"It's beautiful and it's messy and it's tragic": exploring the role of compassion in the eating disorder recovery processes of 2S/LGBTQ + Canadians.

This research explores experiences of compassion among 2S/LGBTQ + Canadians living with eating disorders in the context of eating disorder treatment and community support. There is a growing body of scholarship showing disparities in eating disorder care for those within 2S/LGBTQ + communities. Among the reported concerns is a potential lack of compassion in eating disorder treatment and recovery settings, something which may serve to exacerbate feelings of isolation and perpetuate misunderstandings of 2S/LGBTQ + people's experiences. In an effort to understand these dynamics more deeply, we conducted semi-structured interviews with 2S/LGBTQ + Canadians who have experienced eating disorder care. The data collected were then subjected to Foucauldian discourse analysis, which produced three interconnected discursive considerations: feeling lack of structural compassion, 2S/LGBTQ + communities as places of respite, and 2S/LGBTQ + caregiving. One of the common threads among these discursive considerations was cis-heteronormativity ingrained in eating disorder treatment settings and health care systems more broadly. Our findings underscore the critical need for more enhanced compassion for 2S/LGBTQ + patients in eating disorder care settings. We conclude that compassion, when implemented on the levels of individual clinicians, policy and procedure, and institutions, may represent an avenue toward disrupting ingrained cis-heteronormativity and the associated discursive power structures contained in health care systems.

Two-Spirit, lesbian, gay, bisexual, transgender, queer and other sexually or gender diverse (2S/LGBTQ+) are at increased risk for eating disorders often related to minority stress, discrimination, and heteronormative gender expectations. Compassion is believed to be a fundamental aspect of healthcare that builds human connections and enhances positive outcomes. Healthcare, however, is steeped in heteronormative assumptions that may further isolate many 2S/LGBTQ+ patients. This study explored how 2S/LGBTQ+ Canadians living with eating disorders felt about their care and the role of compassion in their recovery journeys. We found that these individuals often felt misunderstood and isolated during treatment. However, they often experienced understanding by connecting with other 2S/LGBTQ+ people both in care and in the community, which provided the compassionate spaces lacking in their healthcare experiences. These findings highlight a need for making healthcare more compassionate for 2S/LGBTQ+ people. This can be done by changing policies, mandatory training for healthcare professionals, and treatment that recognizes and discusses minority stresses, uses trauma-informed practices, and gender-affirming approaches. By doing such items, standard norms can be challenged and the care for 2S/LGBTQ+ people living with eating disorders can be improved.

Rethinking sexual violence labels: exploring the impact of 'victim' and 'survivor' discourse.

Background: Universities' responses to sexual violence have faced scrutiny for their lack of proactiveness and their failure to address campus socio-cultural norms that contribute to rape myth acceptance. The labels victim and survivor play a crucial role in shaping attitudes toward sexual violence, but there is limited research on how university students perceive these labels.Objective: This paper explores sexual violence labels and their role in perpetuating rape culture. Undergraduate university students' beliefs on using the label survivor instead of victim to describe someone who has experienced sexual violence were examined to consider how these labels create societal discourse on sexual violence.Method: The study draws on qualitative data collected from undergraduate students in Canada and the United States through open-response questions in an interactive textbook. Data were analysed and interpreted using a multi-method approach that combined principles of Critical Discourse Analysis and Feminist Poststructuralism. Direct quotes and word clouds from participants' responses are used as evidence and to visually display discourse.Results: Findings revealed that participants recognised the negative societal discourses associated with the label victim and supported using survivor to challenge perceptions of sexual violence. Despite this, participants expressed hesitancy to adopt the label survivor because of the potential negative implications, such as the label promoting the allocation of individual blame, increasing barriers to justice, and reducing the perceived severity of sexual violence.Conclusions: This study underscores the complexities of sexual violence labels, the influence of language in shaping societal perceptions, and the need for a more comprehensive and equitable approach to responding to sexual violence.

