Biosocial journeys: care and community in experiences of body-focused repetitive behaviours
This thesis follows the emergence of a biosocial community and shows the importance of social relations for British and American people living with body-focused repetitive behaviours (BFRBs). It is based on sixteen months of ethnographic fieldwork in multiple sites across the UK and the US. I describe the experiences of women, men, and young people living with hair pulling (trichotillomania) and skin picking (dermatillomania), as well as their loved ones, health professionals, researchers and hairdressers working in the field of BFRBs. I present an in-depth view of what it is like to live with BFRBs, and the stigma and risk involved in the process of concealing and revealing to others. Exploring the complexities of how BFRBs are embodied, I show the shame and confusion that people feel towards their own bodies, triggering negative perceptions of the self. The suffering caused by BFRBs is reflected in families, with parents sharing feelings of loss, grief and frustration with their BFRB children. I expand on kinship theories to unpack these experiences through the concept of intersubjectivity, illustrating how parents are both connected and separated by their shared experiences with children. From these domestic challenges stem care practices that blur the boundaries between love and harm. Within the wider contexts of care, health professionals are described as unsupportive and uninformed, and people rarely receive effective support from the medical sphere. But despite the disappointments in medical care, diagnosis still has a value, and the journey that people living with BFRBs go through towards biosociality is dependent on the medical label. People therefore transition from isolated shame to connecting with others who share their embodied experience, forming relationships that are comparable to kinship ties. I argue that the process of finding and forming the biosocial BFRB community, allows people to overcome long-term feelings of shame, and leads to alternative notions of recovery. But biosociality is complex; it involves conflict, issues of inclusion, and ongoing work in order to be sustained. Due to the limits of biosociality, some people in the BFRB community are inspired towards biosolidarity; where BFRB experiences are turned into acts of advocacy that raise awareness and make these disorders visible in new ways. This thesis involves combined ethnographic and auto-ethnographic perspectives, and hopes to bring BFRB experiences to the attention of scholars, professionals and lay people living and working with mental disorders.