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Practices of Care in the Recovery Assemblage: an Empirical Study of Drug Services in Liverpool and Athens

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Practices of Care in the Recovery Assemblage: an Empirical Study of Drug Services in Liverpool and Athens Practices of care in the recovery assemblage: an empirical study of drug services in Liverpool and Athens Eleni Theodoropoulou Thesis submitted in accordance with the requirements of the University of Liverpool for the degree of Doctor in Philosophy by Eleni Theodoropoulou January 2020 2 Abstract Practices of care in the recovery assemblage: an empirical study of drug services in Liverpool and Athens Author: Eleni Theodoropoulou This thesis empirically explores the practices of care emerging in two drug recovery services: Genie in the Gutter (Liverpool) and 18 ano (Athens). Thinking with the Deleuzo-Guattarian assemblage, I follow the flows of the service-users’ desires, from their initial encounter with substances to the transformations enabled through their encounter with the recovery assemblage. Throughout this complex and non-linear narrative, the focus is not on the consumption of substances, nor on abstention, but on the body’s desire to increase its power of acting, and accordingly on the encounters and connections that enhance or block the flow of this desire. Following this line of thought, I argue that it is not the lack of the substance that holds the recovery assemblage together, but the production of connections that enhance a body’s power of acting. Therefore, recovery becomes a practice of collective care, entangled with a body’s capacity to affect and be affected. The oral (interviews) and visual (photovoice) methods deployed are connection-building devices, specifically producing, enhancing and accounting for the connection built between the two fieldsites, between the researcher and the services, and the researcher and the service-users. The data produced drive the unpacking of the human and nonhuman encounters that constitute the recovery assemblage in all its complexity. Overall, the aim of this thesis is to methodologically and empirically demonstrate that policy can be practised otherwise. The outcome of the analysis of the lived experiences of the service-users is a call for the dismissal of policy as an intervention coming from outside, and its reconstitution as a practice, emerging organically through the affective relations produced inside the recovery assemblage. I argue that the practices of care unfolded in this account are policy in practice. Furthermore, by closely attending to the affective relationships produced in the recovery assemblage, we can enhance our understanding of drug using realities, of the desires invested in drug use and recovery, and of the ways in which societies fail those whose desires clash with established systems of thought. Finally, this thesis contributes to the sociology of health and illness by expanding the body of work that mobilises Deleuze to empirically challenge wellbeing as a stable state and individual matter. 3 4 Acknowledgements Writing is a collective process and the content of this thesis has been directly and indirectly informed by many encounters. I’m grateful to my supervisors, Dr Nicole Vitellone, Prof Vicky Singleton and Dr Karenza Moore, for their insightful, consistent and caring supervision of this thesis. From the very beginning until the very end, Nicole’s academic and intellectual contribution has been invaluable. Her care and support during all stages of the PhD, and beyond, have been a very much needed source of motivation. Vicky’s and Karenza’s feedback and support has been extremely helpful. Their expertise has assisted me in the development of crucial aspects of this thesis. I couldn’t have asked for a better supervisory team. I’m thankful to the Economic and Social Research Council for financially supporting all aspects of my PhD. I would also like to thank academic and administrative staff of the Sociology, Social Policy and Criminology department for their support over the last four years. This thesis wouldn’t have been possible without the participation of service-users and workers of 18 ano and Genie in the Gutter. I’m indebted to all workers of both services for their trust, and for sharing their insightful experiences and knowledge of recovery and care. I’m especially grateful to the artist and art therapist Adam Mavropoulos, the first person to introduce me to the ‘little planet’ of 18 ano. His enthusiasm, unique approach and long-term experience of recovery and art therapy have informed my growing interest in the field. Special thanks to Dimitris Yfantis, head of research at 18 ano, for his encouragement when a long time ago I shared with him my desire to pursue a recovery-related PhD. Our discussions since then have provided me with an insight and knowledge that I wouldn’t have gained otherwise. I am also indebted to Panayiotis Zaganiaris for accepting me at 18 ano’s theatre group. Thanks to his endless energy and knowledge, every single group has been a unique learning experience. The service-users of 18 ano and Genie in the Gutter that participated in this study will remain anonymous. I cannot however emphasise enough how much the name, life and story of each one of them matters. I’m extremely grateful to all of them for trusting me and supporting this project by making it their own. Although integrating all our discussions in one thesis wouldn’t have been possible, our encounters have shaped my understanding of recovery, 5 and subsequently hold a very special place in the development of the ideas presented in this thesis. Beyond the academic world, I am grateful for the friendship of many amazing people who have informed my way of being and thinking. Lots of love and special thanks to Konstantina Alevra and Filyra Vlastou for their support throughout difficult times, as well as for all the happy memories we share. A warm thank you to Ioanna Drymonitou, Panayiotis Fetsis, Magda Korpi, Manto Melachroinou, Dinos Nikolaou and Nefeli Roumelioti. My gratitude and love goes to Katerina Maniadaki, the best problem-solver that both Athens and London have ever known. From the Goldsmiths years, many thanks to Anna Kontopoulou, Sibley Labandeira Moran and of course the one and only Marimar Suarez Peñalva. I’m very proud of our transatlantic friendship that has remained intact for over a decade. Lots of love to my London ‘family’ (you know who you are!), and especially to Jaya Klara Brekke and Anya Eckbo. Liverpool is the city I currently call ‘home’, and it is the people I’ve met here that make it feel like home. I’m immensely grateful for the friendship of Maike Pötschulat, Laura Harris, Sarah Gordts, Madeleine Rungius and Myriam Lahnite. Writing this thesis would not have been as pleasant and painless if it weren’t for this amazing support network. Special thanks to Chris Staples and a warm thank you to Liverpool Solidarity Federation for always reminding me through their actions that care is political. I’m extremely lucky for growing up in a loving and supporting family. The love and tenderness of Neni Nikolaou and Tzimis Papoutsis have always made me feel safe. I’m grateful to Anna Papoutsi and Tania Papoutsi for never letting me feel like an only child. Growing up with them has shaped me in all sorts of ways. I was raised by two wonderful people who created for me a safe, caring and extremely loving environment. A lot of love and a massive thank you goes to my dad, Sakis Theodoropoulos for his unconditional vote of trust in me and my choices. Seeing the world through his sense of humour makes it a better and more hopeful place. This thesis is dedicated to my mum, Elsa Nikolaou. I cannot thank her enough for having been an endless source of love, strength and inspiration throughout her life. She is now part of who I am and I hold on to this part dearly. 6 Table of Contents Introduction ........................................................................................................................... 11 Chapter 1. Difficult connections: a selective engagement with qualitative drug research through a feminist technoscientific lens .............................................................................. 23 Difficult connections: the response of drug ethnography ................................................. 24 Ethics of care and the researcher’s positionality ............................................................... 26 Practices of policy and practices of care ............................................................................ 31 The desire for an assemblage of care ................................................................................ 35 Chapter 2. The recovery assemblage – a methodology ....................................................... 39 Why Deleuze and Guattari ................................................................................................. 40 Assemblages of recovery and wellbeing ............................................................................ 44 The Deleuzo-Guattarian assemblage ................................................................................. 51 Assemblages .................................................................................................................. 51 Affect and affective relations ......................................................................................... 54 Becoming........................................................................................................................ 54 Desire ............................................................................................................................. 56 Territorialisation (Deterritorialisation and Reterritorialisation) ...................................
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