Dichotomy of Labels and Nuanced Perceptions: Sexual violence labels shape identity perceptions. Participants dichotomised the labels victim and survivor, associating one with negative attributes and the other with positive attributes. However, nuanced views of how people perceive and identify with these labels challenge distinct categories. Victims being negatively perceived, while survivors are admired for their resiliency highlights complexities in societal expectations that may not fully address the underlying determinants of sexual violence.Role of Language in Reproduction of Rape Culture: Poststructuralist theories emphasise the role of language in the production and maintenance of discourse. The study shows that victim discourse is steeped in rape myths. The historical discourse surrounding the label may contribute to the perpetuation of negative attitudes and behaviours toward victims of sexual violence. The emergence of the label survivor reflects a societal shift, but findings suggest this may lead to societal complacency towards sexual violence.Spectrum of Severity and Societal Empathy: Participants' understanding of sexual violence as a spectrum of severity may lead to unequal levels of empathy and support. This discourse creates positions of dominance and oppression, potentially marginalising certain groups who are disproportionately affected by sexual violence. The study highlights how severity discourse can influence institutional agendas and may result in political and institutional neglect of sexual violence.

Examining How Postpartum Videoconferencing Support Sessions Can Facilitate Connections between Parents: A Poststructural and Sociomaterial Analysis.

Postpartum support for new parents can normalize experiences, increase confidence, and lead to positive health outcomes. While in-person gatherings may be the preferred choice, not all parents can or want to join parenting groups in person. Online asynchronous chat spaces for parents have increased over the past 10 years, especially during the COVID pandemic, when "online" became the norm. However, synchronous postpartum support groups have not been as accessible. The purpose of our study was to examine how parents experienced postpartum videoconferencing support sessions. Seven one-hour videoconferencing sessions were conducted with 4-8 parents in each group (n = 37). Nineteen parents from these groups then participated in semi-structured interviews. Feminist poststructuralism and sociomaterialism were used to guide the research process and analysis. Parents used their agency to actively think about and interact using visual (camera) and audio (microphone) technologies to navigate socially constructed online discourses. Although videoconferencing fostered supportive connections and parents felt less alone and more confident, the participants also expressed a lack of opportunities for individual conversations. Nurses should be aware of the emerging opportunities that connecting online may present. This study was not registered.

"Recovery" in mental health services, now and then: A poststructuralist examination of the despotic State machine's effects.

Recovery is a model of care in (forensic) mental health settings across Western nations that aims to move past the paternalistic and punitive models of institutional care of the 20th century and toward more patient-centered approaches. But as we argue in this paper, the recovery-oriented services that evolved out of the early stages of this liberating movement signaled a shift in nursing practices that cannot be viewed only as improvements. In effect, as "recovery" nursing practices became more established, more codified, and more institutional(ized), a stasis developed. Recovery had been reterritorialized. The purpose of this paper is to examine some of the threads of recovery, from its early days of antipsychiatry activism to its codification into mental health-including forensic mental health-institutions through the lens of poststructuralist philosophers Gilles Deleuze and Felix Guattari. We believe that Deleuze and Guattari's scholarship provides the necessary, albeit uncomfortable, framework for this critical examination. From a conceptualization of recovery as an assemblage, we critically examine how we can go about creating something new, caught in a tension between stasis and change.

Poststructuralism and the construction of subjectivities in forensic mental health: Opportunities for resistance.

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that subjectivities are fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system.

Vanishing academics: On the importance of speed and becoming-imperceptible.

Under the influence of neoliberalism, academic work faces mounting pressure to align with imperatives of visibility and perceptibility. Traditionally criticised for working in isolated 'ivory towers', academics are now compelled to showcase the societal value of their work through performance metrics and evaluations. Paradoxically, these efforts have unintentionally led to the rigidification and commodification of academic work, stifling the production of knowledge beyond predefined parameters. In this paper, we contend that academics should resist the imposition of this neoliberal 'grid' and instead seek a path of 'becoming-imperceptible', drawing inspiration from the insights of Deleuze and Guattari. Becoming-imperceptible does not entail silent disengagement; rather, it represents a creative form of resistance challenging prevailing modes of assessment rooted in visibility and perceptibility. By incorporating the concept of 'fast feminism' to subvert Paul Virilio's hypermasculine speed theory, we uncover the transformative potential of temporary absences. Leveraging these moments of absence, academics can intensify their affective connections with both their peers and their work, making them undiscernible to the confines of the academic establishment. We argue that these instances of imperceptibility create fertile ground for creative and inventive academic endeavours on the margins of established boundaries, where original scholarship can flourish. Such a subversive approach is particularly relevant in fields like nursing and the health sciences, where it can challenge the dominant discourses that typify neoliberal academia.

