Of all the statistics that describe the devastation wreaked upon Iraq by the illegal war, I find the figures describing the plight of Iraqi children the most troubling and heart-wrenching.   These children are the ones who will determine what sort of future Iraq will have.  Their well-being, or lack of it, will impact on the lives of all Iraqis regardless of sect, religion, or ethnicity.

A study by the Iraqi Society of Psychiatrists in collaboration with the World Health Organization found that 70% of children (sample 10,000) in the Sha’ab section of North Baghdad are suffering from trauma-related symptoms.

Even if this study is not completely replicated in the whole of Iraq, it clearly shows that huge numbers of children are growing up with mental problems. Many of these childrenhave seen close family members killed; they have walked in streets where they have seen dead and mutilated bodies just lying around. If left untreated, what impact will these mental problems have on the future of Iraq?

First, of course, the suffering, the stress, and the depression that afflicts these children must be alleviated.  All of Iraqi society must see that providing expert medical intervention to help these children cope is a moral imperative.

The effect of Post Traumatic Stress Disorder is bad enough for professional soldiers returning from Iraq and Afghanistan.  It is hard to imagine the effects on a child growing up amongst such carnage.  In macho Iraqi society, such children, particularly the boys, tend to suffer in silence for fear of being labelled wimps. In any case, expertise to treat such cases is woefully inadequate in Iraq,

It is unfortunate that Iraqi society and possibly the entire Arab world is pervaded by a macho culture that sees people who express fear, anxiety and emotional distress as weak, particularly boys and men.  Education is essential to puncture this erroneous and destructive trait.   People need to be able to express these emotions, and be taught that these are expected reactions to the trauma they have experienced.

The Iraqi government must provide the necessary funds to train professionals to treat these children to relieve their stress and misery, of whom 4.6 million have lost one or both parents. Over half a million children live on the streets prey to physical and emotional abuse.

Surely politicians from whatever sect, supported by the intelligentsia and opinion-formers, could work together to make the goal of helping the children of Iraq a priority. Working collaboratively on such a project would, one hopes, generate trust across the ethnic and sectarian fault lines and may lead to further cooperation.

The West can help by providing scholarships to Iraqis to gain the expertise necessary to save Iraq from the consequences of mental impairments that could condemn Iraqi society to a bleak future, with its ripples fanning out well beyond its borders.

Iraqis need to start somewhere to work together, and what better goal to aim for than the future of Iraq’s children. All Iraqis, instead of continuously engaged in blaming each other, could focus on such a worthy, humane, and moral project, and with its success improve the chances of a peaceful, prosperous future to the benefit of all.

One reason for the switch away from pills is that doctors are increasingly wary of prescribing new “blockbuster” drugs after the recalls of Vioxx, Bextra, Baycol, Meridia, Trovan, Fen Phen and new warnings on asthma, epilepsy, pain, bone and hormone drugs.

And there are new wrinkles in compensation. Private and government insurers are becoming less willing to “cough up money for an expensive new drug–particularly when a cheap and reliable generic is available,” the Wall Street Journal reported recently.

So it’s no wonder that Pharma and its benefactors at the National Institutes of Health are mining a new revenue source: the nation’s millions of alcoholics and drugs addicts who need a “vaccine.”

“Sixty percent of people with a substance abuse disorder also suffer from another form of mental illness, says a recent New York Times’ Science Times. (Another?) They are “wired differently” and may have a “developmental brain disorder,” says the article, next to a photo of Amy Winehouse, lest anyone miss The Point.

“We now know that addiction is a disease that affects both brain and behavior,” says Nora D. Volkow, director of the National Institute on Drug Abuse, in an National Institutes of Health newsletter. “We have identified many of the biological and environmental factors and are beginning to search for the genetic variations that contribute to the development and progression of the disease.”

Of course, Pharma’s stratagems to grow its “mentally ill” franchise are well known. People with occasional anxiety are really depressed, then bipolar, then suffering from an assortment of amorphous “spectrum” diseases and dysrythmias with no known cause, no cure, no diagnostic tests and no turnoff valve on the pharmacy spigot.

The situation is even worse for children because they’re given drugs against their will by parents, teachers and doctors. Toddlers are diagnosed with ADHD, conduct disorders, depression, bipolar disorder, oppositional defiant disorder, mood disorders, obsessive-compulsive disorders, mixed manias, social phobia, anxiety, sleep disorders, borderline disorders, irritability, aggression, pervasive development disorders, personality disorders and (pant, pant) even schizophrenia–all of which require expensive medication cocktails.

But the picture gets scarier when researchers start identifying “biological factors” in “animal models” of addiction and depression at major primate research centers.  (There are eight including the University of Washington, Seattle; the University of California, Davis; the University of Wisconsin, Madison; Emory University; Harvard University; the Southwest Foundation for Biomedical Research; Oregon Health Sciences University; and Tulane University.)

Scarier for people that is. It’s already pretty scary for animals.

Because even though “proof” of mental illness in animal and human brain matter is as accurate as phrenology, it allows Brave New World diagnoses in which people suffer from – or are at risk of -psychiatric illness in the absence of symptoms. On the basis of a brain scan!  Because we have a drug to treat it.

Already drugs for pre-asthma, pre-diabetes, pre-mental illness, pre-cardiovascular conditions and pre-osteoporosis are a big part of Pharma’s arsenal. (And bone measuring machines that “prove” risk for osteoporosis, are in doctors’ offices.)

Pharma’s “early treatment” ruse — especially insidious in children who aren’t given the chance to grow up without drugs — is accelerated by disinformation that the mongered “silent” diseases are progressive: the longer you wait to treat them, the sicker you get! But who knows whether the drugs were ever needed, since they’re taken before symptoms appear?

Of course, the first problem with Pharma’s plan to treat alcoholic and drug addicts’ mental illness with a vaccine is that they are not mentally ill or suffering from a vaccine deficiency. But, secondly, alcoholism and drug addiction are diseases of denial in which sufferers want to drink. Hello? (Can anyone imagine Amy Winehouse asking for a vaccine?) That’s why Antabuse, a drug that makes people violently sick if they drink on it, fails.

Thirdly, doctors have long recognized that alcoholism and drug addiction are not strictly medical problems that can be treated by practitioners. “If a doctor is honest with himself, he must sometimes feel his own inadequacy. Although he gives all that is in him, it often is not enough,” wrote William D. Silkworth, MD, in 1939. “We physicians must admit we have made little impression upon the problem as a whole. Many types do not respond to the ordinary psychological approach.”

The only treatment that works for alcoholics and addicts — much to Pharma’s chagrin — is non-medical, non-pharmaceutical and free — administered in self-help groups run by other alcoholics and addicts. Which brings us to the fourth reason Pharma can’t cash in on its new chosen customers: for alcoholics and addicts, drugs are not the solution they are the problem!

In the first paragraph of an article published this week in the academic journal Pediatrics, Angeline S. Lilliard and Jennifer Peterson set up their study with a pick-and-choose somewhat slanted view of television. According to these psychologists, “correlational studies link early television viewing with deficits in executive function . . . a collection of prefrontal skills underlying goal-directed behavior, including attention, working memory, inhibitory control, problem solving, self-regulation, and delay of gratification.” Translated into English, we conclude that psychologists don’t speak English.

To make sure no one misreads the study as anything but pure empirical science, they toss in “covariant assessment,” “covariate,” “posthoc analyses,” “backward digit span,” “encoding,” “cognitive depletion,” and something known as the “Tower of Hanoi,” not to be mistaken, apparently, for the Hanoi Hilton, or the Tower of Babel, which this study seems most likely to emulate.

For their subject group, they rounded up four-year-olds from “a database of families willing to participate.” Three groups of children were given the same four separate tasks. Those who watched a truncated version of a “SpongeBob” cartoon, which has scene changes an average of every 11 seconds, fared worse in the measurements than did the groups that watched a more “realistic” and “educational” PBS cartoon (“Caillou”) that had an average scene change of 34 seconds. The third group (known as a “control” group) drew things and participated in all the tasks. On all four tests, “SpongeBob” lost. The fact the researchers labeled “Caillou” as educational could reveal pre-conceived bias; even a cursory look at “SpongeBob,” although primarily entertainment, reveals numerous social and educational issues that could lead to further discussion.

The pre-schoolers were mostly White, from middle-class and upper-class families. Thus, there was no randomly-selected group, something critical in most such studies. The researchers do acknowledge this, as well as a few defects in the study itself. Possibly salivating over future grants, they tell us that “further research . . . is needed.”
The reality may not be that four-year-olds who watch “SpongeBob” and similar cartoons had developmental defects but that they are far more interested in the cartoon than in other activities and temporarily suspend those “good quality” activities while they remember the cartoon and think of other events or issues that SpongeBob and the cast got into. The researchers measured the students’ responses shortly after watching the cartoons; perhaps measurements a few hours or a week later might have given different results.

Nevertheless, the researchers—hung up on standard deviations, regression analysis, and Cronbach’s Alpha, among other empirical tests—didn’t do the most basic of all research. They didn’t ask the children what they thought about the cartoons, nor any questions leading to why the children who viewed “SpongeBob” may not have performed as well the other two groups on tests that may or may not be of value. It’s entirely possible that watching fast-paced well-written tightly-directed animated cartoons may be more fun—and more productive—than watching slower-paced educational cartoons. But we don’t know because the research was quantified.

The wounded response by Nickelodeon, which airs “SpongeBob Squarepants,” isn’t much better than the academic study. Squeezed into a sentence, the comment is that the cartoon is for 6–11 year olds, not the four-year-olds who were tested. The Nick PR machine wants us to believe that even if everything the researchers said was true, it doesn’t matter because the cartoon isn’t aimed at four-year-olds. Apparently, even if older siblings are watching “SpongeBob” or their parents are watching horror, adventure, or war movies it doesn’t matter because those forms of entertainment aren’t for four-year-olds.

For more than eight decades, animated cartoons have come under fire by all kinds of academic researchers and certain “we-do-good” public groups. From 1930 to 1968, the Hays office, ensconced in Puritan ideals of morality, censored films and cartoons for all kinds of reasons. By the 1960s, academic researchers began questioning the violence in cartoons, focusing primarily upon the Warner Brothers characters. For a few years, television programmers, either believing themselves to be great pillars of morality or afraid of losing sponsors, forcibly retired many of the most popular cartoons from the screen.

At least half of the studies concluded that watching violence could be one of the factors that lead to violent acts. Another group of studies showed little correlation. But, stripping away the academic verbiage, the most logical conclusion of all the studies that denuded a small forest was that persons pre-disposed to violence may become violent if exposed to violence in cartoons. Certainly, watching Roadrunner/Wile E. Coyote cartoons won’t cause a Quaker to go out and mug Baptists.

The mugging that SpongeBob (and other characters in quick-sequencing action) got is another attempt to quantify life by exorcizing a small part of life, running tests, and trying to explain human cognition and development without understanding humans.

I do intend to make this book required reading in two of my courses, including a seminar on the politics of identity which has a gender component. However, as will become clear below, my only hesitation for not totally embracing Barry’s thesis derives from questions I have about the political lessons she draws from her research. But more on that later.

In recent years the gendered dimension of U.S. imperialism has received increasing attention and this book is a welcome addition. Certainly the dominant organizations supporting the empire are gendered and it behooves us to incorporate an understanding of the masculinization of these institutional subcultures into our analysis. Indeed, as Robert Jensen has noted, there is a close overlap between how men are socialized and the mission of the U.S. military’s killing machine: “Dominance and conquest through aggression and violence, in the service of deepening and extending elite control over the resources and markets of the world.”¹ Barbara Ehrenreich, author of Blood Politics, depicts this perverse construction of masculinity, coupled with warfare, as “mutually reinforcing enterprises.”

In a small but telling example of this phenomenon, political scientist Cynthia Enloe wonders about the male soldiers who remained silent about the torture of prisoners at Abu Ghraib. “Did any of the American men involved in the interrogations keep silent because they were afraid of being labeled ‘soft’ or ‘weak,’ thereby jeopardizing their status as ‘manly men’?”² And Francis Shor, a preeminent historian of U.S. imperialism, reminds us that “For hypermasculine warriors, compassion and caring become signs of feminine weakness, marking someone as a wimp or wuss.”³

This foreshadows how Barry answers the vexing question that prompted her to write this book, namely, “Why do wars persist in the face of our human urge to save and protect human life?” Her response is that “War will not be unmade without remaking masculinity.” In fact, the author’s answer to virtually all questions surrounding war is the same: masculinity of the violent, aggressive and militaristic form. The term she coins for this phenomenon is core masculinity. Here she’s careful to specify that this means core socialization and not violence as an essential biological trait in men. Barry argues that early on men are set up to be the protectors of women, children, tribe, and state. Violence and aggression follow from this role. Her argument is more nuanced than I can do justice to here, but she asserts that only by undoing core masculinity, eliminating blinding macho, and violent standards of manhood can we begin “remaking men from the ground up, from the personal to the political.”

The most compelling parts of the book are those in which she explains how masculinity requires that men’s lives be expendable; how the military’s intensive brainwashing reinforces and exploits earlier socialization of boys and men; and the dynamics of the process she labels “From Soldier to Psychopath.” The result is a soldier who kills without remorse, acts without conscience or regret—and then is praised for it. The personal trauma and “loss of one’s soul” that often follows in the wake of this behavior receive careful and sensitive treatment. This heart-rendering recital is driven home by anecdotes collected from firsthand accounts and interviews with soldiers. If empathy is putting oneself in another’s shoes, the indissoluble combination of core masculinity with brainwashing, degradation, and stripping away any sense of self aims to foreclose this response.

Further, there is general agreement in the literature that sociopathy is defined as the lack of empathy. Barry contends that by replacing empathy with desensitized callousness, the military is creating sociopathic characteristics, that the military itself is a sociopathogenic institution. That is, the task of the military is to “normalize amorality for soldiers … the same amorality found in sociopaths.” Here I was reminded of an interview with former combat marine Chris White (not included in this book) who recalled his recruiter explaining the purpose of the initial twelve-week indoctrination as removing any “undesirable traits, such as anti-individuality for the sake of a team work ethic, and, most importantly, the ability and even desire to kill other human beings.”⁴

Why Soldiers Fight

The debauched spirit reflecting an absence of remorse appears in this refrain from grunts on the ground in Vietnam:

Yeah, though I walk through the valley of the shadow of death I will fear no evil, for I am the meanest son-of-a-bitch in the valley.

She quotes one Marine who recalls that shooting to kill “becomes muscle memory, you don’t think about it. You just do it.” Soldiers have “the remorse driven out of them” and the military counts on insensitivity to fill the void, allowing more killing without a second thought. Another Marine tells Barry that “shooting someone was like watching a moving target, hitting it, and watching it fall. It wasn’t real.”

To reshape human groups into effective killing machines the military uses male bonding and attendant fears of being ostracized. It would be unmanly, cowardly behavior not to proceed, even toward one’s own likely death.⁵ Even in retrospect, after feeling a modicum of remorse at “taking someone out” the soldier’s mantra remains “I was only there to defend the person next to me,” even as they return to the killing fields.

Barry understands that one of the consequences is that “support for your buddy and unit is as far as sympathy for others is allowed to go” (emphasis added). Anyone who threatens a buddy’s safety is “the enemy,” a potential enemy, and someone without a life at all. In putting forward this “fighting for each other” argument, Barry’s position is compatible with research suggesting that soldiers fight because those in their unit are depending on them.

Historian S.L.A. Marshall’s study “Men Against Fire” in 1942 concluded: “I hold it to be of the simplest truths of war that the one thing which enables an infantry soldier to keep going with his weapon is the near presence or the presumed presence of a comrade…. He is sustained by his fellows primarily and by his weapons secondarily.” This conclusion apparently holds true for recent wars.

A military study of American soldiers from Iraq concluded that the primary motive was “fighting for my buddies.” One soldier’s answer was typical as he responded, “That person means more to you than anybody. You will die if he dies. That is why I think that we protect each other in any situation.”⁶ And this view wasn’t limited to the “grunts.” Just prior to the start of the Gulf War in January, 1991, one Marine Corps lieutenant colonel remarked, “Just remember that none of these boys is fighting for home, for the flag, for all that crap the politicians feed the public. They are fighting just for each other, just for each other.”⁷ Journalist Sebastian Unger, after five months of observing U.S. troops in eastern Afghanistan, concluded that “The guys were not fighting for flag and country. They maybe joined for those sorts of reasons, but once they were there, they were fighting for each other.”⁸

Patriotism, fear of jail if drafted, lack of economic opportunities, job training, naivete, or boredom might explain a recruit’s enlistment and undoubtedly there are individual exceptions, but topping the list for actually engaging in combat is the social connection of not wanting to let down one’s comrades. This unit cohesion bleeds into self-preservation because remaining alive means keeping fellow soldiers alive. Of course, while the soldier is fighting on behalf of joint survival, the larger context of the mission means he or she is a resource expended on behalf of state-sanctioned killing.

In Vietnam, Prof. James McPherson found that Army psychologists became intensely concerned because the largely draftees not only didn’t want to be there but “didn’t understand in many cases, why they were there.” But the pressing problem for the military was that because fresh replacements arrived individually, the indispensable bonding with other members of the unit was the issue.⁹

In terms of how to unmake war and remake men, Barry wisely advises that we adopt an attitude of critical empathy. This will allow us to see through the lies and disinformation suffusing these matters. That is, we need to employ the potent combination of emotion and intelligence. In that spirit and because I felt Barry was selective in applying the cognitive dimension of critical empathy, I’ll raise a few questions about her analysis.

