practices of appropriation? How are they resisted? How do these devices configure users’ bodies and sense of selfhood and what are the emotional dimensions of this? What are the enabling and constraining aspects of their use? How do users adjust to giving up one device for another? How do they feel if the technology stops working? What are the interactions between the feelings configured and circulated via the texts and images produced by these devices and the physical material objects themselves?

References

Lupton, D. (1995) The embodied computer/user. Body & Society, 1(3/4), 97—112.

Lupton, D. and Noble, G. (1997) Just a machine? Dehumanizing strategies in personal computer use. Body & Society, 3(2), 83—101.

New book: (Re)thinking Violence in Health Care Settings

This comprehensive volume explores various forms of violence in health care settings. Using a broad range of critical approaches in the field of anthropology, cultural studies, gender studies, political philosophy and sociology, it examines violence following three definite yet interrelated streams: institutional and managerial violence against health care workers or patients; horizontal violence amongst health care providers and finally, patients’ violence towards health care providers. Drawing together the latest research from Australia, Canada, the UK, and the US, (Re)Thinking Violence in Health Care Settings engages with the work of critical theorists such as Bourdieu, Butler, Foucault, Latour, and Žižek, amongst others, to address the issue of violence and theorise its workings in creative and controversial ways.  As such, it will be of interest to sociologists and anthropologists with research expertise in health, medicine, violence and organisations, as well as to health care professionals.

• Contents:   Foreword, Dave Holmes; Introduction: (re)thinking violence in health care settings, Dave Holmes, Trudy Rudge, Amélie Perron and Isabelle St-Pierre; Part I Institutional and Managerial Violence: A critical reflection on the use of behaviour modification programs in forensic psychiatry settings, Dave Holmes and Stuart J. Murray; The violence of tolerance in a multicultural workplace: examples from nursing, Trudy Rudge, Virginia Mapedzahama, Sandra West and Amélie Perron; Changing discourses of blame in nursing and healthcare, Hannah Cooke; Hospital policies regarding violence in the workplace: a discourse analysis, Penny Powers; Exploring violence in a forensic hospital: a theoretical experimentation, Amélie Perron and Trudy Rudge; Nurses’ failure to report elder abuse in long-term care: an exploratory study, Gloria Hamel-Lauzon and Sylvie Lauzon. Part II Horizontal Violence: Foucault and the nexus between violence and power: the context of intra/inter professional aggression, Isabelle St-Pierre; Examining nurse-to-nurse horizontal violence and nurse-to-student vertical violence through the lens of phenomenology, Sandra P. Thomas; The rise of violence in HIV/AIDS prevention campaigns: a critical discourse analysis, Marilou Gagnon and Jean Daniel Jacob; Bullying in the workplace: a qualitative study of newly licensed registered nurses, Shellie Simons and Barbara Mawn; Sexual health nursing assessments: examining the violence of intimate exposures, Patrick O’Byrne and Cory Woodyatt; Bullying on the back-channels: everyday interpersonal communicative relations in telephone talk as a space for covert forms of professional manipulation, Jackie Cook and Colette Snowden. Part III Patients’ Violence: Assessment of risk and special observations in mental health practice: a comparison of forensic and non-forensic settings, Elizabeth Mason-Whitehead and Tom Mason; Policing pornography in high-secure care: the discursive construction of gendered inequality, David Mercer; Warning – this job contains strong language and adult themes: do nurses require thick skins and broad shoulders to deal with encounters involving swearing?, Teresa Stone and Margaret McMillan; Prison nursing: managing the threats to caring, Elizabeth Walsh; The mentally ill and civil commitment: assessing dangerousness in law and psychiatry, Cary Federman; Working in a violent environment: the pitfall of integrating security imperatives into forensic psychiatry nursing, Jean Daniel Jacob; Index.

About the Editor:  Dave Holmes is Professor and University Research Chair in Forensic Nursing, School of Nursing, Faculty of Health Sciences, University of Ottawa, Canada and co-editor of both Critical Interventions in the Ethics of Healthcare and Abjectly Boundless: Boundaries, Bodies and Health Work. Trudy Rudge is Professor at Sydney Nursing School, University of Sydney, Australia, and co-editor of Abjectly Boundless: Boundaries, Bodies and Health Work. Amélie Perron is Assistant Professor, School of Nursing, Faculty of Health Sciences, University of Ottawa, Canada.