Not Just Checklists and Rainbows: Exploring Canadian Dietitians' Beliefs, Values, and Knowledge of Transgender Nutritional Care.

Purpose: Many transgender (short form: trans) people are experiencing disparities within Canadian health care systems, including nutritional and dietetic health care systems. This research explores the views, beliefs, and experiences of Canadian dietitians about trans nutritional care and seeks to understand how dietitians can better address the nutritional needs of trans individuals. Methods: Semistructured online interviews were conducted with 16 Canadian dietitians. Interviews were transcribed and the data were analyzed thematically. Results: Three main themes were created; (1) There's an Unjust System, (2) We've Come a Long Way, and (3) Not Just Checklists and Rainbows. The participants explored the historic nature of the Canadian dietetic profession and noted the connection between cis-normativity and the erasure of trans identities. They also explored how dietitians could better address the health needs of trans people, including moving beyond the acknowledgement of trans identities to changing the way gender is viewed in the profession. Conclusion: The dietetic profession must move beyond surface-level activities and rethink gender. Recommendations include adding trans-focused care training into the profession, creating safer spaces for trans individuals, advocacy and allyship, and recruiting trans people to the profession.

"I felt like I had no options": Navigating an ultrasound prediction of a large baby in pregnancy.

BACKGROUND: Pregnancy ultrasound is deeply embedded in maternity care worldwide, undertaken routinely and in response to clinical indicators. Though ultrasound fetal size predictions can be inaccurate, they heavily influence clinical decision-making. As a result, women with a scan prediction of a 'large' baby may be more likely to have unnecessary interventions. AIM: This study aimed to explore the implications of an ultrasound prediction of a 'large' baby on birthing women's experiences of their pregnancies and births. METHODS: The study was underpinned by feminist poststructural theory. Semi-structured interviews were undertaken with women who had an ultrasound prediction of a 'large' baby. Transcripts were analysed using reflexive thematic analysis, with particular attention to discourse. FINDINGS: Dominant medicalising discourses prioritised surveillance and risk-centric care, and problematised large babies. Engagement with these produced oppressive effects on women including loss of control as they were directed towards high intervention care, and the experience of fear and guilt. DISCUSSION: A 'large' baby prediction has a negative impact on women's experiences. Women take up dominant discourses that frame predicted large babies as a medical problem to be managed, with little tangible improvement in outcomes. They struggle with fear and guilt as they experience their pregnancies as sites of risk and are constituted as failed mothers who are responsible for their large babies. CONCLUSION: The prediction of a 'large' baby in pregnancy has undeniably negative impacts on women. We encourage midwives to scrutinise the dominant discourses of authoritative scans and problematic large babies, becoming vectors for critical thinking and resistance.

A critical examination of epistemological congruence between intersectionality and feminist poststructuralism: Toward an integrated framework for health research.

The theoretical perspectives of intersectionality and poststructuralism have contributed meaningfully to advancing issues of social injustice within the realm of women's health research. However, the question of whether the two approaches are epistemologically commensurate has been at the heart of a polarized debate within third- and fourth-wave feminist literature in recent years. In this paper, we draw on the extant literature to explore existing dilemmas within this debate and critically reflect on points of epistemological tension and congruence between the two perspectives. It will be demonstrated that intersectionality and poststructuralism, especially feminist poststructuralism, represent concordant theoretical perspectives and a synthesized theoretical framework for application in qualitative research into women's health will be proposed. We argue that an intersectional feminist poststructuralist framework contributes to a deepened analysis of women's disparate healthcare experiences, and the social mechanisms, power relations, and discourses that mediate these experiences, while offering avenues for advocacy and political praxis on a multitude of levels.

