Those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience. – C.S. Lewis
Especially in times of great change, society manipulates definitions of sanity when unstable social conditions require scapegoats. “Drapetomania” explained the “irrational tendency” of black slaves to flee captivity. Benjamin Rush diagnosed rebels against federal authority with “anarchia…excess of the passion for liberty…a form of insanity.” The dominant medical perspective still reflects Puritan prejudices when it defines some children as born “neurologically defective” (a more acceptable term than “original sin”).
But in America these conditions occur (or are identified) within the all-encompassing situation of late-stage capitalism, in which the most corrupt industries – most especially Big Pharma – have been quick to take advantage of human misery, financially endowing university departments of Psychiatry and selectively funding pro-drug research programs. In 2006, it accounted for thirty percent of the American Psychiatric Association’s $62.5 million in financing. About half of that money went to drug advertisements in psychiatric journals.
(Americans may be ill-educated on these issues, but they are not stupid. Mass resistance to the Covid vaccines is not simply a function of religious intolerance, anti-science ignorance or right-wing propaganda, but very often of fear of corrupted science. In 2015, the editor of the leading medical journal The Lancet, cited “studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest,” concluding that “much of the scientific literature, perhaps half, may simply be untrue.”)
Big Pharma provides the answer to nature gone wrong (previously cured by baptism at birth). In the U.S., 2.5 million children and 1.5 million adults manage hyperactive and attention deficit behaviors with Ritalin, with 17 million prescriptions per year. Peter Breggin, MD, however, writes that the Attention Deficit (ADD) diagnosis was developed specifically to justify “the use of drugs to subdue the behaviors of children in the classroom.” The U.S. produces and consumes ninety percent of the world’s Ritalin, most of which is given to our children, including ten percent of all ten-year-old boys.
However, when we hear of epidemics of depression and anxiety, we need to ask whose interest that impression serves. Cui bono? Follow the numbers: between 1995 and 2002 the number of children and teens diagnosed with depression doubled. American doctors are five times more likely than British doctors to prescribe antidepressants to minors.
Follow the politics: while minimizing poverty, irrelevant schooling and epidemic violence, the psychiatric priesthood maintains a symbiotic relationship with the pharmaceutical industry, which annually spends $25 billion on marketing worldwide and employs more Washington lobbyists than there are legislators. Prior to the Covid pandemic, the top class of drug by revenue ($14.5 billion in 2009) was antipsychotics. In 2008 the New York Times reported on Psychiatrist Joseph Biederman:
A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful anti-psychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials.
Due in part to Biederman’s influence, the number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003.
Simply put, madness is big business: labeling others (Others) as sick, scaring parents and pushing (prescribing) drugs as the only cure. Each edition of the Diagnostic and Statistical Manual (DSM) has included more mental disorders than the previous one.
One of those “disorders”, “Premenstrual Dysphoric Disorder” (PMDD), has defined premenstrual emotional swings as mental illness. A 1992 study took the symptoms listed for PMDD – then called Late Luteal Phase Dysphoric Disorder (LLPDD) – and asked three groups of people to document every day for two months the symptoms they experienced. The groups were women who reported severe premenstrual problems, women who reported no such problems, and men. The answers did not differ among the three groups.
Why did the DSM demonize a natural condition? Follow the money: shortly before, with the patent on Prozac about to expire, its manufacturer, Eli Lilly, rebranded it as “Sarafem” and marketed it as the cure for this new condition. The DSM complied, and recommended antidepressants as the only psychiatric therapy for PMDD. Lilly’s patent on Prozac – and its profits – were extended for seven years.
Deinstitutionalization reduced the asylum population from 500,000 in 1955 (half of all hospital beds) to around 60,000 in 2010. But Reagan-era budget cuts decimated the community mental health systems that had supported the released patients, instantly creating a population of tens of thousands of homeless people. Now, our largest warehouses of the mentally ill are the Los Angeles and Chicago jails.
Drastic overbuilding of hospitals in the 1970s left many institutions in serious financial trouble. Psychiatry provided the answer to this problem in 1980 with new diagnoses like “oppositional defiant disorder.” Marketing campaigns convinced thirty thousand families that only private hospitalization would keep their children from suicide. Ten years later, six times more adolescents – primarily white and middle-class – were confined to locked psychiatric wards. Skeptics, however, called the new disease “KID” (Kid-with-Insurance Disorder), pointing out the amazing rate of “recovery” once the insurance ran out and parents had to start paying out-of-pocket.
But in public facilities, the numbers of teens have actually decreased, because minority kids go to jails and, unsurprisingly, receive no treatment at all.
Enforced hospitalization exemplifies the shadow of a society that claims personal liberty as its highest value. The “therapeutic state,” says Szasz, uses psychiatric justifications to strip individuals of their rights. It creates two classes: those who are stigmatized as crazy and subject to coercive intervention, and “us,” whose conventional behavior and well-concealed abnormalities indicate our innocence. No one else – neither priest nor judge – has the psychiatrist’s power to have someone committed, even if he came into his office of his own free will:
Only in psychiatry are there ‘patients’ who don’t want to be patients…If you’re in a building that you can’t get out of, that’s not a hospital; it’s a prison.
Certainly, many of the involuntarily committed are dangerous to themselves or others. Yet too often, psychiatrists function as the Church once did, as agents of the state, as gatekeepers who determine who is or isn’t the Other.