First, the Pentagon might well prefer to rely on robotic warfare, a variation on empathy-devoid androids.¹⁰ “Closing with the enemy” already occurs with some frequency as “cubicle warriors” in suburban Las Vegas dispense death from 7,500 miles away. This wholesale substitution for “boots on the ground” is projected to occur sometime between 2020 and 2035.9 This doesn’t mean these changes won’t be masculinized or that recruiting posters will soon read “we’re looking for a few good androids.” But it has been suggested that because the combat warrior ethic has been inseparable from the military’s historic emphasis on face-to-face killing, change in military doctrine might strongly influence future generations of military masculine culture.¹¹

Second, military indoctrination is complementary, albeit in more intense form to the subtle and arguably more comprehensive indoctrination of the civilian population under neoliberal ideology. Neoliberalism’s pathological numbing of our empathic disposition is what Shor terms “the hectored heart,” and those “imperial mental enclosures often work to deter most U.S. citizens from expressing empathy toward those brutalized by U.S. imperial policies.”¹²

As products of this empathy-deficient cultural programming, a certain preconditioning may soften up and facilitate some aspects of military training. However, as a tool of the state, the military is less concerned with what a soldier thinks or believes about “the system” because the objective is absolute compliance in service to a specific mission. Empire requires a “trained to kill” culture or the system would break down. Recall that the definition of Marine Corps discipline is “instant willingness and obedience to follow others”—all orders—and to follow them absolutely.¹³

For instance, the respected Zogby polling organization found in 2006 that 72% of American troops in Iraq believed the U.S. should exit the country within one year.13 No matter, as long as they follow orders in the field of combat, this is a non-issue.

Finally, it’s unarguable that the American empire currently requires this particular version of gender construction. In that sense, Barry’s book sheds needed light on the intersection between masculinity and empire. But as Shor argues in his comprehensive and accessible account of recent approaches to understanding U.S. imperialism, this endemic masculinism is only one constituent element deployed on behalf of creating, expanding, and defending political-military control of the globe.¹⁴ Therefore, in trying to understand war, it’s not helpful to claim, as Barry does, that U.S. presidents have repeatedly led the country into “unnecessary wars” to test and prove their machismo, their virility. In her treatment of psychopathic leadership, Barry specifically identifies machismo as the primary shared pathology of “leaders,” from George W. Bush and Ariel Sharon to Bin Laden and Dick Cheney. But not brutal war-mongers like Golda Meier, Indira Gandhi, and Margaret Thatcher? And what of our rogues’ gallery of militarism enablers including Jeanne Kirkpatrick, Madeleine Albright, Condoleeza Rice and Hillary Clinton? If it’s socialized and not essential, it’s not confined to men.

Perhaps it’s the lack of opportunity for women rather than core masculinity? Women now make up 20 percent of new recruits for the U.S. military, 14 percent of the active-duty force, 17 percent of the reserves and some 16 percent of senior officers. Women in the military have bitterly complained about the heretofore “military exclusion” rule because the lack of combat experience slows down their promotion through the ranks. Valorizing these behaviors for women will facilitate career advancement and based on reports requested by Congress that rule is now being reconsidered. Here I’m reminded of political scientist Michael Parenti’s observation (I’m paraphrasing) that it’s not what’s between one’s loins but what’s between one’s ears that matters. U.S. imperialist wars require empathy anesthetizing socializing agents that we generally associate with traditional masculinity—whether the soldiers are male or female. I wish Barry had done more to address these questions and I expect she’ll do so in the future.

At still other points she cites masculine revenge and irrational masculine thinking as the key factors behind U.S. interventions around the globe. I would argue that making core masculinity the stand-alone, virtually monocausal explanation for U.S. (and all) war making tends to weaken an otherwise sterling contribution. And to argue that all this violence is the result of a culture of socialized masculinity is more of a tautology than an answer. Don’t we need to understand whose interests are being advanced by this culture? Exactly who is reinforcing it? Yes, in some important aspects the military is an end in itself but I felt that Barry failed to address its primary role as servant to the ruling interests and their capitalist state. In fact, unless I missed them, Barry never mentions capitalism or imperialism, the critical political-economic context. Here I reference Parenti’s definition of imperialism: “The process whereby the dominant investor interests in one country bring to bear military and financial power upon another country in order to expropriate the land, capital, natural resources, commerce, and markets of that country.”¹⁵ Unquestionably “core masculinity” complements the overriding motive of protecting and advancing the interests of transnational capital. However, I didn’t detect any appreciation of the very real geopolitical and economic motives behind U.S. global behavior. There’s not a single reference to pillaging of natural resources like oil and gas, military Keynesianism, exploitation of workers, the reasons for 750+ U.S. military bases around the world and related factors. I offer these few objections only to suggest that while socialized masculinity facilitates war-making, in and of itself it can’t explain the basis for U.S. imperialism.

1. Robert Jensen, “Critiquing Masculinity at the Corps.”
2. Cynthia Enloe, “Wielding Masculinity Inside Abu Ghraib: Making Feminist Sense of an American Military Scandal,” Asian Journal of Women’s Studies, 10/2/2004.
3. Francis Shor, “Hypermasculine Warfare: From 9/11 to the War on Iraq.”
4. Chris White, “Double Think: The Bedrock of Marine Corps Indoctrination,” Counterpunch, July 13, 2004.
5. I was reminded of Becky Johnson’s counter recruitment postcard reading “You Can’t be All That You Can Be If You’re Dead.”
6. Leonard Wong, “Why Soldiers Fight.”
7. Former New York Times war correspondent Chris Hedges in James M. Skelly, “Iraq, Vietnam, and the Dilemmas of United States Soldiers,” Open Democracy, 24 May, 2006.
8. Quoted in Skelly.
9. James McPherson, “Why Do Soldiers Fight?” Interviewed on NPR.
10. The classic sci-fi treatment is Philip K. Dick, Do Androids Dream of Electric Sheep, 1968.
11. Paul Higate and John Hopton, “War, Militarism, and Masculinities,” in M. Kimmel, J. Hearn and R.W. Connell, Eds., Handbook of Studies on Men and Masculinity (Thousand Oaks, CA: Sage Publishers, 2005), p. 442.
12. Francis Shor, Dying Empire (London: Routledge, 2010, paper).
13. Chris White, “First to Fight Culture,” Counterpunch, May 29/30, 2004.
14. Shor, Ibid., 37.
15. Michael Parenti, The Face of Imperialism (Boulder, CO: Paradigm Publishers, 2011, paper), p. 7.

Not to be missed here is that this bad information is coming from Consumer Reports, an organization devoted to consumer protection. And, if my attacking Consumer Reports strains your credulity, I will ask you to accept something even harder to believe: Much of Consumer Reports problem is traceable to the NIMH, which is putting out public information not to be trusted.

Let’s take a look at the article’s first paragraph, which sets the stage for considerable nonsense:

A 46-year-old teacher saw a psychiatrist on referral from his primary-care doctor because he felt so depressed he couldn’t function at work. The psychiatrist asked about his past relationships, his symptoms, his medical history and more. And then he ordered some blood tests. Medical history? Blood tests? Absolutely. Feeling depressed can mean many things, and not all of them represent true depression. A doctor needs to pay attention to all the patient’s symptoms and consider all possible causes for them.

While this description may appear eminently reasonable, it creates a quite false impression of what we know about mental disorder and what we have reason to do in treatment. Although the psychiatrist asks about relationships, the importance of life experience factors is all but lost in the medical posturing. Psychiatry, in concert with the pharmaceutical industry, has promoted a genetic chemical imbalance theory for mental disorder. The theory is a mythology because there is no good empirical basis for the theory or the claims being made. There are no peer-reviewed studies that corroborate the serotonin hypothesis for any mental disorder, including depression. Research results are not simply non-supportive, they are contradictory to the theory. Despite more than 100 years of research seeking to uncover physical causes for mental disorders, aside from the discoveries a century ago related to general paresis (from syphilis) and Karsakoff’s syndrome (from alcohol abuse) no underlying physical cause has been found for any mental disorder.

Blood tests? There are no blood tests for mental disorder. Psychiatrists do blood tests not because they help to diagnose mental disorder (they don’t), but because the drugs they prescribe (which outcome studies have found to be ineffective) can be lethal if the dosage is too high. While these blood tests prevent psychiatric prescriptions from killing patients, they are not sufficiently sensitive to detect harm. Robert Whitaker, in his book, Anatomy of an Epidemic, discusses data concerning how disability rates have soared since the widespread prescription of antidepressants. Many primary care doctors have been deceived along with the public because the published psychiatric research is highly biased toward drugs (this has been documented), giving a misleading impression to doctors and the public of their effectiveness.

Medical histories? Consumer Reports also assigns undue weight to physical illness as a cause of mental disorder and gives an exaggerated picture of psychiatrists as possessing broad medical diagnostic competency. Both are overstatements that appear to be an attempt to justify the necessity and importance of a medical degree to treat mental disorder. There is an abundance of evidence that mental disorders are of environmental, not physical origin. It is true some physical illnesses (for example, hormonal problems) can produce symptoms that sometimes have been misdiagnosed as depression, and all therapists need to be aware of this possibility and make appropriate referrals. But this is an atypical occurrence and far more likely to be within the diagnostic competency of the patient’s primary care physician. It is simply false that psychiatrists, with their meager training in internal medicine, are geared to make complex differential diagnoses. The patient’s primary care physician is much better trained and experienced than the psychiatrist to discover an illness that is responsible for negative emotional reactions.

Consumer Reports Insights goes on to convey additional misinformation by conflating sadness with depression. Prior to DSM-III (published in 1980), sadness and depression were viewed as different. Whereas depression was regarded as a mental disorder, sadness was recognized as a normal, temporary response to loss. Losses occur throughout life and a lot of research establishes the connection between loss and sadness. Sadness is simply a part of experiencing life, but we get over it, even when it has the intensity of grief. Now sadness/depression is diagnosed as an illness – an illness, we are told, that is best treated medically. The pharmaceutical industry has become extraordinarily profitable as a result of this psychiatric construction. Abandonment of the distinction between sadness and depression has led to many people being prescribed drugs who would get better and be better off if left alone. When treatment for sadness is warranted, more effective help comes from a doctor who pays close attention to the patient’s life circumstances rather than one who prescribes drugs. The same point applies to depression, particularly when treated by a behavior therapist who is trained to know what to pay attention to (research results bear this out).

Consumer Reports Insights then discusses “true depression” (whatever that is, since the article never defines depression properly) as distinguished from “atypical depression,” which “usually responds well to SSRI antidepressants and psychotherapy.” In actuality, outcome studies find little or no support for the SSRIs as being effective in the treatment of depression. When measured short-term (after three months of treatment), SSRIs produce results no better than placebos (and for this reason are properly regarded as placebos); measured long-term, the SSRIs are found to be no good at all. Results indicate that after a year’s time all but a small fraction of patients on antidepressants have either relapsed or dropped out of treatment (because not only do antidepressants not work, they have aversive side effects).

Finally, lest you have missed getting their point, Consumer Report Insights ends the article by stating that the 46-year-old teacher who sought help from a psychiatrist because he felt depressed was found to have a “mild long-term panic disorder that had been worsened by an under-active thyroid gland. With the help of thyroid pills and anti-panic medication, he soon felt much better.” Are we to believe that the psychiatrist, not the primary care physician, discovered (and treated?) the thyroid problem? How odd that would be. Cases with hormonal deficiencies or other physical causes for emotional disorder certainly exist, but as stated above, (a) physical illnesses are infrequent causes of mental disorder, (b) depending on psychiatrists to make this diagnosis would be a mistake, and (c) drugs don’t reliably treat anxiety conditions any more than they do sadness or depression. And, incidentally, not mentioned in this recounting of the teacher’s experiences, those anti-panic meds are habit forming (there are more than ten million addicts from anti-anxiety meds in this country) and they have been found to be a major cause of deaths from automobile accidents and when combined with drinking alcohol.

The medicalization of psychiatry began roughly thirty years ago when psychiatry switched from a psychological (psychoanalytic) theory of mental disorder to a biological theory (the chemical imbalance theory). From its inception this medicalization of psychiatry has been aimed at two goals. First, increasing the respectability of psychiatry within the medical community by becoming “real doctors” who prescribe drugs to their patients, rather that offering talk therapy. Second, was the challenge of overcoming the stiff competition psychiatry faced from other mental health professionals, primarily psychologists, which by the 1980s threatened to put psychiatry out of business. People need to know that the medical claims that were made then, and which continue to be made now, have failed to be validated. Psychiatry has achieved success and respectability on the basis of marketing, not science. The Consumer Reports Insights article is representative of a great deal of misleading public information that needs to be set straight. Fundamentally, the article is a false credentialing of psychiatry to the public and to the rest of medicine, and a not very subtle unfounded attack on the competency of non-medically trained mental health practitioners, many of whom are operating on a far more solid research foundation.

The medicalization of psychiatry has been highly successful for the profession of psychiatry – far less so for patients. As described briefly above, outcome research has revealed that drug treatment produces poor results. Patients initially interpret the side effects of these drugs to mean the drug is helping (a placebo effect). However, since the drugs do not produce changes in the conditions or behaviors that have given rise to the patient’s problem and because they also induce noxious side effects (weight gain, constipation, loss of sexual desire), with time many patients lose faith in the drugs and stop taking them. For those, who continue on the drugs there is increasing evidence that long-term use of these drugs makes people worse (more prone to relapse). Particularly alarming in this regard is prescription of these drugs to children. As indicated earlier, the explosion in prescriptions of the SSRIs has been accompanied by a very significant increase in the number of people diagnosed as mentally disabled. Contrary to the rosy, benign picture of psychiatric practice painted by Consumer Reports Insights, there is reason to believe psychiatrists are providing poor treatment in the short run and injuring their patients when prescribing drugs long-term. In terms of both effectiveness and safety, outcome research indicates the medicalization of psychiatry has led us astray.

A great deal of research points to how the development of faulty responses to life’s challenges constitutes the basis for mental disorder. Correction of problems with this kind of origin can’t be done medically. The best treatments we have today for a wide range of mental disorders are behavioral (non-medical) treatments, all of which have been derived empirically. These promising results have taken place despite the fact that the amount of grant research devoted to behavioral treatment has been miniscule compared with drug research. We need therapists who possess the more trustworthy expertise of understanding how mental disorders are acquired and maintained as a consequence of people having learned debilitating behaviors in response to difficult conditions in their lives.

The Consumer Reports Insights column has contributed to the problem, not the solution. That aside, most importantly, we need to get over our wishful thinking that we can get rid of our problems simply by taking a pill. Although many doctors encourage this fantasy, it’s just not that easy. Help is available, but as is the case with most of our accomplishments in life, effort is required to make it happen.

If you are interested in reading more about the background of history and research on which these comments are based, including NIMH’s role in disseminating disinformation, read my article entitled, “What Underlies Psychopharmacology?”

In an increasingly urbanized world such a phobia could be paralyzing (and for some people, is) absent the psychic mechanism Canetti also proposed that we possess and that compensates for this primal fear by allowing our sense of individual identity to dissolve, merging with the strangers around us in a collective persona.

In its positive forms this defense mechanism is responsible for the phenomenon of good-natured crowds at sporting events and along parade routes. In its destructive manifestation this defense mechanism is the driving force behind the sudden and unpredictable formation of mobs.

In our own history there are numerous examples of this destructive kind of crowd formation. Between 1890 and 1920, lynch mobs were responsible for murdering some 3,000 people – and those are only the cases that we know about. The New York City Draft Riots of 1863 lasted three days, resulted in the deaths of numerous innocent victims, and were only quelled when federal troops were commandeered from the front to restore order.

For most of history, mobs have formed spontaneously, dissipating their energy once they have achieved their immediate end of destroying property and/or harming or killing human beings, then disbanding as quickly as they form.

But one of the most sobering lessons of the 20th Century is the discovery that, under the right circumstances – the rise of skillful demagogues, the control of the organs of mass media by those demagogues – it’s possible to generate a sustained mob mentality, and to direct its demonic energy toward specific, hellish goals.

Political science offers numerous definitions of fascism, but none strike us as definitive. That’s because fascism is not simply a political ideology like Soviet-style Communism; that is to say, fascism is not just the product of reason gone awry.

Fascism is, essentially, the modern nation state as mob rule, with a national mob mentality constantly stirred up by the state with inflammatory rhetorical attacks directed against scapegoats – Jews, Blacks, immigrants, homosexuals, socialists, Muslims or whichever other group happens to bears the brand of The Other in a given culture.

Fascism’s intentional harnessing of the defense mechanism that drives the formation of crowds explains fascism’s allure, at least to some, which is the opportunity to unburden one’s isolated, individual sense of self by identifying completely with the exhilarating collective energy of the “Volk.” It is this dynamic that renders fascism, by whatever name, irredeemably irrational and destructive.

Thus institutionalized, and married to the apparatus, organizational power and armed might of the modern nation state, the mob energy harnessed by fascist regimes in the last century came very close to destroying the civilized world as we know it and could only be stopped by massive organized violence inflicted upon those regimes by other advanced nation states.

This critical mob mentality component of fascism also explains why countries do not “slide” into fascism, as some warn is happening in the United States; mobs do not form slowly. They gel, they materialize, they appear instantaneously, almost magically, with little or no forewarning.

In his speech this past week to military personnel, Barak Obama announced that the targeted assassination of Osama bin Laden reflected “The essence of America, the values that have defined us for more than 200 years” and that, furthermore, these values are “stronger than ever.”

He was dead right, though not in the way he intended. The manner in which bin Laden’s death was carried out reflects at least one face of American values as did, even more dramatically, the deprave celebrating that erupted in the wake of his killing in cities and on college campuses around the country.