Mothers' Access to Social and Health Care Systems Support during Their Infants' First Year during the COVID-19 Pandemic: A Qualitative Feminist Poststructural Study.

Social support and health services are crucial for mothers and families during their infants' first year. The aim of this study was to explore the effect of self-isolation imposed by the COVID-19 pandemic on mothers' access to social and health care systems support during their infants' first year. We utilized a qualitative design using feminist poststructuralism and discourse analysis. Self-identifying mothers (n = 68) of infants aged 0 to 12 months during the COVID-19 pandemic in Nova Scotia, Canada completed an online qualitative survey. We identified three themes: (1) COVID-19 and the Social Construction of Isolation, (2) Feeling Forgotten and Dumped: Perpetuating the Invisibility of Mothering, and (3) Navigating and Negotiating Conflicting Information. Participants emphasized a need for support and the associated lack of support resulting from mandatory isolation during the COVID-19 pandemic. They did not see remote communication as equivalent to in-person connection. Participants described the need to navigate alone without adequate access to in-person postpartum and infant services. Participants identified conflicting information related to COVID-19 as a challenge. Social interactions and interactions with health care providers are crucial to the health and experiences of mothers and their infants during the first year after birth and must be sustained during times of isolation.

Women's Experiences Regarding Physical Activity during the Postpartum Period: A Feminist Poststructuralist Study.

Although recovery after birth can be promoted through bodily movement, many women do not engage in regular postpartum physical activity. While research studies have identified some of the reasons behind their decisions, including a lack of time, only a limited number of studies have been carried out to explore how postpartum physical activity is socially and institutionally constructed. Thus, the present study aimed to investigate the experiences of women regarding postpartum physical activity in Nova Scotia. Six postpartum mothers participated in semi-structured, virtual, in-depth interviews. Women's experiences of postpartum physical activity were examined through a discourse analysis guided by feminist poststructuralism. The following themes were identified: (a) socialization in different ways; (b) social support; (c) mental and emotional health; and (d) being a good role model for their children. The findings indicated that all women perceived postpartum exercise as a positive behavior that can promote mental health, although some postpartum mothers experienced social isolation and a lack of support. Furthermore, social discourses about motherhood caused the personal needs of mothers to be disregarded. The results showed that collaboration among health care providers, mothers, investigators, and community groups is necessary to promote and support mothers' engagement in postpartum physical activity.

The shiny new object: Deconstructing the patient-oriented paradigm in health sciences.

RATIONALE: A 'patient-oriented' research paradigm, also known as patient and public engagement, has infiltrated the field of health sciences and continues to spread. At first blush, it is difficult to reprove anything labelled 'patient-oriented'; however, the patient-oriented paradigm may easily become an ideological 'good', leading to unintended consequences that may well prove more detrimental than beneficial. While patient-oriented research has its roots in more radical forms of patient and public engagement, its recent instantiation betrays its roots and forecloses on more radical forms of engagement, such as critical participatory research. AIM AND OBJECTIVES: The objective of this article is to deconstruct the patient-oriented research narrative and to demonstrate how such a discourse imposes itself as a dominant approach in health sciences. APPROACH: Following Derrida's deconstructive approach, we bring to light the unexamined presuppositions, false pretences, and presumed 'goodness' and 'naturalness' of patient-oriented discourse. DISCUSSION: By deconstructing the patient-oriented narrative we demonstrate how pre-existing power structures (biomedical, economic, etc.) shape the conduct of the approach and serve to depoliticize the truly participatory aspects of research. Rather than being modelled on the evidence-based movement or seen as its natural 'evolution', patient-oriented research should resist by affirming itself as a radical form that is both participatory and emancipatory.

"Classifying D/s Profiles Without Prior Assumptions: An Application of Cluster Analysis to Social Data".

