More Than a High : Exploring Pleasure and Investigating Components of Wellbeing in Chemsex

Cairns, Callum and Bourne, Katy and Eastham, Rachael (2024) More Than a High : Exploring Pleasure and Investigating Components of Wellbeing in Chemsex. PhD thesis, Lancaster University.

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Abstract

This thesis contains two papers focusing on Chemsex as the subject area. The literature review explores experiences of pleasure in Chemsex literature, while the empirical paper investigates the relationship between Chemsex and wellbeing. The literature review utilised a thematic synthesis of 10 UK and Ireland papers exploring qualitative reflective accounts of direct Chemsex experiences. Using an inductive pleasure-focused interpretive frame, the review highlighted that experiences of pleasure extend beyond heteronormative assumptions limited to “hedonism”. Pleasure was also found in areas such as the myopic properties of using chems, escaping from pressures of the outside world, feelings of collective and personal safety in seclusion, elevated physical/emotional/divine pleasures, and an array of social pleasures in areas such as acceptance, connection, and identity exploration. The findings highlight the power of the heteronormative gaze and judgements of ‘appropriate pleasure’, understanding types of safety, and pleasure(s) as a need. Implications include the necessity of incorporating pleasure into health service and supportive intervention considerations. The empirical paper investigated associations between Loneliness, Self-Acceptance, Social Connectedness and Subjective Wellbeing via an anonymous online survey with UK-based Men who have Sex with Men (MsM). Results indicated that Loneliness was the key variable influencing Wellbeing in the analysis, linking with social connectedness appraisals as a unified theorised construct. Social connectedness was the only variable that significantly predicted wellbeing once included in regression analyses. Loneliness was also linked with relationship status, Chemsex appraisals, and participation demographics. Implications include considerations for medical history taking and psychological assessment practices. This also includes recommendations for MsM-aligned therapies and general considerations of fostering reconnection to meaningful supportive communities. The critical appraisal reflects on the researchers’ learning and experience in undertaking this research. This includes further exploration of the limitation and clinical implications of the project findings, as well as an evaluation of personal learning.