From the extrajudicial execution of a dehumanized enemy to the choice of “Geronimo” as code name for Osama bin Laden to those outbursts of jubilation, the killing of The World’s Most Wanted Man does indeed connect to those American values responsible for the country’s history of violent racism, imperialism, repression, militarism, and near-genocide of the indians.

And those post-assassination victory celebrations were not analogous at all to the outpouring of relief and joy that accompanied the end of World War II. Bin Laden’s assassination did not spare millions of Americans from the prospect of going off to fight in a global war or from the equally harrowing prospect of watching one’s child, husband or brother being marched to the front.

The killing of OBL ended nothing, except his life. The celebrations were not about victory. They were about death. They were celebrations of death. Those dancing in the street were acting out their own version of the motto of the Falange – i.e., fascist — movement during the Spanish Civil War. “Viva la Meurte.”

Long live Death.

The time is not yet ripe for the clock to strike Midnight in America, but it won’t take much to push us over the edge. Another major terrorist attack on the “Homeland.” Another financial crisis on the scale of the most recent one, which could easily be triggered by the failure to raise the federal debt ceiling. The appearance on the scene of a skillful demagogue with the organizational ability to marshal a mass movement and an unslakable thirst for political power.

Even now, egged on by the right-wing demagogues already among us and bankrolled by right-wing billionaires plotting in undisclosed locations, the American mob longs to shake its collective fist and cry out for vengeance and blood in a hoarse collective voice.

Long live Death! And long live the Death of Democracy!

Psychoanalysis

Sigmund Freud proposed psychoanalytic theory with publication in 1900 of his “Interpretation of Dreams” and, in this country, through a series of lectures he gave at Clark University in 1909.¹ Although Freud was trained in physiology and began practice as a neurologist, his theory is predominantly psychological in nature. He theorized the presence of a basic force of psychic energy (libido) driving development, with human personality being shaped during childhood by psychological experiences related to the demands imposed by fixed stages of psychosexual development (oral, anal, phallic). Emotional conflicts during these stages are theorized to be processed through fundamental psychic structures Freud called the id, ego, and superego. Psychoanalytic theory views mental disorder as the outcome of unconsciously determined symbolic efforts that only partially resolve these intrapsychic conflicts, resulting in pathological adjustments to the vicissitudes of psychosexual development.

Psychoanalytic treatment in its classical form makes use of the technique of free association, which requires the patient to say whatever comes to mind. Because of the patient’s distress and the absence of direction by the analyst, not infrequently these thoughts are accompanied by strong emotion (catharsis) directed at the analyst. These emotional reactions are referred to as transference, which is theorized to be a projection onto the analyst of unresolved conflicts involving childhood figures. The analyst makes interpretations of these projections aimed at enabling the patient to gain insight into the unconscious (repressed) conflicting elements in his psyche. Patients reject the interpretations (resistance) and the curative “work” of psychoanalysis entails resolving resistance (emotional re-education).

Known by its iconic couch, psychoanalysis is conducted by means of three or more hourly sessions per week for five years or more with a complex orthodoxy of procedures. Qualifying for certification as an analyst requires completion of a program of study at a psychoanalytic training institute and a training analysis. Admission is largely restricted to psychiatrists.

Over the years other theorists who followed Freud (Jung, Adler, Rank, Sullivan) modified some of its basic tenets and psychoanalytic theory became highly elaborated into a fascinating, intricate accounting for human personality and deviancy, eventually gaining quite general acceptance.

Following World War II there was a blossoming of interest in mental health with greatly increased demand for mental health services. Many psychiatrists, psychologists, and social workers were trained in response to this interest and to meet the demand. Psychiatry embraced psychoanalysis as the preferred method of treatment. PhD programs in Clinical Psychology taught basic concepts of psychoanalytic theory along with instruction in other approaches to psychotherapy that were undergoing development in psychology laboratories and university counseling centers. Principal among these techniques were psychodynamic psychotherapy, non-directive counseling, and behavior therapy. Howcver, for much of the next thirty years, psychoanalytic theory and treatment was generally regarded to be the “gold standard” for the explanation and treatment of mental disorder.

Freud and his followers published a vast literature of case studies elucidating interpretations of their method of treatment. Freud’s writings alone cover 23 volumes. These case studies accumulated over the course of more than fifty years and constituted the “data” invoked to corroborate and expand psychoanalytic concepts.

Eventually, because anecdotal reports lack objectivity, a number of attempts were made to apply scientific rigor to testing psychoanalytic theory. However, the theory is so complex and nuanced that objective tests proved to be impossible; there was always another aspect to the theory that could be cited to explain negative results as a proof of the theory rather than a negation. Psychoanalysts dismissed negative critiques as neurotic resistance and for a long time most of the professional community and the public ignored or dismissed problems with a theory that was untestable by the scientific method.

The first major challenge to psychoanalytic theory and treatment occurred in 1958 in relation to the treatment of phobias. Psychoanalysts believed eliminating mental disorder required exploring unconscious psychological forces underlying behavior. They eschewed efforts directed at “symptoms,” viewing the behaviors that characterize the disorders as being decidedly secondary in importance. Phobias (for example, an excessive fear of heights or confined spaces) were interpreted as merely symbolic representations of an underlying intrapsychic conflict. Elimination of a phobia was deemed to require ferreting out the repressed determinants of the disorder. Few phobic patients got better; the condition was regarded as largely intractable.

A South African psychiatrist challenged this assumption head on. Making use of research on fear conditioning and extinction that had been carried out on rats and cats in psychology laboratories, Joseph Wolpe devised a treatment technique that focused directly on eliminating the phobic fears.² Wolpe stated that phobias should be construed simply as deviant behaviors that had been learned according to the same principles as other behaviors and could be eliminated like other learned behaviors if addressed directly. He designed a treatment technique (systematic desensitization) that was based on behavioral extinction procedures regularly used in research on animals to weaken a conditioned response. Psychoanalysts were horrified and warned that focusing on the phobia itself rather than the underlying intrapsychic cause would deprive the patient of his defenses and precipitate a psychosis. A heated controversy erupted in the medical and psychology journals that lasted several years until outcome research disclosed that Wolpe’s method was effective with 90% of patients. Wolpe’s success stimulated considerable research in psychology laboratories and clinics aimed at other disorders and led to what became known as behavior therapy.

By the 1970s, quite a number of more open and flexible psychotherapies had been devised, principally by psychologists. Predominant among these talk therapies was psychodynamic psychotherapy which retained some core psychoanalytic ideas but replaced the couch and free association with a format of two facing chairs and a more interactive conversation that paid more attention to the present than to childhood experiences. Other approaches were based on different theoretical viewpoints (for example, non-directive counseling and behavior therapy) and made use of alternative techniques (for example, active listening and exposure). The success of these more open, flexible, and evidence-based approaches to treatment led to serious questioning of the relative effectiveness and costliness of psychoanalysis. Many patients who had been in psychoanalysis several times a week for several years seemed to have little to show for it. (Woody Allen later offered himself in his movie roles as a prime example of continued unhappiness and haplessness despite years of analysis). Talk therapies practiced by psychologists and social workers who were making use of less intensive treatments, at lower cost, were achieving results at least as good as psychiatrists were achieving with psychoanalysis, in far less time. Moreover, psychologists (that is, Clinical Psychologists with PhDs) were by this time licensed to practice psychotherapy and the treatment costs were partially reimbursed by health insurance, mirroring a financial coverage that had previously been the exclusive province of psychiatry.

The Chemical Imbalance Theory

Psychiatry, which had boomed as a professional choice after WW II, began having considerable difficulty recruiting medical students to the field as psychiatric practices waned in the face of unsatisfactory results with psychoanalytic treatment and stiff competition from other professions. Medical students viewed specializing in psychiatry as a poor way to make a living.³ This crisis, which threatened the continued existence of psychiatry, produced a revolution in the field. In the early 1980s biologically oriented psychiatrists, despite being a small minority, persuaded their psychiatric colleagues to replace the field’s reliance on psychoanalytic (psychological) explanations for mental disorder with a theory based on neurotransmitters in the brain (a biological explanation) as the true cause. Overcoming stiff resistance from the analysts, they argued successfully that survival of the specialty of psychiatry required psychiatrists to practice like “real doctors” by treating their patients with medicine, not talk.

The change entailed explaining mental disorders as being due to genetic defects causing neurotransmitter imbalances in the brain. Four neurotransmitters were cited as being the cause of psychopathology: norepinephrine, dopamine, serotonin, and GABA. A wide array of mental disorders, such as schizophrenia, depression, anxiety, obsessive-compulsive disorder, as well as alcoholism, eating disorders, sleep difficulties, and shyness now were described as resulting from such chemical imbalances. Each disorder was attributed to a chemical imbalance correctable by prescription of drugs targeting particular neurotransmitters.

Psychiatrists, a good number of whom had been allowed to skip a medical internship because of their choice of psychiatry, abandoned their psychoanalytically-oriented practices and began espousing a neurochemical, genetic basis for their patients’ problems and treating their patients with drugs. Psychiatrists in charge of the NIMH reorganized the institute around this basic change in orientation, including eliminating the Psychotherapy Branch, which had supported research on psychotherapy. And a new Diagnostic and Statistical Manual of Mental Disorders (DSM-III) was published in line with this biological explanation for mental illness.

In testimonial to how successful this revolution has been, prescription of psychiatric drugs is now the “gold standard” for treating mental illness; psychiatry has regained its attraction to medical students as a specialty; psychiatric residencies concentrate on teaching brain neurochemistry and provide little training in psychotherapy; other medical practitioners have fully bought into this change, with an estimated 40% of the prescriptions for psychiatric drugs being written by non-psychiatric physicians; and psychiatric drugs now are among the biggest blockbusters in pharmaceutical industry sales, indicative of how the public has been led to embrace this theory and treatment.

What is the evidence for the chemical imbalance theory? The theory arose from observations by researchers in the 1950s of the side effects of several drugs being tested for other purposes. Miltown (meprobamate), the first drug marketed to treat anxiety, was discovered during research aimed at finding an effective agent against gram-negative microorganisms. Marsilid (iproniazid), the first drug offered as an antidepressant, was discovered during research on V-2 rocket fuel. Lithium, the drug still used to treat bipolar disorder, was discovered because of its industrial usefulness in metallurgy and ceramics. Researchers noticed that some of these compounds appeared to induce a sedative effect and others an energizing effect when people were exposed to them. Psychiatric researchers (many of whom were supported by the drug companies) began studying these compounds and when it was discovered that these drugs had an influence on neurotransmitters in the brain they speculated that an imbalance in neurotransmitters is the cause of mental illness. This was the prime basis psychiatry invoked in making the transformation from a psychological to a biological explanation for mental disorder.

Such backward reasoning, however, is not good science and subsequent research results bear this out. Contrary to the ads frequently seen on TV, studies have shown these claims to be without scientific merit. As Valenstein has pointed out the fact that aspirin helps to relieve headaches does not mean there is an aspirin deficiency in the brain. We now know there are not four neurotransmitters, there are hundreds, interacting with billions of neurons and trillions of synapses in complex and largely unknown ways. After more than fifty years of research, no single neurotransmitter or combination of neurotransmitters (serotonin, norepinehphrine, dopamine, acetylcholine) has been shown to be the cause of anxiety, depression, or schizophrenia.⁴

Depression, today’s prime psychiatric diagnosis, provides a ready example of the failure of the theory to be validated. Although antidepressant drugs are prescribed to boost serotonin, most depressed patients do not have low levels of serotonin or norepinephrine and some have very high levels; patients with no history of depression have been found to have low levels of serotonin and norepinephrine; studies have shown that reducing the levels of these neurotransmitters (with cocaine, for example) doesn’t cause depression, nor does increasing these neurotransmitters reduce depression. Reviewers of the scientific literature have reported not being able to find a single peer-reviewed study that supports the serotonin chemical imbalance theory for any mental disorder.⁵

The Physicians’ Desk Reference (PDR) is the main resource doctors use for information on drug actions and safety. Examination of the PDR discloses that regardless of which psychiatric drug is being reviewed, the evidence for a neurochemical explanation for effectiveness is described as “suggestive.” This characterization has about as much substance as red traffic lights in Naples, which drivers and the local police regard as “suggestions.” In science, when observations are suggestive one is at the level of hypothesis generation, not at a conclusion.

Thus, research results show that the chemical imbalance theories, just as was the case with psychoanalytic theories, are hypotheses, not verified statements of actions or outcomes – hypotheses that have failed when tested scientifically.

Genetics

What about the claim of a genetic basis for these disorders? The prime contributors to our understanding of genetics are Darwin’s theory of natural selection and Mendel’s discovery of “units” (now called “genes”) passed on from one generation to the next. Darwin’s theory holds that the differences between species occurred as a result of taking different evolutionary paths from similar ancestries. Mendel’s research on pea plants established how these evolutionary paths are controlled by genetic factors passed on to the next generation. Dawkins, in The Selfish Gene, succinctly ties these principles together in his description of plants and animals as fundamentally survival machines, programmed to preserve the DNA in those genes that ensure having descendants. Results from the Human Genome Project, which deciphered the human genetic code, are providing a basis for comprehension of how and how much various genes affect health and disease.

Genes determine such physical features as gender and eye color, genes make a significant contribution to height and weight, and they have an important bearing on traits, such as introversion/extraversion. However, many human characteristics and traits are now well known to have a basis both in genetics and life experiences. Research related to the Human Genome Project indicates that many effects of genes are not rigidly expressed. Researchers were surprised to find that how and when genes are activated are importantly affected by the environment (epigenetics). And environmental factors appear to be predominant in many behaviors of interest. Kendler has studied genetic and environmental factors in mental disorder for many years. On the basis of his review of twin studies and the Human Genome Project, he reports that the strength of association between genes and psychiatric disorders is weak and non-specific and that environmental factors are more significant than genes as determinants of mental disorder.⁶

Nevertheless, with the advent of the biological revolution in psychiatry, whereas previously traits were regarded as normal variations in individual differences influenced by social learning, many traits (shyness and boisterousness in children, for example) now are presented as genetically determined illnesses, which qualify for drug treatment. In other instances, diagnoses are justified in the absence of meeting the previously required criteria for these diagnoses (depression and bipolar disorder, for example), by referring to them as “sub-threshold” incipient illnesses, warranting drug treatment. Notwithstanding an enormous growth in such diagnoses, there are no scientific grounds for these claims.

Drug Effectiveness

A prime question to be answered is how helpful are psychiatric drugs? While these drugs are being prescribed on the basis of unsatisfactory neurochemical and genetic explanations, their effectiveness can be judged independent of the theories. Research results show that despite widespread acceptance of psychiatric drug treatment by the medical profession and the general public, outcome studies have failed to find psychiatric drugs to be effective.

Because depression is today’s most prevalent psychiatric diagnosis the value of antidepressants has been studied extensively. Measures of effectiveness of antidepressants have been taken at two points in time: after three months of treatment (short-term effectiveness) and after twelve months of treatment (long term effectiveness). In double blind studies, about 25% – 30% of patients report benefit from antidepressants after taking the drugs for three months, the same percentage regularly found in double blind studies for patients treated with a placebo, raising serious doubts about what is being contributed by the active ingredients in antidepressant drugs.⁷ An estimate of long-term outcome is best provided by the NIMH’s recently published STAR*D study (2006). This study was of 4,041 patients being treated at various centers in this country who were diagnosed as moderately to severely depressed. At a cost of 35 million dollars, it is by far the largest depression study ever conducted and was led by psychiatrists who are firm advocates of drug treatment.

The STAR*D study aimed at a thorough examination and refinement of current psychiatric guidelines for treating moderate to severe depression which call for long-term continued use of antidepressants to achieve remission of the disorder and to prevent relapse. The researchers expected results to endorse and more fully clarify how the guidelines should be exercised. However, in contradiction to the guidelines, results showed that after a year’s time all but 108 of the 4,041 patients had either dropped out of treatment or relapsed.⁸ This represents 3% of those originally enrolled in the study (7% of those who made it into continuing care), a shockingly poor showing for long-term antidepressant drug treatment.

Short-term results for STAR*D were in the same range found in other studies using placebo and are in good agreement with the first NIMH depression treatment study (the Collaborative Treatment of Depression study published in 1989), which found no difference in effectiveness between the drug and placebo conditions, short-term or long-term. Moreover, STAR*D’s results failed to support the latest chemical imbalance theory (a heterogeneity theory that different patients require different antidepressants) because a wide range of antidepressant drugs with divergent neurochemical actions were equivalent in their ineffectiveness.

Simply put, the current guidelines calling for treatment of depression by antidepressants failed to be supported. Antidepressants are placebos short-term and practically no good at all, long-term.

Reviews of published research against the FDA data base have documented a significant pro-drug bias in psychiatric publications that has promoted a mistaken belief in the effectiveness of antidepressant drugs. Meta-analyses have documented how studies showing negative results for antidepressants were not published or were published as if the results were positive by changing the criterion measures after the data were collected. This form of researcher bias is now so prevalent in reports of drug studies it has acquired a name in science, “HARKing” (hypothesizing after the results are known). Bias in articles published in medical journals gives doctors a very misleading impression of drug effectiveness. Marcia Angell, the former editor of the New England Journal of Medicine, has written of an alarmingly corrupt alliance that has developed between doctors and the drug companies, such that “it is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative guidelines.” She states “the most florid example” of the problem is found in psychiatric research.⁹ The editors of two other prominent medical journals have raised the same kind of alarm. Richard Horton, editor of the Lancet, wrote, “Journals have devolved into information laundering operations for the pharmaceutical industry.” Richard Smith, former editor of the British Medical Journal, also has written of how the pharmaceutical industry is corrupting doctors and patient advocacy organizations and recounted his own experience as an editor, “Journal editors are becoming increasingly aware of how they are being manipulated… but I must confess that it took me almost a quarter of a century editing for the BMJ to wake up to what was happening.” He lists eight ploys the drug companies have used to get the results they want from clinical trials.¹⁰ Since we depend on publications in the medical journals for development of our understanding of disorders and their treatments, the charges by these distinguished editors are very serious and deserve far more attention than they have received.