Dominant/submissive role-play (D/s) is associated with specialized roles including Mistress, Master, Slave, Switch, Sadist, and Masochist. The current study uses cluster analysis to provide empirical evidence that no binary opposition or single spectrum constitutes a workable typology of individuals based on their affinities for these roles. The optimality of a particular choice of clustering scheme, including the number of clusters, is established using a replication technique which is presented in detail. A large number (n = 236,353) of individualized results (profiles) generated by the BDSM Test, a popular anonymous web survey, were analyzed. We hypothesize a two-dimensional typology of D/s profiles as the inferential result of our cluster analyses.

Heteroprofessionalism in the Academy: The Surveillance and Regulation of Queer Faculty in Higher Education.

This article engages with Robert Mizzi's theorization of heteroprofessionalism to describe the experiences of two queer professors in the fields of Education and Psychology. We explore how heteronormative and cisnormative expectations of post-secondary professors impact professional practices and increase the regulation and surveillance of queer professors in academia. We methodologically employ Grace and Benson's queer life narratives approach to retell and ground our personal stories of being queer higher education faculty. To do this, we analyze our experiences teaching and working in higher education through a queer poststructural theoretical lens. We then deconstruct how normative ideas regarding professionalism in higher education have regulated our professional practices as professors, particularly pertaining to our respective embodiments, genders, and sexualities. We focus on two nexuses of heteroprofessionalism: paradoxical (in)visibility and queer relationality. These nexuses are used to illuminate heteroprofessionalism as a neoliberal mechanism in higher education that regulates gender and sexual diversity by promoting respectability politics.

From domestication to imperial patronage: Deconstructing the biomedicalisation of occupational therapy.

Occupational therapy knowledge emerged in the 19th century as reformist movements responded to the industrialisation of society and capitalist expansion. In the Global North, it was institutionalised by State apparatuses during the First and Second World Wars. Although biomedicine contributed to the rapid expansion and establishment of occupational therapy as a health discipline, its domestication by the biomedical model led to an overly regulated profession that betrays its reformist ideals. Drawing on the work of Deleuze and Guattari, our aim in this article is to deconstruct the biomedicalisation of occupational therapy and demonstrate how resistance to this process is critical for the future of this discipline. The use of arts and crafts in occupational therapy may be conceptualised as a 'nomad science' aesthetically resisting the domination of industrialism and medical reductionism. Through the war efforts, a coalition of progressive nurses, social workers, teachers, artisans and activists metamorphosed into occupational therapists. As it did with nursing, biomedicine proceeded to domesticate occupational therapy through a form of 'imperial' patronage subsequently embodied in the evidence-based movement. 'Occupational' jargon is widely used today and may be viewed as the product of a profession trying to establish itself as an autonomous discipline that imposes its own regime of truth. Given the symbolic violence underlying this patronage, the future of occupational therapy should not mean behaving according to biomedicine's terms. As a discipline, occupational therapy must resist the appropriation of its 'war machine' and craft its own terms through the release of new creative energy.

Wired Sex Assemblages Among Men Who Have Sex with Men: Sexualized Drug Use, Hookup Apps, and HIV Service Provision.

Sexualized drug use is a form of sexual practice that resists risk-based discourses (otherwise referred to as "radical sex practices") and is reportedly common among gay, bisexual and other men who have sex with men (GBMSM). With the growth of online technologies, the use of hookup apps has also increased. We refer to men's use of drugs, apps, and sex form as "wired sex" that forms what post-structuralist theorists Deleuze and Guattari described as an assemblage. Perspectives of the health and social service providers who work directly with GBMSM has not been explored. This research project involved a critical discourse analysis of 13 semi-structured interviews with service providers in Canada to understand their perspectives and interactions with wired sex assemblages. We identified several themes reflecting the social and political effects of wired sex assemblages and discuss the implications of these effects on services provision with GBMSM.

Two Attitudes towards Textuality in International Law: The Battle for Dualism.

This article sketches out two distinct attitudes towards textuality in international law, namely international hermeneutics and international poetics. It argues that these two attitudes towards textuality espouse very different types of dualism of thought. This difference bears major implications on how the international lawyer approaches international legal texts. In exposing these two attitudes towards textuality and the distinct types of dualism they reveal, this article makes a plea for a greater embrace of international poetics by international lawyers, and thus for a complete remoulding of international lawyers' dualist patterns of thought.

