Truer Words—Pathologizing and Medicalizing Life

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Today’s Truer Words come from an article by Martha Rosenberg entitled Psychiatrists Seek New Patients at Annual Meeting. Rosen writes about the recent meeting of the APA—American Psychiatric Association. Here’s an excerpt from Rosenberg’s article early on:

This is the year the APA puts the finishing touches on DSM-V, the Diagnostic and Statistical Manual of Mental Disorders, a compendium that determines what treatments insurers will cover, what disorders merit funding as “public health” threats and, of course, Pharma marketing and profits. Some question the objectivity of a disorder manual written by those who stand to benefit from an enlarged patient pool and new diseases. Furthering the appearance of self-dealing is the revelation that 57 percent of the DSM-V′s authors have Pharma links [my emphasis].

The rest of Rosenberg’s article talks about efforts by the APA to, in essence, either pathologize or otherwise medicalize normal life. This is nothing new. Young kids are not supposed to stay still for hour upon hour listening to teachers talk in stifling classroom environments. They’re kids. But mental health care providers, along with big Pharma, have successfully labeled normal childhood activity and inattentiveness ADHD or attention deficit and hyperactivity disorder. Why not call it Normal Young Kid Disorder. By making normal life and normal development pathologic, both mental health care providers and big Pharma can make money, tons of it. So, if normal you and your normal development can be pathologized or medicalized, then you can be sold back to you in the form of a cure, often very expensive cures.

Why should the above be true? Writing in his book Self Comes to Mind (which I have blogged about in earlier posts), neurobiologist Antonio Damasio allows us to glimpse at a possible answer. Damasio writes:

Human childhood and adolescence take the inordinate amount of time that they do because it takes a long, long time to educate the nonconscious processes of our [middle] brain and to create, within that nonconscious brain space, a form of control that can, more or less faithfully, operate according to conscious intentions and goals.

Translation: Normal human development takes a long, long time and requires huge amounts of effort. Simply, we live in a quick fix society that wishes for a quick fix for everything, including liberating us from the demands of normal development. I’m pulling this from Ronald Dworkin’s 2006 book Artificial Happiness: The Dark Side of the New Happiness Class. Dworkin’s book could have been just as easily entitled Artificial Development. So, we cannot entirely blame big Pharma. If we as a society did not demand pharmacological quick fixes for every little thing—from antsy kids to men with erectile dysfunction—pharmaceutical companies would not be so willing to in essence make up cures. And as Dworkin points out, if the general population did not regularly go out “Jonesing” for a quick fix for every normal life inconvenience, doctors would not be as willing to write prescriptions. Both sides need to take their half out of the middle.

Let me end with words from Rosenberg’s article. Rosenberg is still talking about the APA meeting mentioned above:

Of course, disorders that Big Pharma has helped monetize like bipolar (which was termed “under diagnosed” and emerging in the elderly at the meeting) and “mood disorders” (once called “life”) were well represented. But an alarming amount of attention also went to the apparent new Pharma profit center of alcoholism and drug addiction.

So, the Truer Words I’d focus in on are those conveying the idea that what was once simply called life is now called mood disorder. I’ve got to go because my legs are getting restless. Hmmm … I wonder if they have a pill for that yet….

Interesting side note: It’s a long story but a number of years ago I read a 1990 Ph.D. dissertation by Elizabeth Matz entitled The Social Construction of Gender as the Foundation of Sexualized Violations. Dr. Matz provides an interesting “behind the scenes” look at how psychology and psychiatry types come up with the various categories and labels contained in the DSM (mentioned above). Consider this excerpt from Dr. Matz’s dissertation (with my comments in brackets):

In 1985 a group of feminist psychologists and psychiatrists was invited to meet with Dr. Robert Spitzer and his Committee on Personality Disorders. Spitzer heads the American Psychiatric Association’s workgroup which devises and proposes revisions to the Diagnostic and Statistical Manual of Mental Disorders produced and published by the American Psychiatric Association. This manual (known as DSM-III at the time of the meeting) is an influential codification of categories and labels for mental disorders. Walker (1986) [contact me if you really want this reference], describing the APA committee in action with group members at their computers, writes:

… each shouted out ideas for criteria coming from their own experiences…. If the behavior was observable in patients then a nosology category [e.g., a disease classification] could be created. If one of the committee members saw the behavior in themselves, however, out with that criterion! (Seriously; one criterion was dropped because a workgroup member popped up with ‘I do that sometimes.’ The institutionalization of the Us-Them phenomenon was amazing to behold.) (Walker, 1986, p. 1)

I laughed when I read the above excerpt. But it’s really not funny. This is how the psychology and psychiatric communities—along with substantial prodding from pharmaceutical concerns—feeds you to you, all the while charging lots of money for the privilege. Maybe bonus Truer Words to also focus in on are, “The institutionalization of the Us-Them phenomenon [is] amazing to behold.”