Acceptance of Drugs

These findings are, of course, quite inconsistent with the claims made for the effectiveness of antidepressant drugs and with the enormous increase in their prescription. Antidepressants not only are now the most highly prescribed psychiatric drugs, they are among the most highly prescribed drugs of any kind. How is it that millions of people have been persuaded to spend billions of dollars on antidepressants? How do we explain this acceptance in the face of such poor effectiveness?

Several factors clearly are involved (and, of course, this is hardly the first time large numbers of people have been led down some garden path). Most importantly there is the attractiveness attached to being able to solve one’s problems simply by taking a pill. Few among us resist complying when doctors offer to prescribe a pill as the answer to our problem.

Moreover, some people who are simply unhappy are being diagnosed as ill – and prescribed a pill – when they are experiencing a normal, time-limited reaction to life’s trials and tribulations. There is good reason to conjecture that many of the satisfied customers of antidepressant drug treatment have been misdiagnosed as depressed instead of being recognized as sad. Sadness is a normal, time-limited response to loss. Losses in life are common and sadness induced by loss can range from mild to severe (as in grief). Because sadness is a temporary reaction any treatment can look good. Patients not treated at all would likely fare as well. Patients who make occasional or regular use of antidepressants following experiences of loss in their lives may be mistakenly attributing their improvement to their medications. And, since losses are experienced throughout life, sadness can be expected to recur.

Well-intentioned doctors, who have been influenced by the biased scientific literature and slanted handouts given to them by drug company representatives, are believers in the drugs. They readily prescribe antidepressants (often in response to patients’ citing drug ads on TV), and encourage their patients to take these meds when there is a new sign of sadness to another loss.

The placebo effect is an important contributor to belief in antidepressants. Fear and sadness are forms of pain and it is well known that pain is highly susceptible to placebos. Kirsch has reviewed the data for the clinical trials conducted by the drug companies that were submitted to the FDA for approval of the antidepressants. His statistical analyses indicate that many of the drug trials were non-significant and when significance was found the predominant factor accounting for antidepressant effectiveness was a placebo effect.¹¹ Placebo effects occur when a doctor is accepting, reassuring, and confidant in the treatment being offered, inspiring hope. The side effects of these drugs play an important role in the placebo effect. Patients undergoing drug treatment interpret side effects as meaning the drug is taking action, which significantly increases the placebo effect. In recent years, placebo effects have been strengthened by direct to consumer advertising on television of prescription drugs, which beginning in 1998 was allowed in the U.S. (New Zealand is the only other country to permit this). These TV ads promote unwarranted positive belief in antidepressant drugs by exaggerating their effectiveness.

But the hopeful expectations at the heart of placebo effects often are short-lived. This is because the behaviors that are contributing to and maintaining depression go unchanged by drug treatment. For most patients who are truly depressed, the realities of the patient’s life eventually conflict with the positive expectations connected with the placebo effect. The drugs also cause aversive side effects, which leads most patients to dislike taking them. Absence of improvement in the patient’s life situation and the presence of negative side effects cause people to lose faith in the drugs.

In some instances, belief in the value of these drugs also is due to misunderstanding the withdrawal effects associated with ending drug use. Negative physiological reactions induced by withdrawal often are misinterpreted by the patient and by the doctor as a recurrence of depression, an error that serves to keep the patient on the drugs – a mistake that is expensive and has negative consequences.

The regimen of drug treatment also is a significant contributor not only to the use of these drugs, but to the disorder by promoting dysfunctional behavior. Patients are told they have a malfunction in their brain that needs to be corrected chemically by ingesting a pill, which the doctor will prescribe and monitor. They are told they will need to wait for the pill to kick in, the dosage will likely need to be adjusted by the doctor to get it right, and the drug may need to be replaced by a different pill before the right one is found. Passivity is encouraged at each step in the process. Patients are led to expect their depression will disappear without they themselves having to do anything about it. Since passivity is a hallmark of depression, this is a process that promotes the very condition that needs to be remedied. Moreover, explaining the problem as a brain defect serves to exacerbate the problem by inducing a seriously negative self-definition – an explanation, which we have seen, lacks a scientific basis.

Each of these psychological reactions contributes to initial acceptance of prescriptions written for these drugs and for some patients continues to operate longer term. However, as results of the STAR*D study and other studies have shown, much more often than not patients eventually become dissatisfied and discontinue taking these prescriptions.

Psychiatric Diagnoses

How has the transformation of psychiatry affected diagnoses of mental illness?

In 1985, epidemiological studies found the lifetime incidence of diagnoses of depression for males to be 3-5% and for females, 6-9%; in 1994, the rates were estimated as 15% for males and 24% for females; in 2005 it was reported that the combined lifetime prevalence of diagnoses of depression by age 75 was 60%. Since we know that genetic changes take many thousands of years, these figures make no sense as reflective of genetics. They also make no sense in terms of environmental influences since cultural changes of this kind and magnitude very rarely occur so quickly. This pathologizing of normality also has been given a name, “disease mongering,” which is defined as the practice of expanding the definition of illness to increase markets for those who sell or offer treatments.

DSM-III, published in 1980 as one of the building blocks in the biological transformation of psychiatry, has been central to inflation of diagnoses of mental illness. Previous editions of the DSM had been found to be embarrassingly unreliable, failing to meet the most elementary requirements for a sound diagnostic system. Beginning with its publication in 1980, DSM-III was heralded as correcting the problem, but this claim is in full consonance with the false claims made for the chemical imbalance theories. No studies have demonstrated DSM-III or DSM-IV’s reliability to be improved.¹², ¹³ Moreover, because the number of diagnoses in these newer editions has more than tripled, room for error was expanded. Since reliability sets the ceiling for validity, there is considerable reason to view psychiatric diagnoses as having dubious validity.

As noted above, diagnoses of depression also have been profoundly affected by a change instituted with publication of DSM-III when sadness was conflated with depression. Prior to that time sadness was regarded as a normal response to loss. Experiences of loss are a salient aspect to ordinary life, which often includes losses of important relationships, status, limitations imposed by one’s own ill health and that of loved ones, financial losses, etc. A great deal of empirical evidence verifies a connection between losses in life and feeling sad.

Sadness, like fear, signals distress. Our capacity to experience these negative emotions is of genetic origin, but this does not mean fear and sadness are abnormal states. They qualify as normal because they are time limited functional reactions to threats to survival. The connection between fear and the flight/fight response was selected genetically as an integrated survival mechanism. Similarly, the connection between loss and sadness reveals the importance to survival of establishing and maintaining social relationships and holding onto valued conditions and objects. Because fear and sadness accompany behaviors that are disruptions of other behaviors necessary for survival, of necessity these states ordinarily operate only temporarily. When the stressors to survival that elicited fear disappear the organism returns to normal behaviors that sustain life. Likewise, with respect to sadness, with time the losses that elicited sadness are replaced by accommodation or compensation, enabling the individual to return to normal activities. Since fear and sadness serve a purpose as temporary survival mechanisms, they do not ordinarily represent illnesses.

Fear becomes abnormal when it continues to govern actions in the absence of objective danger. Fear then functions to maintain recurring dysfunctional behaviors. Phobias are a readily recognizable example of this abnormality. Sadness also becomes abnormal, i.e., is properly diagnosed as depression, when the behaviors necessary to replace what has been lost are blocked.¹⁴ When this happens sadness is transformed into depression because, as is the case with fear, the individual comes to function in such a way as to maintain recurring dysfunctional behaviors. Contrary to current practice, diagnoses of depression should be reserved for patients who meet this standard. There is abundant evidence that normal states of sadness are today being diagnosed as illnesses, with many people who are not ill being prescribed antidepressant drugs.

Safety

What evidence do we have bearing on the safety of these drugs? There are significant reasons to believe psychiatric drug treatment often is iatrogenic. The first wave of drugs associated with the biological revolution in psychiatry were the anti-anxiety (anxiolytic) drugs. These were the benzodiazepines (xanax, valium, librium) and they proved to be dangerous. They are highly addictive, with estimates of 10 million valium addicts in this country. Many automobile accidents were found to be associated with the anxiolytic drugs and the interaction of these drugs with alcohol can be life threatening. Recognition of the serious adverse effects of the anti-anxiety drugs led to Congressional hearings, provoking much negative publicity and stronger restrictions on their prescription.

Unfavorable publicity about anti-anxiety drugs and curtailment in their prescription served to usher in, instead, greatly increased diagnoses of depression and prescription of antidepressants. With plenty of allegedly safe and effective antidepressant drugs on hand, depression soon replaced anxiety as the prime psychiatric diagnosis. However, there is considerable evidence that the harmful effects of psychiatric drugs are not restricted to the benzodiazepines.¹⁵ Harmful effects of antidepressants and antipsychotic drugs may be less immediately apparent, but they are substantial. Whitaker points out that since the introduction of these drugs the disability rates for mental disorder have multiplied six times what they were in 1955. With respect to schizophrenia, before the arrival of thorazine, 65% of patients were able to live independently in the community five years after initial hospitalization; today only 5% of medicated patients end up “recovered” and able to work over the long term. In 1955 about 50,000 patients were hospitalized for affective disorders (depression and bipolar disorder); today, 1.4 million adults receive a federal payment because they are disabled by an affective disorder. Since the SSRIs began being prescribed to children twenty years ago, the disability rates for children have increased thirty five times. Prescription of antidepressants, anti-psychotics, and anti-seizure drugs to military personnel parallels an increase in suicides.¹⁶ There is evidence of significant under-reporting of increased suicidality associated with antidepressants¹⁷ and of a significant association between antidepressants and acts of violence toward others.¹⁸ Whitaker sums up the great increase in disability rates that has accompanied the psychiatric drug era, taken together with the explosion in prescription of psychiatric drugs written for children, as indicating the likelihood of an impending catastrophe of widespread iatrogenic illnesses.¹⁵

In summary, we now have better than thirty years of experience available to us to examine the effectiveness of psychoanalysis and another thirty plus years available to examine the effectiveness of psychopharmacological treatment for mental disorder. And for each of these treatments we have at least as many years testing the theories on which these approaches rest. Both of these theories and both of these treatments have failed to be substantiated when exposed to scientific scrutiny – and drug treatment has raised serious concerns about safety. Failure to validate these two systems should not be surprising since neither of these systems grew out of replicated empirical research, as characterized the development of our understanding and treatment of physical illness.

Learning theory

The third model to offer an explanation for mental illness and propose a treatment is learning theory and behavior therapy. A fundamental strength to the behavioral system is that the theory and the therapy evolved empirically. In this regard the behavioral model parallels development of the germ theory in medicine and the discovery of effective treatments originating in the germ theory. Just as basic research in anatomy and physiology led to an understanding of the mechanisms responsible for many physical illnesses and how to treat them, basic research on the process of learning has produced a coherent description of the mechanisms governing mental disorder and this understanding has guided the design of therapeutic interventions.

Establishment of psychology as a science usually is traced to Wilhelm Wundt, who set up the first psychology laboratory in Leipzig in 1879 (to study consciousness), but perhaps a better point of origin is found in the work of John B. Watson. In 1912 Watson set up a psychology laboratory at the University of Chicago to study the relationship between the behavior of animals and variables he manipulated experimentally.

Psychology is defined as the science of behavior in context, a science that examines what an organism does that is observable, how these behaviors are related to environmental conditions, and how these behaviors are modifiable. Fundamentally, this approach entails studying learning and “unlearning” (extinction).

Two forms of learning have been identified: classical (or respondent) conditioning, which pertains mainly to involuntary muscular reactions and secretions, and instrumental (or operant) conditioning, which applies to voluntary activities. Classical conditioning, the simplest form of learning, was first demonstrated experimentally by Pavlov in the late 1920s when he showed how new stimuli could be conditioned.¹⁹ In this form of learning a stimulus-response connection that is built-in genetically comes to be elicited by a previously neutral stimulus as a result of experience. A second form of learning, instrumental (or operant) conditioning, occurs entirely because of the animal’s interactions with the environment. Instrumental conditioning depends upon the environmental effects on an organism after a response occurs. Successful responses are selected by their consequences (reinforcement). These consequences are labeled positive or negative depending upon whether their occurrence reinforces behavior when they appear or when they disappear. Fundamental in Nature is selection on the basis of consequences. Evolution selects the fittest to survive (selection occurs because with time the less fit meet their demise). Similarly, instrumental conditioning, the primary determinant of human learning, selects those behaviors that are reinforced by their consequences (selection occurs because with time non-reinforced behaviors drop out).

From an infant’s earliest days learning takes place continuously. A considerable amount of research has explored learning in lower animals and humans, studying the effects of positive and negative reinforcement by means of cumulative records of various schedules of reinforcement, shaping of responses, discrimination and generalization, chaining of responses, language acquisition and expression, imitation, habituation, and extinction. Over the course of almost a hundred years’ time a vast body of basic and applied research has accumulated concerning the process of learning. Unlike psychoanalytic case histories and the alleged basis for the chemical imbalance theories, behavioral research meets scientific standards. Behavioral studies have yielded results that agree with predictions derived from research on learning and are replicated. These studies show that a broad range of human behavior is attributable to learning, including behaviors we regard as deviant. On the basis of this research, Skinner stated that an adequate explanation for behavior depends only on description of organism/environment interactions, specifying the setting for the behavior, the behavior itself, and the reinforcing consequences of the behavior.²⁰

Learning theory views the behaviors that characterize mental illness as acquired by the same principles as other behaviors. This is not to say that genetic influences are deemed to be irrelevant. An important genetic factor that has been found to govern learning is that learning occurs on the basis of the immediate effects of reinforcement, not the long-term consequences. In fact, many deviant behaviors are acquired because of this feature to how we are wired. Some deviant behaviors characterizing mental illness are construed as learned on this basis as a function of positive reinforcement (obesity, alcoholism, drug addiction) and others because of negative reinforcement (phobias, obsessive-compulsive states, social anxiety, depression). Learning in these two ways occurs because of behaviors that have immediate reinforcing effects despite eventually inducing serious disorders. This effect probably is attributable to an ancient survival mechanism that applies poorly to the more secure conditions of modern society.

Considerable research has demonstrated how powerfully these learning processes control behavior in ordinary life. The neurologist Oliver Sacks has written of how profoundly the human brain has evolved to support learning even under other than ordinary circumstances. He has described our brain’s remarkable plasticity for new learning when there has been loss of vision or hearing by substituting information from other sensory systems. Human beings have a powerful genetic legacy of being wired for learning even when key senses are seriously injured.

Behavior therapy

Behavior therapy was spawned by research studying how to change (eliminate, replace) learned behaviors. Wolpe’s treatment of phobias (now practiced as in vivo desensitization) developed out of this context, as have other therapies for other mental disorders. Foa’s treatment²¹ for obsessive-compulsive disorder (exposure) comes from this line of laboratory research, as do treatments devised by Barlow²² for social anxiety (cognitive behavior therapy), Linehan’s treatment²³ for borderline personality disorder (dialectical behavior therapy), and behavioral treatments for depression (behavioral activation).¹⁴ Cognitive behavior therapy, a frequent element in behavior therapy, is based on the assumption that irrational ideas about oneself, others, and the future contribute to mental disorder by creating a sense of helplessness and hopelessness, which in turn, negatively affect behavior. The goal of this form of behavior therapy is to replace dysfunctional beliefs and expectations with more adaptive ideas, thereby promoting positive behavioral change.

The learning model, unlike the disease model, does not assume an underlying deviant physical cause for mental disorder. The chemical imbalance theories discussed earlier presume (a priori) the same disease model for mental illness as has been established (empirically) for physical illness. While the disease model fits the data very well for physical illnesses, the value of the disease model for mental illness is open to question. Research studying the process of learning indicates a very different model for mental disorder may make better sense.

Learning theory is based on a theoretical model which asserts that behavior is a function of individual/environmental contingencies, not on an underlying biological or psychological abnormality. This is not a denial of the fact that we are physical creatures who depend upon biological functions to sustain life. It is simply a statement that describing the functional relationships between an individual and his environment will account for behavior, including the preponderance of behaviors that characterize mental disorder.

An important point to be made is that a behavioral approach works well without the requirement of our being able to accurately identify the physical substrate in the individual that at a physiological level supports learned behavior. Given the complexity of the brain, it is no wonder that we are still so ignorant of the brain’s functioning. It also would not be surprising if we never arrive at the level of biological knowledge necessary to predict a specific behavior at a specific time or to affect the nervous system so directly and precisely in the moment as to control behavior to our wishes. Fortunately, although we know there is a biological substrate of neurological memory functions and mechanics underlying the performance of a learned response, producing the desired outcome is not contingent upon knowledge of such physical processes.

Appealing to physical or psychological processes inside the individual may have distracted us from the more productive route of examining the observable contingencies available for objective study and management. Behavioral research indicates understanding the learning paradigm is sufficient to account for the behavior and to specify a remedy. Since the deviant behavior has been acquired according to well-understood individual/environmental interactions and can be extinguished through behavioral change programs devised in therapy, there is considerable evidence indicating we are in the position of being able to treat most mental disorder absent an understanding of the brain’s enormous complexity.