The Hegemonic Politics of 'Strategic Autonomy' and 'Resilience': COVID-19 and the Dislocation of EU Trade Policy.

The outbreak of COVID-19 in March 2020 led to substantial upheaval in the EU's trade policy. Over the course of a year, EU Trade Policy as a field witnessed the launch of hitherto unthinkable ideas; the proliferation of a range of new buzzwords such as resilience, autonomy, and reshoring; and ultimately the arrival of a new consensus in the Trade Policy Review of February 2021. This article uses a discourse-theoretical approach (PDT) to retrace the political process that unfolded throughout this year, from the start of the COVID-19 crisis, to a fundamental dislocation of EU trade politics, and ultimately to the consolidation of a partial, temporary, and frail new hegemony within the policy field. Our goal is to explain the trajectory and the dynamics of this process by studying the discourses, the framings, and the political strategies that comprised the hegemonic struggle underlying it.

Compassionate Discourses: A Qualitative Study Exploring How Compassion Can Transform Healthcare for 2SLGBTQ+ People.

Compassion can be seen as a necessary, but often lacking, concept and practice in healthcare. Due to the cis-heteronormative nature of societies, people who identify as Two-Spirit, lesbian, gay, bisexual, transgender, queer (2SLGBTQ+) often experience health disparities and disparities in accessing compassionate healthcare. We aimed to explore the meanings of compassion in healthcare for Canadian 2SLGBTQ+ people. Using a poststructuralist framework, 20 self-identifying 2SLGBTQ+ participants were interviewed. Data was analyzed through discourse analysis. Three main discursive considerations are discussed, including (1) meanings and expectations of compassion in healthcare, (2) compassionate healthcare is not guaranteed, and (3) prescription for care: self-compassion for healing and health. The results provide insights into how compassionate healthcare is framed for 2SLGBTQ+ participants and how compassion is often lacking for them due to discourses of cis-heteronormativity and healthism.

A dupla volta da subjetivação em Winnicott / The double turn of subjectivation in Winnicott / El doble giro de la subjetivación en Winnicott

O propósito principal deste texto é o de avaliar a pertinência do conceito de subjetivação à guisa da contribuição de Donald Winnicott. Tradicionalmente associadas ao desenvolvimentismo psicológico e mais recentemente ao identitarismo, as ideias do psicanalista inglês têm ficado de fora dos debates contemporâneos acerca da desconstrução do sujeito e da crítica às identidades. Pretendemos reposicionar Winnicott nesse debate avançando à ideia de uma subjetivação propriamente histórica e contingente, caracterizada pelo que chamamos de uma dupla volta, a primeira sendo a que organiza a posição pré-subjetiva que Winnicott chamou de being; e a segunda, a emergência do sujeito propriamente dito a partir da dialética da destruição x sobrevivência do outro.

In this paper, we aim to reassess the relevance of the concept of subjection in the guise of the contribution of Donald Winnicott. Traditionally associated to psychological development theories and more recently to identitarianism, the ideas of the English psychoanalyst are usually eschewed in contemporary debates regarding the deconstruction of the subject and the critique of identities. Advancing a repositioning of Winnicott in this debate, we propose the idea of a double turn, the first organizing the pre-subjective position that Winnicott named as being; and the second turn, the emergence of the subject itself from the dialectics of destruction x survival of the other.

El propósito principal de este texto es el de evaluar la relevancia del concepto de subjetivación bajo la contribución de Donald Winnicott. Asociadas tradicionalmente al desarrollismo psicológico y más recientemente al identitarismo, las ideas del psicoanalista inglés han quedado fuera de los debates contemporáneos sobre la deconstrucción del sujeto y la crítica de las identidades. Pretendemos reposicionar a Winnicott en este debate, avanzando la idea de una subjetivación propiamente histórica y contingente, caracterizada por lo que llamamos un doble giro, siendo el primero el que organiza la posición presubjetiva que Winnicott llamó ser; y el segundo, el surgimiento del sujeto propiamente dicho desde la dialéctica destrucción x supervivencia del otro.