Medicines as Emotional Objects: Multimorbidity and Polypharmacy in Socio-Historical Perspective

This 3-year PhD project is funded through the QMUL Life Sciences Initiative and is a collaboration between the Centre for Primary Care and Public Health and the Centre for the History of Emotions. It arises from the shared interests of two existing research programmes: a NIHR-funded project, Addressing the Polypharmacy Challenge in Older People with Multimorbidity (APOLLO-MM see www.polypharmacy.org.uk) and a Wellcome-funded project, Living with Feeling (https://projects.history.qmul.ac.uk/emotions/livingwithfeeling/). The successful student will benefit from existing networks and events associated with these projects.

We are looking for a highly motivated graduate with a background (including a relevant Master’s degree) in a relevant social science or history. The project is interdisciplinary and an explicit aim of the project is the integration of knowledge gleaned from both social science and history disciplines.

Students for whom English is not a first language will also be required to meet our English language requirements.

EU students must meet the UKCISA Higher Education guidelines to be eligible for EU fees.

Project Outline:

This project will explore the emotional dimensions of polypharmacy, past and present, asking what lessons can be learned by medical practitioners and patients from sociological and historical research into medicines as material and emotional objects. Its point of departure is that medicines-taking - especially in situations of polypharmacy - is a complex, embodied and emotional experience evoking unique feelings, rituals, responses and speculations.

Medicines exist in numerous formulations (e.g. tablets, capsules, solutions, inhalers, pessaries, lotions, creams, injectables) and are associated with a range of other material artefacts (prescriptions, containers, medicines compliance aids such as blister packs / dosette boxes). We postulate that the different material attributes of medicines (and the associated paraphernalia) may summon up a range of emotional responses and relationships which may be relevant to patients’ decision-making, meaning-making and practices around their medicines, including their likelihood (or not) of taking medicines as prescribed, and the rituals that result.

Medicines also vary in their site of action. Of particular relevance to this project is the fact that medicines may directly affect the emotional state (either intentionally - in the case of treatments for depression or anxiety for example - or unintentionally as a side-effect). This project will explore how patients view their medicines and whether, how and to what extent they prioritise and adjust their medicines-taking according to their emotional response to them. We will adopt an orientation to emotions as essential elements of human intelligence and rationality (rather than irrational obstacles to proper decision-making).

The project will involve:

1) Reviewing historical texts / archival resources / social science literature to identify accounts of the relationship between emotional experience and medicines-taking and how this has evolved over time. This will include appreciation of the ways in which different scholars (adopting a range of ontological and epistemological stances) frame emotions, emotions work and emotional states.

2) Exploring contemporary accounts of patients’ emotional relationship with their medicines through in-depth interviews (importing theory and concepts identified in the literature review in the analysis)

3) Development and use of a range of research-informed ‘trigger’ materials in focus groups with clinicians, to elicit inter-professional discussion and gain insights into clinicians’ response to evidence of the emotional dimensions of medicines-taking
It is anticipated that alongside the PhD thesis the student will work with supervisors to prepare a public engagement project (e.g. online collection and/or exhibition)

The PhD will commence in April 2020.