Possible exceptions to this conceptualization are schizophrenia, autism, and mania. These are very serious and relatively uncommon conditions. The jury is still out on this issue, but accounting for them may require including underlying physical factors as contributors along with learning. Arriving at an answer to this question is complicated by the unreliability of psychiatric diagnosis and the over assignment of psychiatric diagnoses described earlier. What qualifies as schizophrenia is poorly understood and the threshold for making the diagnosis has been lowered to a point that the diagnosis is now quite compromised. Much the same can be said for bipolar disorder, formerly known as manic-depressive disorder, in that mania, the primary defining feature to this condition, often no longer is required to make this diagnosis. Diagnostic errors undoubtedly have hampered our understanding of these disorders.

Nevertheless, it may be that a small percentage of patients diagnosed as mentally ill are suffering from disorders that are properly considered illnesses as the term is used for physical ills. Even if true, this may not be a persuasive argument for drug treatment. Studies indicate social treatments for schizophrenia are safer and more effective in preventing relapse than drug treatments.¹⁵ Current psychiatric guidelines for depression, which call for long term use of antidepressants, and the greatly expanded prescription of antipsychotic drugs, has led to a significant increase in rates of disability attributable to long term use of these powerful drugs. The greatly increased number of mentally ill being reported in epidemiological surveys undoubtedly includes mainly patients who have been assigned a diagnosis inappropriately, but there is reason to believe the number of patients being rendered more prone to relapse by their prescriptions is growing considerably.

Comparative effectiveness

How successful is behavior therapy? Behavioral treatments have been applied to all of the mental disorders.²⁴ How does the effectiveness of behavior therapy compare with drug treatment?

Research funding to develop behavior therapy has been miniscule compared with the investment that has been made studying psychiatric drugs. Nevertheless, outcome studies for a wide range of disorders show behavior therapy to be at least the equal of drug treatment. Studies have shown behavior therapy is more effective in the treatment of depression (less than half the relapse rate),²⁵ obsessive-compulsive disorder,²⁶ and borderline personality disorder.²⁷ Studies indicate no difference in effectiveness for drugs versus behavior therapy in the treatment of some other disorders, for example, in the treatment of phobias²⁸ and generalized anxiety disorder.²⁹

The playing field, however, is not level. An artifact built into double blind studies favors drug treatment. Many patients in double blind studies have had prior experience with the drugs being studied and recognize if they are on the drug or the placebo because of the presence or absence of side effects (they become unblinded). Those who recognize they are on the drug are inclined to rate their experience positively, those who realize they are on the placebo to rate their experience negatively, inflating the apparent effectiveness of the drugs. In addition, outcome measurements are generally taken after three months of treatment when placebo effects are robust; when measured long term, drug treatment is more likely harmful than helpful.⁸,¹⁵,³⁰ Perhaps most revealing, the studies that have used active placebos (placebos with side effects) have found that the drug effects reported in studies using inert placebos (the far more common practice) disappeared.³¹ Given that the placebo effect plays a larger role when measuring the effectiveness of drug treatment, and that drug treatment, unlike behavior therapy, raises safety concerns, a case can be made for behavior therapy being the more trustworthy choice even when research results appear to show parity.

Correction of avoidance behavior often is central to behavior therapy. If there is a unifying theory for behavioral treatment, correction of avoidance behavior has primacy. For example, elevator phobic patients are trapped in their fears because of the relief they experience when they choose not to take an elevator. OCD patients who repeatedly check the stove to be certain the gas jets are turned off derive immediate relief from fears of asphyxiation by checking. Depressed patients become inactive because they fear being incapable of replacing what has been lost. Socially anxious patients, by staying away from social situations, feel spared social failure. Sometimes a behavioral understanding of these problems discloses behavioral deficits needing attention or cognitive distortions needing to be corrected and these goals are built into the treatment, but the primary task of the behavior therapist generally entails elimination of avoidance behavior and promotion of more functional behaviors. Avoidance behavior by these patients occurs automatically and is governed by the principle of negative reinforcement because in each case avoidance behavior terminates an aversive situation. Effective behavioral treatments have been developed to remedy avoidance behavior.

Constructive change in behavior therapy occurs by means of specifying the dysfunctional behaviors that comprise the patient’s problems, identifying the interactions with the environment that trigger these behaviors, and progressing through programs designed to remedy these learned dysfunctional behaviors. Through a collaborative process, hypotheses are generated to account for the problems and to promote positive steps, which are tested by keeping track of the results of behavioral changes and by discussing problems encountered in this process. Rather than having “insight” as a goal (as is the case in psychoanalytically-oriented psychotherapy), the goal is arriving at an understanding of the contingencies controlling problematic behaviors and identifying the specific new behaviors necessary for positive change. Basic to the treatment is teaching the patient how to analyze and correct problems when they arise in the future.

Unfortunately, while there are many behavior therapists well trained in how to deliver behavior therapy within a learning theory framework, they still are too few in number. Great Britain’s national health service, recognizing the greater value of this approach to treatment and the need for more therapists with behavioral training, has embarked on a large-scale training program to address this need. A similar program should be established in this country.

Behavior therapy is far from a fully developed treatment. To give some examples: Studies are needed to determine the most effective means of conducting the assessment phase, which sets the stage for treatment. The centrality of cognitive versus strictly behavioral variables is disputed. There also are outstanding questions about the optimal length of the treatment. For example, in studies comparing behavioral versus drug treatment for moderately to severely depressed patients, outcome typically is measured after two to three months of treatment. Not only does this bias the outcome in favor of drug treatment (because measuring outcome after two to three months of treatment capitalizes on the placebo effect for those on drugs), it also probably represents a too limited amount of time for behavior therapy to produce lasting change for at least some patients. While patients in behavior therapy for three months have been found to have less than half the relapse rate of those treated with drugs for a year,³² this does not answer the question of how long behavior therapy should continue for more robust, longer lasting results. Questions such as these make it plain additional research on behavior therapy is needed to improve the effectiveness and efficiency of this form of treatment.

Today

Finally, some comment is called for with regard to how these three models are represented today. The chemical imbalance theory and treatment by pharmacological methods dominates the treatment of mental disorder. And this preference is rising. A survey in 2006 reported the number of Americans taking antidepressants had doubled in a decade from 13.3 million to 27 million. The use of antipsychotic drugs to treat children and adolescents for problems such as aggressive behaviors and mood changes increased five fold from 1993 to 2002. A 2009 survey found that 73% more adults and 50% more children were using psychiatric drugs than in 1996.

This acceptance has been a marketing triumph for psychiatry and the pharmaceutical industry. Psychiatric leaders have carefully managed what information about drugs makes it into print and what is disseminated to the public. A combination of psychiatry fully embracing drug treatment, drug promotion and obfuscation sponsored by the drug companies, and patient and parental time constraints and wishful thinking have prevented the truth about the ineffectiveness of these drugs to register on doctors or the public.

An eclectic approach to psychotherapy dominates the talk therapies. Psychoanalytic theory and treatment for the most part has evolved into an eclectic form of psychodynamic psychotherapy, which retains some core psychoanalytic concepts, discards many others, and incorporates ideas from other theoretical orientations. While behavior therapy usually is available and has had a significant impact on treatment, not infrequently it takes place primarily as an adjunct, one of a number of arrows in a quiver made use of within this general approach to psychodynamic treatment. And unfortunately, therapists who lack sound behavioral training often misapply the procedures of behavior therapy reducing the effectiveness of these techniques.

Basic psychoanalytic concepts are now so ingrained in how we think about personality and the dynamics of daily life that a psychodynamic therapy relying on these ideas is very consumer friendly. Science writers and novelists regularly write in this fashion, as if psychoanalytic ideas correctly describe and account for human behavior. But face validity and validity rarely are synonymous. Behavior therapy is based on a very different kind of explanation for human behavior that fits the data better but includes concepts less familiar to many people and requires more explanation. In the hands of a skillful therapist, therapeutic practices derived from this approach readily become accepted as they demonstrate their usefulness.

Most patients are seeking help for ordinary problems in living and are suffering from behaviors that may be making them miserable but are not necessarily debilitating. Because these problems often are transitory, drug treatment is accepted as beneficial by doctors and their patients. The eclectic talk therapies often are helpful, most certainly when the problems are less entrenched. Eclectic talk therapy has a success rate equivalent to or better than drug treatment since its success is less attributable to a placebo effect. Its strengths are that it offers support and helps patients to construe their situation more constructively. Psychodynamic therapy is at its best when in addition to giving “insight” it enables patients to be more active and successful agents in their own behalf.

There are inherent problems, however, with this approach to treatment. When successful, the eclectic format makes it impossible to know what it is in the therapy that is responsible. And when the treatment is unsuccessful or only partially successful, the usual response is to refer the patient for drugs, which is the sanctioned treatment and excuses the therapist for the psychotherapy’s lack of success. The reality is that this referral is nothing more than bucking the problem to someone else to solve who has even less to offer. And, if the patient is then prescribed a drug while continuing in psychotherapy, even though the great likelihood is that the patient will have abandoned taking the drug after enduring several months of aversive side effects, everyone feels pretty good about the combined treatment having worked – at least for a while. In the absence of a treatment based on a functional analysis of the contingencies governing the problem, too often the patient leaves therapy without having learned the tools needed to address problems when they arise in the future.

An important purpose served by having a clear theoretical model, with methods derived from it empirically, is that purity enables specific tests of effectiveness. Eclectic psychotherapies presently serve a worthwhile purpose for people in need, but if we are to determine what methods are effective, we must view this approach as a temporary measure while we invest in research aimed at isolating the ingredients responsible for successful treatment. Of the three systems described in this article, learning theory and behavior therapy, despite having been relegated to a secondary role, offers a more promising outcome for conceptualizing and treating mental disorder successfully.

Favorable results have been obtained for behavior therapy despite a paucity of research support in comparison with the funding of studies related to drug treatment. It is vital that we as a society invest a lot more in perfecting behavior therapy, but the NIMH, our primary public funding source (the drug companies now fund the great bulk of the research), has shown insufficient interest in making the deserved investment in behavior therapy.

The NIMH

Since psychiatry’s transformation to a biological orientation the NIMH has been committed to the pharmacological treatment of mental disorder and has led the way in establishing drugs as the treatment of choice even when the results of outcome studies are inconsistent with this choice.

A prime example of NIMH’s determined advocacy for drug treatment and the chemical imbalance theory, regardless of evidence to the contrary, is amply revealed in the institute’s handling of the STAR*D study, discussed earlier in this paper. The STAR*D study was funded for 35 million dollars, making it one of the most costly studies ever conducted by NIMH, and was designed to examine the guidelines for antidepressant treatment of moderate to severe depression. Although double blind studies had found antidepressants to be no better than placebos, STAR*D’s experimental design included no control groups. Nevertheless, as reviewed earlier, STAR*D’s results for antidepressants, short-term, were identical to what double blind studies have found for placebo. The long-term results for antidepressants, which rarely have been measured, were shockingly poor. Thus, STAR*D’s results were hardly an endorsement for treating depression by antidepressant drugs. But that is not how the results were reported:

1. The main result reported in STAR*D publications was a remission rate of 67% for antidepressant treatment, which the researchers claimed gave solid support for treating depression with antidepressant drugs. This figure was arrived at by summing across trials, a calculation the researchers admitted having failed to meet the conditions required for its use. They then went ahead and used it anyway and greatly compounded the misrepresentation of their results by declaring this bogus figure to be the prime outcome of the study. The calculation is spurious, highly misleading, and part of a pattern of unwarranted manipulations of the data that inflate the reported effectiveness of antidepressants.³³, ⁸

2. As their tables show, the actual long-term results for antidepressant treatment were that by the end of a year’s time all but 108 of the 4,041 patients had either relapsed or dropped out of treatment (a 3% success rate). Nowhere in STAR*D’s publications of results is there any mention in the text of this outcome. Rather than being an endorsement of the treatment guidelines, the results call for a change in the guidelines.

3. In the short-term (measured at three months), STAR*D’s actual results are remission rates of 25-30%. These results are precisely what double blind studies have found as the outcome for placebos, indicating the short-term benefit for antidepressants is a placebo effect. No mention is made of the similarity of these findings to the results of placebo controlled studies or that these results also are in close agreement with the findings of NIMH’s first depression treatment study, published 17 years earlier, which found no difference between antidepressant drugs and placebo. In the short run, antidepressants perform no better than sugar pills; these results also call for a change in the guidelines.

4. In fact, the results are even worse because STAR*D researchers violated their own admission and remission protocol criteria by changing measures mid-stream. These changes had the effect (easily shown in their data) of inflating the apparent effectiveness of antidepressants by several percentage points.

5. STAR*D’s researchers nonsensically claim their results support the latest chemical imbalance theory (that different drugs are necessary and successful for different conditions) despite the fact that drugs with different neurochemical actions were equivalent in their ineffectiveness.

Absent these manipulations of the data, STAR*D’s results are a clear-cut repudiation of the psychiatric guidelines calling for treatment of moderate to severe depression by antidepressant drugs. Yet the NIMH has presented the findings to the public as if they were an endorsement of the current guidelines, encouraging people to choose antidepressant drugs to treat depression. With regularity, this fictitious reporting of results is repeated in the media, considerably expanding the likelihood that treatment choices will be influenced by this erroneous information. This biased reporting needs to be publicized if misrepresentations of this kind are to be corrected.

The NIMH’s mishandling of the 35 million dollar STAR*D study (that’s our money, folks) is a prime example of what the medical journal editors (cited earlier) have warned is taking place as a consequence of various forms of payment made to doctors and researchers by the pharmaceutical industry. But in this instance it is the NIMH, the agency mandated to protect the public, that is manipulating the data not a drug company. How can one fail to conclude the NIMH is more determined to promote what is deemed to be of value for psychiatry than what is good for the public?

Psychiatry and Big Pharma

Psychiatry’s adoption of the chemical imbalance theory for mental illness rescued the profession. Establishing a model that required a medical degree gave psychiatry a competitive advantage and the economic success of this strategy undoubtedly exceeded the wildest imaginings of those who engineered the change. Psychiatry’s transformation to treatment by prescription of drugs not only filled all the empty hours in psychiatrists’ weekly schedules, it increased their hourly income by 40%. The pharmaceutical industry made this conceptual change possible by partnering with psychiatry in establishing acceptance of allegedly effective psychiatric drugs as the preferred treatment for mental disorder and Big Pharma has been rewarded royally. Yet concealed behind today’s continuing complacent promotion of the chemical imbalance theory and prescription of psychiatric drugs is the absence of empirical evidence for the theory or the treatment. The NIMH plays a central role in promoting this system by the choices the institute makes in the allocation of funds for research and through dissemination of slanted information and advice to the public.

Psychiatry and Big Pharma are in a symbiotic relationship with one another where neither could function profitably without the other. Working together they have benefited enormously and they have huge financial incentives to maintain current practices. A behavioral model offers meager financial returns compared with the bonanza associated with a biological model and reliance on drug treatments. Given the self-interest of these businesses for maintaining the current model, the power and credibility accorded to psychiatric opinion by the general public, and the practically unlimited resources of the drug companies for marketing their products, the truth about which treatments for mental disorder work and are safe and which treatments don’t work and are unsafe is largely unknown by doctors and the public.

In short, while the biological revolution in psychiatry shows little evidence of being beneficial for patients, it has been very good for business for psychiatrists and extraordinarily profitable for the pharmaceutical industry. The situation is analogous to the alliance of Wall Street bankers and traders, who with the help of some esteemed economists, established acceptance of a rationale for a financial system of great benefit to them personally. In the end the one-sided nature of the transactions led to an economic crash causing great financial losses for the public. Similarly, psychiatry and Big Pharma have perpetrated a utopian pharmaceutical mythology that serves their interests very well but has served the public very poorly. Drug treatment has not yet crashed, but there are ominous signs that we may be headed toward widespread mental disability as a consequence of this misguided treatment of mental disorder. In contrast, behavior therapy is safe and more effective. Given the superior substantive base and the greater promise offered by treatments based on a behavioral approach, more support is warranted for training behavior therapists and for pursuit of basic behavioral research. As a society we need to invest far more in developing this model for treating mental disorder.

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The findings of this study demonstrate that allegations by these nine detainees of torture were corroborated by forensic evaluations by non-governmental medical experts and that DoD medical and mental health providers at GTMO failed to document physical and/or psychological evidence of intentional harm.

In each case we reviewed, detainees alleged forms of abuse that are highly consistent with torture as defined by the UN Convention Against Torture as well as the more restrictive US definition of torture that was operational at the time [12]. In one case, unclassified interrogation plans and interrogation summaries provided precise corroboration of the methods of torture and ill treatment that the detainee alleged.

….

The medical evaluations in this case series revealed evidence of severe physical and severe and prolonged psychological pain as stipulated in the Bybee definition of torture. But, according to the Bybee definition of torture, even if the requisite pain thresholds had been exceeded, the infliction of such pain had to be the interrogator’s “precise objective” to constitute torture.

….

The medical doctors and mental health personnel who treated the detainees at GTMO failed to inquire and/or document causes of the physical injuries and psychological symptoms they observed. Psychological symptoms were commonly attributed to “personality disorders” and “routine stressors of confinement.” Temporary psychotic symptoms and hallucinations did not prompt consideration of abusive treatment.

The documentation of torture and ill treatment in medicolegal evaluations conducted by non-governmental medical experts indicates that each of the detainees continues to experience severe, long-term and debilitating psychological symptoms that are likely to persist for many years, and possibly a lifetime.

The Defense Department has issued a response to Iacopino and Xenakis which, in its failure to even mention their main charges can be taken as an official confirmation that Guantanamo health professionals do no investigate or document the terrible abuses suffered by many prisoners there:

DoD personnel working in detention facilities operate under a high level of scrutiny and consistently provide the most humane and safe care and custody of individuals under their control. The Joint Medical Group is committed to providing unconditional appropriate comprehensive medical care to all detainees regardless of their disciplinary status, cooperation, or participation in a hunger strike. The healthcare provided to the detainees being held at Guantanamo Bay rivals that provided in any community in the United States. Detainees receive timely, compassionate, quality healthcare and have regular access to primary care and specialist physicians. The care provided to detainees is comparable to that afforded our active duty service members. All medical procedures performed are justified and meet accepted standards of care. A detainee is provided medical care and treatment based solely on his need for such care and the level and type of treatment is dependent on the accepted medical standard of care for the condition being treated. Diagnosis of such conditions and medical care and treatment for them are not affected in any way by a detainee’s cooperation, or lack thereof, during an interrogation session. Similarly, medical care is not provided or withheld based on a detainee’s compliance or noncompliance with detention camp rules or on his refusal to end a hunger strike. Medical decisions and treatment are not withheld as a form of punishment. Additionally, the medical staff has no involvement in discipline decisions made by detention personnel.

This DoD reesponse also neatly elides the Iacopino and Xenakis claims in another way in that it is written in the present tense and thus only applies to current practices. Yet Iacopino and Xenakis, by their methodology of examining medical records, are talking about past practices. The DoD “response” makes no claims whatsoever recording the appropriateness of past practices. It thus seems likely that some of those practices were indefensible, even by Defense Department spokespeople not usually noted for their truthfulness.

The Iacopino and Xenakis findings are entirely consistent with my experience reading medical files on one Guantanamo prisoner on whom I consulted. Despite claims that he had been subjected to abuse, and mental health symptoms consistent with abuse, there was no indication in the hundreds of pages I read that any health professional had made any attempt to find out if he had been abused or to document possible abuse. Rather, the mental heath staff seemed only interested in whether the prisoner might make a suicide attempt. Beyond that, his obvious anguish appeared to be of no interest to the psychologists and other mental health staff.

Further, the Guantanamo medical unit and the Obama Justice Department fought tooth and nail to prevent any independent examination of these records, much less of the prisoner himself. The prisoner’s attorneys requested, and the habeas judge ordered, that the records be made available for examination by an independent psychologist, me, to determine if there was a possibility that mental health issues might interfere with the prisoner’s ability to cooperate with his attorneys. The Guantanamo medical staff filed a declaration denying any need for independent evaluation. And the Justice Department appealed every step. First they opposed any access to records as too burdensome. Then they appealed access to more than the past few month’s records. They appeared to objected to any scrutiny on principle, which in itself in a sign of inadequate transparency at Guantanamo and is the exact opposite of what should occur in an institution run by a democratic government. We cannot take the word of officials at an institution absent meaningful independent scrutiny that abuses and ethical lapses were, or are, absent.

The Iacopino and Xenakis paper contributes to existing evidence, including the questionable use of anti-malarial drugs, that Guantanamo healthcare was often problematic and deserves independent scrutiny. While the Bush and Obama administrations have made every effort to keep those records secret, health professionals should challenge that secrecy. We should demand that Guantanamo medical records be opened, with prisoner consent, to independent inspection. Further, all detainees desiring it should be able to receive independent medical evaluations.

Additionally, independent of the issues of possible abuse, the complete medical records of released prisoners should be made available to those prisoners and/or their current health providers. To suppress medical records for years of a person’s life is unethical as it interferes with released individuals’ ability to obtain required care in the present and the future. Health professionals from all disciplines should make clear that denial of access to their records by released prisoners is in simply unacceptable.

It was the best of times, it was the worst of times …

– Charles Dickens

The neoliberal revolution, which began in the 1970s, has produced inequality not seen since the gilded age.¹ From circa 1942 to 1978, the top 10% of households held around 33% of the nation’s wealth. Currently, the wealth share of the top 10% stands at 47%. Even more strikingly, the top 0.1% (1 in 1,000) of households increased their share of income from less than 1% in 1978 to roughly 5% in 2008.² The policies that produced this wealth disparity, including privatization, deregulation, and the promotion of macroeconomic stability, have attracted the opprobrium of critics and the plaudits of apologists. In mainstream discourse, free market encomia and anti-government pabulum are virtual necessities.³ It is considered a badge of virtue to harbor mystical beliefs about the thaumaturgical properties of the free market. Of course, leaving the platonic ether, both progressives and conservatives desire a powerful regulatory apparatus and interventionist state. Progressives prefer that these tools be used to create greater equality; conservatives that they allow income to flow upward.⁴

Critics of neoliberalism have penned countless works detailing the negative economic and social consequences associated with neoliberal policies.⁵,⁶,⁷ Most progressives are familiar with these critiques and utilize them in discussions, blogs, articles, and books. Unfortunately, there remains a lacuna in progressive critiques which allows apologists to remain untarnished defenders of the faith: the psychological consequences of neoliberal policy have not been rigorously assessed—outside of specialist journals.⁸ The results are straightforward: the neoliberal enthusiast concedes economic facts but asserts that increased freedom, individualism, and prosperity more than outweigh the costs. Sure, low and non-skilled workers are worse off than they were 30 years ago, but who cares? The apologist then waxes effusive over the unparalleled consumer goods that are available for purchase. He (or she) concludes with a yarn about his working-class neighbor who owns 2 cell phones and a flat screen TV. What if such an argument has validity? If data collected over the past 40 years provided evidence that U.S. citizens are happier and healthier than ever, it would make an outright condemnation of neoliberalism more difficult. Conversely, if the data provided evidence of increasing psychological and physical malaise, this would render it difficult to tout the salubriousness of neoliberalism

Happiness is the meaning and the purpose of life, the whole aim and end of human existence.

– Aristotle

Neoliberalism and Happiness

Neoliberal advocates often point to increased prosperity, freedom, and consumer choice to justify their brand of market fundamentalism. Inherent in this argument is the assumption, left conspicuously untested, that consumer choice and wealth are, by necessity, conduits of happiness. Turning to the scholarly research, it is true that higher levels of income cross-nationally are associated with increased happiness. For example, researchers have found moderate to strong correlations (between .50 and .70) between per capita income and average well-being across nations.⁹ However, once income reaches a moderate level (roughly U.S. $10,000 per capita), the effects of additional income on happiness are marginal or nonexistent.¹⁰,¹¹ In the U.S., mean happiness has remained flat since the end of World War II, while the percentage of Americans reporting being very happy stagnated in the 1960s (see figure below).¹²,¹³,¹⁴

Myers, D.G., & Diener, E. (1995). Who is happy? Psychological Science, 6, 10-19. p 13. Reprinted with APA permission.

Neoliberal advocates are correct in asserting that a sense of freedom increases subjective well-being; they are wrong in assuming that neoliberal policies maximize perceived freedom.¹⁵ Neoliberal policies increase inequality which decreases perceived freedom and is associated with a host of social ills (detailed below). Further, nations possessing the highest life satisfaction—Denmark, Netherlands, Norway, and Switzerland—are all more egalitarian and collectivist than the United States.¹⁶ This is consistent with research demonstrating that more generous welfare state policies are associated with higher levels of happiness.¹⁷ There are a couple of reasons that relatively collectivist countries with generous welfare policies tend to be happier than the U.S. First, in a hyper-individualistic, competitive social milieu, income becomes a salient social desideratum causing individuals to overrate its importance in generating well-being and to lose sight of more important factors.¹⁸ Second, while people generally prefer choice, there is evidence that too much choice is deleterious to well-being. This phenomenon has been given the felicitous label the paradox of choice.¹⁹ For an example of the paradox of choice, think of your last trip to the supermarket. Were you overwhelmed by the sundry toothpastes? What is the difference between advanced vivid fluoride and iso-active fluoride? Should you use fluoride or peroxide or baking soda or all three? The paradox of choice occurs because we wish to make rational choices but have limited time and resources. It is often impossible to gather sufficient information for optimal choice. Thus, we are glutted by consumer goods that do little to increase happiness and much to increase anxiety. To the extent that neoliberalism promotes consumerism, it is likely to decrease subjective feelings of well-being.

An imbalance between rich and poor is the oldest and most fatal ailment of all Republics.

– Plutarch

Inequality and Psychological Functioning

Inequality has increased dramatically in the neoliberal era—even the most insouciant apologist admits this much. Pollyannaish pundits argue the inequality is irrelevant so long as society is getting richer in absolute terms. They also argue that inequality is the price paid for the freedom to pursue one’s talents. The scientific research, however, tells a drastically different tale. Hundreds of studies demonstrate that inequality is destructive socially and psychologically.²⁰ ,²¹,²² The table below presents an overview of the effects of inequality on select social and psychological outcomes.²³,²⁴,²⁵,²⁶,²⁷

References 23-27. Note: Ý = indicator increases with greater inequality. ß = indicator decreases.

A quick glance at the table reveals that inequality is associated with lower overall population health and mental health as well as a host of social ills. Even social mobility, the cause célèbre of neoliberal aficionados, is negatively correlated with inequality (i.e., the more equal the society, the greater the social mobility). These data further help to understand the lack of a relationship between per capita income and happiness: It is not the income that matters so much as its relative distribution.

We’re the middle children of history… no purpose or place. We have no Great War, no Great Depression. Our great war is a spiritual war. Our great depression is our lives.

– Fight Club

The effects of Growing up Neoliberal

Generation X and the proceeding generations are, in a frightening way, the guinea pigs of neoliberal history. If the advocates of neoliberalism are correct, these generations should be blessed with a happiness and psychological robustness not afforded to previous generations. On the other hand, if the concerns of critics are closer to the mark, we should see cohort trends on a host of psychological and social outcomes that are not in a desirable direction. Here, as Mike Males has eloquently pointed out, we must be careful not to scapegoat younger generations.²⁸ We must also resist the opposite temptation—Males comes dangerously close to writing what amounts to hagiography.²⁹

In the past, all we could rely on to provide evidence about generational trends were animadversions cast on the younger from the armchair of the older. Of course, these do not qualify as unbiased testimonials. Fortunately, in recent years, Jean Twenge and her colleagues have pioneered the use of cross-temporal methods to assess generational trends rigorously and objectively.³⁰,³¹ The gist of this method is to collect scores on surveys as far as back the data allow. For example, we might collect college students’ scores on a scale measuring self-esteem from 1976 to the present. We can then take the average score of college freshmen from 1976 and compare them with the college freshmen of 1977 and so on up to the most recently published data. The brilliance of this method is that we can perform all sorts of statistical analyses comparing cohorts of college students and we can quantify cohort trends. It may be a bit more challenging than pontificating anecdotally, but it does have the distinct advantage of scientific soundness.

The table below presents a select sample of social and psychological indicators (i.e., empirical manifestations of our general concept of socio-psychological well-being) as well as the general cross-temporal trend. The table also presents the age of the cohort (e.g., college students) the data is taken from as well as the duration (e.g., 1976-1993).³²,³³,³⁴,³⁵,³⁶,³⁷,³⁸,³⁹,⁴⁰,⁴¹,⁴²,⁴³,⁴⁴

References 32-44. Note: Ý = indicator increased over period listed in ‘Year of Trend’. ß = indicator decreased. Sample refers to the age of the cohort studied.

There has been a decline in social capital since the middle of the 1960s across all age groups. This is manifest in everything from decreased voter turnout to less frequent conversations with neighbors. Within young cohorts there is a trend toward individualistic narcissism as indicated by cross-temporal increases in positive self-view, self-esteem, and narcissistic personality. That is, the youth of today score much higher on scales measuring these than did youth 10 or 20 years ago. While high self-esteem is generally desirable, it is not when it becomes unhinged from external accomplishment. When this occurs, as it currently has, it leads to irrational ambition, competitiveness, defensiveness, and narcissism. The same applies, a fortiori, to positive self-views. Of course, it is desirable to view yourself in a positive light. However, if you believe you are the most intelligent, attractive, and athletic person in the known world, you are less likely to be cooperative and altruistic.

Interestingly, both external locus of control and just world beliefs have risen since the 1970s. External locus of control refers to the belief that it is mostly luck that determines one’s lot in life. Individuals who rate high on external locus of control tend to be cynical as they do not believe their own actions can be efficacious in producing desirable outcomes. Thus, with rising external locus of control, it is likely that sustained activism decreases. Just world belief refers to the inclination to believe that the world is fundamentally just and that people get what they deserve. Individuals who possess just world beliefs tend to justify the status quo and blame others for their failings—even if these are caused by external phenomena (e.g., structural changes in the economy, severe illness). Therefore, youth today are more likely to justify the status quo and blame victims than were youth in the 1970s.

Taken as a whole, the research summarized in the above table is damning for advocates of neoliberalism. Youth today suffer from increased anxiety, depression, and mental illness; exhibit inflated self-views and decreased empathy; believe money is more important than previous generations; and are more likely to accept the status quo with cynical acquiescence. These psychological trends are mirrored by a steady decline in social capital and a rise in crass materialism.⁴⁵ We must be careful not to blame youth for these trends. They are caused by material and cultural changes, not by changes in innate psychology. These are the outcome of a culture predicated on material values and individualism. In short, these are the predictable results of neoliberal policy.

Conclusion: Neoliberalism is a Health Risk

They made a wasteland and called it peace.

– Tacitus

The evidence presented above taken in toto is overwhelming and points to one conclusion: Neoliberal polices are a public health risk. Like cigarettes, neoliberal propaganda should come with a Surgeon’s General Warning: Neoliberalism may cause depression, anxiety, cynicism, and has been linked to declining social capital. Progressive critics of neoliberalism should make use of these findings in blogs, articles, and conversations. It is difficult to believe that the majority of Americans would tolerate neoliberal policies if they were aware of the consequences.

It is hoped that this evidence fills the lacuna discussed in the opening. There is no reason for us to ignore psychology when debating social policies. In fact, it is only through the effects of these policies on flesh and blood humans that we are critical of them. Progressives have, at times, shied from psychology. Unfortunately, the neoliberal apologists have used this to their advantage: As they bloviate about the supposed virtues of free markets and consumer choice, progressives, for the most part, retort with dry statistics about inequality and unemployment. It is not difficult to see which resonates more with the average citizen. Armed with data from psychology, progressives can retort with poignant descriptions of increasing psychological malaise.

While we are possessed of no special wisdom to offer activists advice, it is important to keep in mind that neoliberalism is not written in the stars: There are alternatives.

1. Saez, E., & Picketty, T. (1998). Income inequality in the United States, 1913-1998. Quarterly Journal of Economics, 118, 1-39.
2. Saez, E. (July 17, 2010). Striking it richer: The evolution of top incomes in the United States (updated with 2008 estimates).
3. Bo Winegard (March 31, 2011). Synecdoche Wisconsin: Neoliberalism and Economic Inequities in America. Dissident Voice.
4. Baker, D. (2006). The conservative nanny state: How the wealthy use the government to stay rich and get richer.
5. Harvey, D. (2005). A brief history of neoliberalism. New York: Oxford.
6. Chomsky, N. (1999). Profit over people: Neoliberalism and global order. New York: Seven Stories Press.
7. Dumenil, G., & Levy, D. (2011). The crisis of neoliberalism. Cambridge, MA: Harvard University Press.
8. Kasser, T., Cohn, S., Kanner, A.D., & Ryan, R.M. (2007). Some costs of American Corporate Capitalism: A psychological exploration of value and goal conflicts. Psychological Inquiry, 18, 1-22.
9. Diener, E., & Biswas-Diener, R. (2002). Will money increase subjective well-being? A literature review and guide to needed research. Social Indicators Research, 57, 119-169.
10. Frey, B.S., & Stutzer, A. (2002). Happiness and economics: How the economy and institutions affect human well-being. Princeton, NJ: Princeton University Press.
11. Helliwell, J.F. (2003). How’s life? Combining individual and national variables to explain subjective well-being. Economic Modelling, 20, 331-360.
12. Easterlin, R.A. (1995). Will raising the incomes of all increase the happiness of all? Journal of Economic Behavior and Organization, 27, 35-47.
13. Diener, E., & Seligman, M.E.P. (2004). Beyond money: Toward an economy of well-being. Psychological Science in the Public Interest, 5, 1-31.
14. Myers, D.G., & Diener, E. (1995). Who is happy? Psychological Science, 6, 10-19.
15. Inglehart, R., Foa, R., Peterson, C., & Welzel, C. (2008). Development, freedom, and rising happiness: A global perspective (1981-2007). Perspectives on Psychological Science, 3, 264-285.
16. Diener, E., & Biswas-Diener, R. (2008). Happiness: Unlocking the mysteries of psychological wealth. Malden, MA: Blackwell.
17. Pacek, A., & Radcliff, B. (2008). Assessing the welfare state: The politics of happiness. Perspectives on Politics, 6, 267-277.
18. Kahneman, D., Krueger, A.B., Schkade, D., Schwartz, N., & Stone, A.A. (2006). Would you be happier if you were richer? A focusing illusion. Science, 312, 1908-1910.
19. Schwartz, B. (2003). The paradox of choice: Why more is less. New York: Ecco.
20. Sapolsky, R.M. (2005). The influence of social hierarchy on primate health. Science, 308, 648-652.
21. Wilkinson, R.G., & Picket, K.E. (2006). Income inequality and population health: A review and explanation of the evidence. Social Science & Medicine, 62, 1768-1784.
22. There is a wealth of information and documentation supporting specific claims about the effects of inequality at The Equality Trust, a nonprofit group.
23. Kondo, N., Sembajwe, G., Kawachi, I., van Dam, R.M, Subramanian, S.V., & Yamagata, Z. (2009). Income inequality, mortality, and self rated health: Meta-analysis of multilevel studies. British Medical Journal, 339, b4471.
24. Pickett, K.E., James, O.W., & Wilkinson, R.G. (2006). Income inequality and the prevalence of mental illness: A preliminary international analysis. Journal of Epidemiology and Community Health, 60, 646-647.
25. Picket, K.E., & Wilkinson, R.G. (2010). Inequality: An under acknowledged source of mental illness and stress. British Journal of Psychiatry, 197, 426-428.
26. Wilkinson, R., & Pickett, K.E. (2009). The spirit level: Why more equal societies almost always do better. New York: Penguin.
27. Daly, M., Wilson, M., & Vasdev, S. (2001). Income inequality and homicide rates in Canada and the United States. Canadian Journal of Criminology, 43, 219-236.
28. Males, M.A. (1996). The scapegoat generation: America’s war on adolescents. Monroe, ME: Common Courage Press.
29. Mike Males (April 26, 2001). The True “Greatest Generation” of Our Time: X. Los Angeles Times.
30. Twenge, J.M. (2006). Generation me: Why today’s young Americans are more confident, assertive, entitled—and more miserable than ever before. New York: Free Press.
31. Twenge, J.M., & Campbell, W.K. (2009). The narcissism epidemic: Living in the age of entitlement. New York: Free Press.
32. Putnam, R. D. (2000). Bowling alone: The collapse and revival of American community. New York: Simon & Schuster.
33. Twenge, J.M., & Campbell, W.K. (2008). Increases in positive self-views among high school students: Birth cohort changes in anticipated performance, self-satisfaction, self-liking, and self-competence. Psychological Science, 19, 1082-1086.
34. Reynolds, J., Stewart, M., MacDonald, R., & Sischo, L. (2006). Have adolescents become too ambitious? High school seniors’ educational and occupational plans, 1976-2000. Social Problems, 53, 186-206.
35. Twenge, J.M., Konrath, S., Foster, J.D., Campbell, W.K., & Bushman, B.J. (2008). Egos inflating over time: A cross temporal meta-analysis of the Narcissistic Personality Inventory. Journal of Personality, 76, 875-901.
36. Twenge, J.M., & Foster, J.D. (2010). Birth cohort increases in narcissistic personality traits among American college students, 1982-2009. Social Psychological and Personality Science, 1, 99-106.
37. Twenge, J.M., Zhang, L., Im, C. (2004). It’s beyond my control: A cross-temporal meta-analysis of increasing locus of control, 1960-2002. Personality and Social Psychology Review, 8, 308-319.
38. Gentile, B., Twenge, J.M., & Campbell, W.K. (2010). Birth cohort differences in self-esteem, 1988-2008: A cross-temporal meta-analysis. Review of General Psychology, 14, 261-268.
39. Twenge, J.M., & Campbell, W.K. (2001). Age and birth cohort differences in self-esteem: A cross-temporal meta-analysis. Personality and Social Psychology Review, 5, 321-344.
40. Twenge, J.M. (2000). The age of anxiety? Birth cohort change in anxiety and neuroticism,1952-1993. Journal of Personality and Social Psychology, 79, 1007-1021.
41. Twenge, J.M., Gentile, B., DeWall, C.N., Ma, D., Lacefield, K., Schurtz, D.R. (2010). Birth cohort increases in psychopathology among young Americans, 1938-2007: A cross-temporal meta-analysis of the MMPI. Clinical Psychology Review, 30, 145-154.
42. Konrath, S.H., O’brien, E.H., & Hsing, C. (2011). Changes in dispositional empathy in American college students over time: A meta-analysis. Personality and Social Psychology Review, 15, 180-198.
43. Malahy, L.W., Rubinlicht, M.A., & Kaiser, C.R. (2009). Justifying inequality: A cross-temporal investigation of U.S. income disparities and just-world beliefs from 1973 to 2006. Social Justice Research, 22, 369-383.
44. Twenge, J.M., & Campbell, W.K. (2010). Birth cohort differences in the monitoring the future dataset and elsewhere: Further evidence for Generation Me: Commentary on Trzesniewski & Donnellan. Perspectives on Psychological Science, 5, 81-88.
45. Astin, A.W. (1998). The changing American college student: Thirty-year trends, 1966-1996. The Review of Higher Education, 21, 115-135.

Writes Fisk, “Gaddafi is a fruitcake and … he probably does occasionally chew carpets as well” and “Gaddafi is completely bonkers, flaky, a crackpot on the level of Ahmadinejad of Iran and Lieberman of Israel…” Yes, Fisk did add in Lieberman, but the implication is that Arab rulers are flakes while flakes do not become rulers in Israel.

Fisk avers that seldom do fruitcakes rule in Europe: “The Middle East seems to produce these ravers – as opposed to Europe, which in the past 100 years has only produced Berlusconi, Mussolini, Stalin and [Hitler] …”

Fisk acknowledges that “there is a racist element in all this.”

And for Fisk, the apple does not fall far from the tree, as he describes Gaddafi’s son, Saif al-Islam, as “crazed” and states the father-son “should meet their just rewards, along with their henchmen?”

Did Fisk ever write that Bush Sr and Bush Jr “should meet their just rewards, along with their henchmen?” Does Fisk ever describe the mercenaries² of the US, UK, Canada, etc. as “henchmen?” Is this not tendentious reporting, if not racist?

When did Fisk become a psychologist?

What makes western rulers such as George W. Bush, Tony Blair, Barack Obama, David Cameron, Stephen Harper saner than Gaddafi? Was aggressing Iraq on a contrived pretext and slaughtering upwards of a million Iraqis and forcing millions more to become refugees sane?

Can mass murders be sane? Is not mass murder the apical quintessence of sociopathology? Meanwhile, the killing continues under Obama whose sanity Fisk has never called into question.

Fisk’s entire piece is tinged with bias and demonization. For example, he writes of “Gaddafi’s tanks,” but would he write of “Blair’s tanks,”³ Cameron’s planes, or Obama’s warships?

What are readers supposed to deduce from Fisk’s superfluous ad hominem? Has he lost a journalistic marble or two?

That Arabs are saddled with authoritarian rulers is immensely due to western states foisting such rulers upon the people, as Fisk well knows.

Instead of rabbiting on about the mental delusions of Arab or Iranian rulers, Fisk might define sanity for his readers and what makes western rulers such as Bush, Blair, Cameron, Obama sane versus Middle Eastern rulers. Otherwise, he is casting stones from a glasshouse.

Fisk realizes that the invasion of Libya now is “a Nato force committed to regime-change…”; however, he does not delve much into the more important matter of whether regime change is legitimate or sane.

He does address whether “we” should be the ones to invade. In doing so he neglects recent history when he writes: “However bad our behaviour in the past, what should we do now?” He finds such a question is too late. Late or not, surely a retreat into a distant past is unnecessary when invasions/occupations in Iraq, Afghanistan, Haiti and succor to coups in Honduras and Venezuela are current history. And there is the decades-old, ongoing western — overt and tacit — support for the dispossession of, discrimination against, and killing of Palestinians.

Gaddafi may well be mentally unbalanced, but he is not launching insane massive invasions of far-flung countries. Criticizing his long tenure as a “leader” in Libya is also fine; however, this criticism should be applied equally to other countries. There is virtually no US criticism of the unelected Abdullahs in Jordan or Saudi Arabia, the unelected king Hamad bin Isa Al Khalifa in Bahrain, nor was there of the despotic ruler of Egypt — Hosni Mubarak.

Surely what “we” should not be doing now is focusing on psychologically assessing the mental fitness of rulers from afar, while giving free passes to “our” own rulers who are, at a minimum, accomplices in mass killing. As for colonially created nation states, I submit what they should do now is try to undo the monumental crimes they committed against Indigenous peoples whose land they stole and remain in occupation of before passing judgement on others.

1. Robert Fisk, “First it was Saddam. Then Gaddafi. Now there’s a vacancy for the West’s favourite crackpot tyrant,” Independent (UK), 19 March 2011.
2. Mercenary is arguably an apt term for fighters in western “volunteer” militaries because surely a number of them enlisted for a paycheck
3. My internet search turned up nothing attributable to Fisk on this nor for “Blair’s warships,” “Blair’s ships,” “Blair’s planes,” and since the British public is Fisk’s main readership, this search was deemed sufficient. I leave it to more diligent readers to try and snoop out such a quotation.

Human Resources begins with the psychological research on animal behavior, how rat, dog, pigeon behavior might be shaped. Behaviorist scientists John B. Watson and B.F. Skinner applied the behavior-shaping experiments to humans.

The human experiments turned even more sinister with an emphasis on eugenics, which is based in the notion that there are superior and inferior humans, superior and inferior races. Academia was very much involved in this movement, and as the documentary points out, it went to the highest levels of government, as president Calvin Coolidge supported eugenicist notions. Corporations funded the research, with the Rockefellers playing “a particularly devious role,” said historian Sharon Smith.

Rebecca Lemov, author of World as Laboratory, said the Rockefeller largesse made for the most funded social science project in history.

Taylorism and the Disempowerment of Workers

Even though moral philosopher Adam Smith had warned against the division of labor, another man, Frederick Taylor, disagreed. He atomized the workplace and work tasks. He set target times for worker tasks. This increased efficiency but at a cost of de-skilling workers and disempowering them.

Skilled labor was undermined by the atomization of tasks, the result being a loss of power and control by skilled workers. The exemplar is the assembly line instituted by anti-worker Henry Ford, which consolidated hierarchical control.

Human Resources calls it dehumanizing.

Labor does not need to be dehumanizing though. Human Resources interviews Michael Albert who, with Robin Hahnel, espouses an economy called participatory economics – or parecon. Albert says the corporation is pathological.¹ The pathology is the drive for profit without concern for people or the environment. The parecon workplace is egalitarian.

Paradoxically, Bolshevik leader Vladimir Lenin supported Taylorism’s scientific management although it was disliked by workers. Human Resources quotes Lenin: “Socialism is merely state-capitalist monopoly.” If this is the case, then the state has merely replaced the corporations in the economic system, and the Marxist refrain of a dictatorship of the proletariat becomes a meaningless slogan.

Human Resources argues that Lenin and Trotsky destroyed socialist institutions and waged a war against anarchists. They forced industrialization, leading to totalitarianism.

Thus, argues anarchist professor, Noam Chomsky, the term “socialism” became degraded.

Mikhail Bakunin, an anarchist opponent of authoritarian Communism, had foreseen the dangers of the state. Consequently, hierarchical political systems became entrenched worldwide.

Political scientist Stephen M. Sacks discusses the Hawthorne experiments, which looked at the quantity of work and worker satisfaction. It found that having discussions with workers, regardless of whether or not workers concerns were taken into consideration, increased productivity. Sachs says it doesn’t have to be that way. The workplace can be democratized.

Why should the economic system not be rational, for example, like a parecon?

Educating Workers

Educator John Taylor Gatto, author of Dumbing Us Down, illustrated how the education system makes people unable to think in context. Initially, he says, compulsory schooling was resisted by parents (who battled for control) and enforced by state militia.

Corporations, however, feared educated workers, and students were converted into “obedient tools.”

Educational theorist Alfie Kohn extolled on the paucity of critical thinking and debilitation of forced competition. He argues against grading because grades 1) cause a loss of interest in learning; i.e., it is no longer learning for the sake of knowledge, 2) lead to shallower thinking, and 3) lead students to choose easier tasks (the logical choice).

Competition, says Kohn, undermines character and destroys relations. He points to research which shows that competition isn’t necessary for excellence and tends to impede excellence at most tasks. Competition disrupts more difficult tasks and problem solving.

“Excellence,” he says “pulls in one direction and competition in another.”

If the system is one of competition, then that system must have winners and losers of competition. What does that mean for a society?

The Origins of Violence

Noble segues into causes of violence. He turns again to behaviorist psychology (which really does not have that much sway in contemporary psychology) and the frustration-aggression hypothesis which states that thwarting people from achieving their just rewards frustrates them and leads to aggression.

Human Resources portrays rampant hatred of the other in American society that is promulgated by the media. Historian Howard Zinn, in one of his last interviews, saw an intentionality in design; the hatred of others is scapegoating — deflecting the anger onto to others so the system can perpetuate itself.

Anthropologist Elliot Leyton even implied the system as being partially responsible for mass murders. He saw multiple murderers as “alienated individuals … that represent central cultural themes” that “are relatively ignored by government institutions…”

Governments, said Leyton, focus much more on control of public than serial and mass killers. “Governments and politicians are the main killers.” The state is a mass murderer.

Human Resources holds that modern military training best encapsulates the frustration-aggression hypothesis. The military funnels frustration into hatred and fear of a group.

Fear was used to manipulate human behavior.

Mind-control Experimentation

The CIA’s mind-control project MKULTRA “abandon[ed] any pretense to morality, leading to a nightmarish search for the holy grail of social engineering: a fully controlled, fully obedient human being.”

Projects included Artichoke, Bluebird, MKULTRA (truth serum, mind wipes) etc. Since 1973 these projects remain classified.

Under the auspices of the government, military, CIA, academia (universities and “leading professors”) drug, electroshock, brain surgery, noise manipulation, and other experiments were carried out on animals, patients, soldiers, citizens, and even children as “unwitting guinea pigs” for various drugs. Among the outcomes were psychosis and death. Compensation is denied for many cases.

Psychiatrist Colin Ross says authorities typically deny human experimentation, or when undeniable blame the laxer restraints of the time period. In the case of children used in mind-control experiments, national security was proffered as a justification.

MKULTRA was deemed a failure except that it produced Kubark, in essence a “torture manual.” It detailed deprivation experiments, stress positions, and electric shock – all used by US personnel on humans at Abu Ghraib, as horrific video shows.

How is that humans can live in a system that subjects them unwittingly to dangerous experimentation? How is it they can allow their country to terrorize people in other countries in a “war on terror”?

Human Resources points to TV and its fear-based programming which becomes reality. TV entertains but it also induces passivity and suggestibility in people.

Eugenics underlies Human Resources. Yet, a capacity for cruelty has been demonstrated in supposedly learned people, even by those who might consider themselves superior: management, politicians, commanders, and doctors.

Human Resources is another excellent documentary by Noble – a documentary that should cause all people to question the nature of the society they live in, who the authorities serve — and even more — should society have authorities, should it exist as a hierarchy? The film causes us to ask who we should fear – the authorities who pursue the development of weapons of mass destruction, who develop and implement the practice of torture, who use their own citizenry as unwitting guinea pigs? Who is the genuine terrorizer? Who is the genuine enemy?

1. The thesis of another excellent documentary, The Corporation.

In his Escape From Freedom, the radical psychoanalyst Erich Fromm described the features of authoritarian psychology: hierarchical relations (dominance/submission), military nationalism, and the worship of brute-technical force.  To the authoritarian character, Fromm wrote, “the world is composed of people with power and those without it.  The very sight of a powerless person makes him want to attack, dominate, humiliate him.”  The prototype for the dominant-vengeful ruler was the authoritarian father who harshly punished disobedience through physical and/or emotional abuse.  The cycle perpetuated itself, as the humiliated child, displacing his rage through a potent “identification with the aggressor,” would himself eventually experience the power-thrill of dominating the weak. ²

In Bush’s case, as the psychoanalyst Justin Frank noted in his devastatingly revealing Bush on the Couch, the authoritarian-punitive parent who administered harsh disciplines was his mother.  In a chapter entitled “The Smirk,” Dr. Frank offered abundant evidence for Bush’s sadism and destructiveness, from blowing up frogs as a child to rubber-stamping the execution of a record number of death-row inmates while governor of Texas.  Ultimately: “The sadism that motivated the war [was] evident in Bush’s lack of a plan for postwar Iraq: the invasion was an end in itself.” ³   Given the dynamics of a dominant-punitive mother and remote, often-absent father, Bush’s sadism seems to have been complemented by compensatory displays of “protest masculinity”–such as his belligerent rhetoric, or swaggering in a flightsuit aboard the U.S.S. Abraham Lincoln.

I might note as well as that, according to the diagnostic manual of American psychiatry, youthful cruelty to animals as well as substance abuse are predisposing factors to a possible adult diagnosis of sociopathy (“antisocial personality disorder”).  Certainly Bush often exhibited the roguish charm of the con-artist, as he gratuitously lied or invented “facts”–and blithely broke laws, shredded treaties, ordered (illegal) torture and joked about not finding WMD under his desk.  Indeed, manifestations of Bush’s lawless mentality—such as deceitfulness, impulsivity, aggressiveness, irresponsibility, reckless disregard and lack of remorse—are defining traits of sociopathy. ⁴   Evidently, as members of an elite profession, psychiatrists were reluctant even to consider that the individual holding the most elite position in the country was significantly sociopathic.  Perhaps more insidiously, as Dr. Frank suggested, the leader Bush became a sadistic role-model, “normalizing” the unleashing of aggressive, vengeful attitudes in everyday social life.

Authoritarian social relations are hierarchical power relations, whether in patriarchal families or in the militarization of society as a whole.  The compulsive need to dominate: top Bush administration figures were impatient to vindictively crush defiant former clients such as Saddam Hussein, to bend them into submission or destroy them entirely.  The eagerness to “go to war,” with only the flimsiest of pretexts for doing so, inadvertently revealed the anxiously awaited delight in cruelty: the anticipated satisfactions of punishing, killing, and destroying “targets.”

It is hard to deny the enduring link in American culture between authoritarian upbringing, right-wing ideology and the cult of militarism.  Identification-with-the-aggressor: insofar as “they are powerless,” demonized foreigners “offer a vast opportunity for sadistic satisfaction” for a soldier otherwise consigned to a humiliatingly low-status back home.  The power to kill or dominate, total control over helpless victims: most infamously exhibited in the unmistakable enjoyment of the perpetrators at Abru Ghraib. Once ordinary people—whether in Iraq or elsewhere—were demonized as the “enemy,” there was little limit to the sadism inflicted (and tacitly accepted by Bush and his gang).  Military sadism on a mass scale has also been grotesquely exhibited in such fiendish, redundantly cruel weapons of torment such as white phosphorus, napalm and cluster bombs.

In his last major work The Anatomy of Human Destructiveness, Erich Fromm offered this psycho-political insight: “The sadomasochist has also been called the ‘authoritarian character,’ translating the psychological aspect of his character structure into a political attitude.  The concept finds its justification in the fact that persons whose political attitude is generally described as authoritarian (active and passive) usually exhibit (in our society) the traits of the sadomasochistic character: control of those below and submission to those above.” ⁵

1. Ron Rosenbaum, Explaining Hitler, Random House, 1998; p. 188
2. Erich Fromm, Escape From Freedom, Fawcett Books, 1965 [1941], pps. 190-191. See also: Alice Miller, For Your Own Good: Hidden Cruelty in Childrearing and the Roots of Violence, Farrar, Straus & Giroux, 2002
3. Justin Frank, M.D., Bush on the Couch, Regan Books, 2004; p. 118
4. Diagnostic & Statistical Manual of the American Psychiatric Association, 4th edition, 1994; pps. 98-99, 704-706
5. Erich Fromm, The Anatomy of Human Destructiveness, Holt, Rinehart & Winston, 1973; pps. 290-292

Remarkably, Renaldo hired in already diagnosed as schizophrenic.  Because medical confidentiality dictated that only Health Services (the nurse and company doctor) knew about this diagnosis, no one else in the facility — from the floor supervisors to Human Resource personnel to the plant manager himself — were aware of his condition.

While media reports have indicated that Jared Loughner, troubled as he was, never sought or received professional care, Renaldo was seeing a doctor.  Indeed, his psychiatrist had stated that Renaldo’s schizophrenia was treatable, and that so long as he stayed on his prescribed medication he should be able to function in an industrial environment, even one as stressful as ours.

Carl’s circumstances were different.  His illness progressed over the course of several years.  Although I knew Renaldo fairly well (we once played half-court basketball together), I knew Carl even better, having trained him for 80 hours as a new-hire fresh off the street.  In the way that trainers and trainees often bond, we hit it off and became work friends.  Carl was a great kid:  boisterous, enthusiastic, generous, out-going, fun to be around.

Renaldo was quieter.  Although he regularly unnerved people with his comments and actions, no one was frightened of him because he was too polite and deferential to scare anybody.  Renaldo had two basic personas: mellow or manic.  Alas, there was precious little in-between.  Some of the older employees spread rumors that he was on drugs, but the younger ones, those who’d experimented with drugs themselves, thought otherwise.  Whatever Renaldo’s problem was, they didn’t believe it was drugs.

One day Renaldo was sitting all alone in a break area, laughing at some private joke.  He began laughing so hard that his face and neck turned beet-red and his body began trembling.  After watching him a moment or two, I made casual eye contact with a woman sitting about forty feet away who’d also been watching.  She gave me an all-knowing look, then put her finger to her temple and made the circular “coo-coo” sign.

In his third or fourth year in the plant (he would have been about 30 years old by then), Renaldo was fired for assaulting a fellow worker.  Without his parents’ or doctor’s knowledge, he had stopped taking his meds, and in a psychotic episode on graveyard shift, violently wrestled a man to the ground and tried to choke him.

It was during the union’s investigation of the incident that we learned of his schizophrenia.  Because physical violence — no matter what the cause — will always be grounds for termination, Renaldo was immediately discharged, and that was the last anyone heard of him.  Everyone, including the man he attacked, felt sorry for the poor guy and wished it could have ended differently.

Carl’s case was sadder.  Over the years it had become apparent to those closest to him that he was undergoing some sort of transformation.  Besides the inappropriate comments, the temper tantrums, the manic outbursts, he’d become a religious zealot, going around the converting department lecturing people on the Bible and screaming about God.  A forklift driver once found him crouched behind a stack of pallets, sobbing as he prayed.

The obvious question:  Why didn’t we do something to help him?  There’s no easy answer.  As president of the union at the time, I honestly believed it was the company’s responsibility — and not ours — to deal with something like this.  After all, this was their plant, they were the ones in charge, and they had the resources and authority.

But human behavior can’t always be conveniently classified.  Just because someone behaves strangely doesn’t mean they’re mentally ill.  No one — not even those who were alarmed by his antics — wanted to embarrass themselves or harass Carl by going to the authorities and pointing an accusing finger.  In truth, there were lots of eccentric folks working in that nearly 1,000-person facility.  It was part of the plant’s charm.  Carl just happened to be one of them.

Moreover, he drifted in and out of these phases, so there were prolonged periods where he seemed almost normal.  Yes, he could express oddball opinions with lunatic certainty, and yes, he occasionally screamed at people.  But he never threatened anyone and never appeared dangerous.  One of Carl’s pet insults was to call people “hemorrhoids,” which, while crude and juvenile and tiresome, was usually greeted with weary smiles or exasperation rather than hurt feelings.  It was just Carl being Carl.

As for his frequent shows of rage, they were extreme but not incomprehensible.  As anyone on the floor could tell you, displays of temper weren’t exactly rare on a high-stress production line.  And although some people did regard his religious zealotry as off-the-chart bizarre, others took a broader, more understanding view of it, writing him off simply as “a religious nut.”

Unlike Renaldo, who lost his job due to violent aggression, Carl lost his as a result of a hideous, self-inflicted accident.  It happened on swing-shift.  As the crew watched in horror, Carl walked up to a piece of high-speed machinery and deliberately reached into it, snapping a bone and mangling his arm.  When they pulled him out, he was as white as a sheet and in shock.

It was after this incident that we learned he had been under the care of a psychiatrist.  In the hope of saving his job, his mother gave the union written authorization to see his complete medical record.  To laymen like us, who knew next to nothing about mental disorders, reviewing that dreadful document was both heartbreaking and terrifying.  We were unprepared for it.  We had no idea he was this sick.

Carl was given a medical retirement.  The last anyone heard of him was a couple years later when one of our members saw him at the LA County fairgrounds, working as a parking lot attendant, and said hello to him.  She barely recognized him.  “It looked like he’d gained a hundred pounds,” she said.

It’s clear to me now that waiting for the company to act was irresponsible.  The union should have intervened.  If the union executive board had insisted that Carl be examined by company doctors, they would have done it, because we had that power.  Not only did we have that power, as awkward as it might have been, we had that duty.  We could have prevented his accident.

On the other hand, several people later observed that we had all been lucky.  As disturbed as Carl was, instead of injuring himself — which was tragic enough — he could just as easily have entered the plant with a loaded gun in his lunchbox.

In the Realm of Hungry Ghosts: Close Encounters with Addiction
By Gabor Maté, MD (2008)

As in his two previous books, Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder (1999) and When the Body Says No: The Cost of Hidden Stress (2003), Maté situates human suffering in a social context, inviting a political discussion of how social relations affect human health.

Scattered Minds locates symptoms of ADD in the social neglect of children’s needs and concludes, “What begins as a problem of society and human development has become almost exclusively defined as a medical ailment.”

When the Body Says No indicts “industrialized society along the capitalist model” as a source of toxic stress that “escalates as the sense of control diminishes” and causes physical and mental breakdown.

In the Realm of Hungry Ghosts condemns society for depriving human beings of what they need to thrive and then persecuting and punishing them for using drugs to relieve their pain.

All three books are well-written, engaging and brilliantly expose the fake science that pushes a pill for every ill.
Personal solutions?

While Maté situates human distress in the social realm, he seeks solutions in the personal realm.

In When the Body Says No the author concludes,

“In numerous studies of cancer, the most consistent identified risk factor is the inability to express emotion, particularly the feelings associated with anger.” (p.99)

Maté ignores industrial pollution as a cause of cancer and promotes the myth of “the cancer personality” – people who are more likely to get cancer because they repress their emotions, ignore their needs and put others first.

Even if there was evidence to back this myth (which there is not), these characteristics are not individual failings, but behaviors that society demands of all women and that employers demand of all workers.

In Hungry Ghosts, Maté questions why the war on drugs and drug addicts continues despite its total ineffectiveness and considerable harm. He avoids the logical conclusion that this war is not about drugs; it is the means by which the ruling class very effectively justifies its repressive military-prison system.

In all of his books, Maté questions why policy makers consistently ignore the research linking child deprivation and social stress with medical and social problems. He can’t answer this question until he acknowledges the impact of class conflict; the ruling class can accumulate capital only by sacrificing the needs of the working class.

Maté’s books are commercially successful because they tap into popular awareness of social problems while avoiding the uncomfortable conclusion that social revolution is required to solve them.

The result is a liberal version of blaming the victim – society cannot be changed, so the individual must change. This regressive message is more insidious because it is hidden behind a progressive cover.

I recommend these books for the wealth of facts within them. But draw your own conclusions about the solutions we need.

Madness is best understood in relation to its social, political and economic contexts rather than the medical model of ‘mental illness.’ (p.1)

With this opening salvo, author Stephen Harper expertly challenges common assumptions about mental distress and how it is portrayed in the media.

Madness, Power and the Media situates mental distress in a historical context,

“Designating mental illness as a punishable abdication of God-given reason, the Christian Bible can be seen as the earliest ‘media text’ to stigmatize mental illness.” (p.2)

As Foucault observed, while ‘mad behavior’ has been documented for centuries, the ‘mad person’ was created by the 19th century practice of incarcerating those displaying such behavior. Harper concludes, “psychiatry constituted a powerful means of ideological and physical containment” (p.5).

As early as the 14th Century, psychiatric labels were used to discredit social revolt.

“The Peasants’ Revolt of 1381, for example, was described within official discourse as an outbreak of diabolical madness which threatened to overturn the supposedly natural and divinely ordained feudal hierarchy.” (p.2)

Psychiatric diagnoses continue to be used to persecute and incarcerate social and political rebels (i.e., the 1930s eugenics purges in the US, the UK and Nazi Germany and the designation of homosexuality as a mental disorder in the 1970s).

Alongside the religious condemnation of madness, there also developed a secular image of the hero, driven mad by suffering, who rebels against an oppressive social order. As a result, the media not only equates madness with violence, but also with genius and understandable responses to oppression or persecution (Pi).

The media can both villainize and romanticize mental illness.

…by embracing a sense of victimhood and vulnerability, Western culture has succumbed to an infantilising celebration of mental fragility, a development which undermines the capacity of human subjects to take control of their lives or to engage in political activity. (p.7)

Harper cites television series (Profit) and movies (American Psycho) to show how the media sometimes uses individual madness to illustrate the insanity of the capitalist system. These media

“… feature conscience-free anti-heroes who epitomize the values of corporate capitalism and who are nonetheless – or perhaps therefore – merciless killers.” (p.6)

While the State raises the spectre of the ‘mad rebel,’ the pharmaceutical industry prefers to portray mental illness sympathetically, and the mentally ill as victims, in order to expand the market for its remedies.

Madness, Power and the Media is unique among the many books that address these issues, because it

…attempts not simply to applaud or condemn media and film images of madness as ‘positive’ or ‘ negative’ from the inevitably narrow perspective of medical discourse, but to also understand how these images can underline or reinforce the unequal relations of class, race and gender which characterize contemporary capitalist societies. (p.7)

Harper emphasizes that the media portray mental distress differently depending on the race, gender and social class of the sufferer, and these portrayals reinforce class, race and gender oppressions.

Madness in men and upper-class individuals tends to be portrayed as more heroic and creative (Shine) than madness in women, which is shown as more tragic and irrational (The Hours) and madness in working-class individuals, who are typically portrayed as social rejects and deranged killers.

With the odd exception (The Soloist), non-white characters rarely appear as protagonists on television and in films that feature mental distress, even though visible minorities are disproportionately represented in psychiatric institutions.

I especially appreciated the way that Harper challenges both the media portrayal of the mentally ill as more violent (which has no social context) and those who protest that they are not violent (which also ignores social context).

There is… a clear link between violence and poverty…[P]eople suffering with mental distress often belong to a lower social class than those who do not; their higher rates of violent behaviour might therefore be explained in terms of their frustration or anger at their lack of social power… Understanding violence as a response to social coercion is strategically useful, dislodging the stigmatizing notion of violence as an individual act of evil. (p.46)

Harper contrasts the violence of the mentally ill individual with the systemic violence perpetrated by politicians (war, imprisonment, unemployment, strike-breaking, poverty, etc.). While these ‘pillars of society’ are considered sane, they are far more dangerous to society. He concludes that violence can be both oppressive and liberatory, depending on which social class is wielding it and for what purpose.

On reading this book, one is struck by the extent to which mental distress is featured in film, television and print media and the different ways that it is portrayed – as comedic, tragic, heroic, criminal, vulnerable, violent, admirable, despicable, endearing and threatening.

When it comes to treating mental distress, the media universally promote individual solutions and the personal cultivation of happiness while excluding any discussion of social change.

Harper provides a detailed and informative discussion of how men’s and women’s magazines handle mental distress differently, while both obscure the social sources of distress.

As a Marxist, Harper views mental distress as a reasonable response to social inequality, insecurity and alienation, and he questions how psychological equilibrium can be achieved in a context of unequal social relations. He identifies capitalism, rather than neoliberalism, as the problem and argues,

“…for the suppression rather than the reform of capitalism; alienation and poverty are structural features of capitalism itself rather than the side-effects of any particular phase of its development.” (p.198)

Madness, Power and the Media is rich in detailed, thought-provoking analysis. Harper has done an excellent job of organizing a huge amount of material into a comprehensive social context that is both sensitive and astute.

The biggest problem with this book is its academic language and price ($68) which limit its readership. This is unfortunate, because the ideas contained in Madness, Power and the Media should be broadly discussed among working-class readers who can solve the problems it identifies.

It is no coincidence that concerns about fascism have emerged during a time of crises. War, likely global depression, and the turmoil in their wake present an opportunity and need for refuge to people who have fear of uncertainty in their genes and their personality make-up (authoritarianism either as followers or leaders), if not outright social dominance (social dominance orientation personality dimension). Fear makes most people acquiescent, and many become obedient, in a growing vortex of authoritarian leaders and followers who become mutually emboldened – bullies who smell the opportunity to control their world or close their group and protect each other. Both Zimbardo’s Stanford Prison Experiment and Stanley Milgram’s obedience to authority research illustrate what some (many) of us can do when fear and control become institutionalised. Theodor Adorno called this the ‘authoritarian embrace’. Outright authoritarians (right wing authoritarianism; RWA) are few, perhaps around ten percent of the population, and those whose authoritarian genes can be switched on during times of crisis and fear represent around twenty percent more. That is no more than a third of the population primed to bring fascism into being, but this minority make themselves heard, and felt, visciously, intuitively and infectiously.

How can I assert the above percentages so confidently? Well, I have watched the psychology of authoritarianism for almost two decades now, but don’t take my word for it. The authoritarian personality, or its present title Right Wing Authoritarian, has been studied since Theodor Adorno began to look for the roots of fascism after WW2. The mantle is now carried by Dr Bob Altemeyer (U. Manitoba). He is concerned enough that he published a book detailing the history of his and others’ research on the topic free online, The Authoritarians, along with a forward by Sen. John Dean whose concerns about fascism have led him to champion Altemeyer’s work. Altemeyer also recently published an addendum assessing the authoritarian personality in terms of its influence in the Tea Party movement, including reference to social dominance oriented personality which has strong links with authoritarianism.

The following is a very brief outline of Altemeyer’s findings about the enemy of humanity residing within our societies. It is a pared down quote of Bob Altemeyer’s words from his addendum to The Authoritarians - “Comment on the Tea Party Movement.” The twelve traits (and the SDO personality) form an apposite description of the RWA and SDO in terms of Tea Partiers that most can easily relate to ‘…you can hardly miss the authoritarian follower tendencies in the behavior of the Tea Partiers’ (Altemeyer). It also serves as rule of thumb that can be applied to the social world and institutions around us more generally. I write this article as a European, and I see the same traits within our own movements and institutions here. This is not solely an American problem, indeed it was in the twentieth century a genocidal European problem, and has blown up at various times globally throughout history, and even though we in Europe have no dictators and brown/black shirts at the moment we are still subtly attuned to watch for their emergence.

Twelve key traits:¹

1. ‘Authoritarian submission. Authoritarian followers submit to the people they consider authorities much more than non-authoritarians do. In this context, Tea Partiers seem to believe without question whatever their chosen authorities say […] The followers don’t find out for themselves what the Democratic leader truly said, what is really in a bill, what a treaty actually specifies, or whether taxes have really gone up. They are happy to let Rush Limbaugh and Sarah Palin do their thinking for them. It has gotten so bad that their leaders casually say preposterous things that are easily refuted, because they know their audience will never believe the truth, or even hear about it.’

2. ‘Fear. Fear constantly pulses through authoritarian followers, and Tea Partiers are mightily frightened. They believe President Obama is a dictator. […] The people who orchestrate the Tea Party movement know well what button to push first and hardest among social conservatives, and they work it overtime. And they know spreading fear “works” with others as well. Sometimes it seems they are all trying to out-boogie-man each other.’

3. ‘Self-righteousness. Self-righteousness runs very strongly in authoritarian followers, and combines with fear to unleash aggression in them. The Tea Partiers commonly describe themselves as “the good Americans,” “the true Americans,” “the people,” and “the American Patriots.” They could hardly wrap themselves in the flag more thoroughly or more often than they do. Theirs is the holy cause. They believe they are the only ones who can save the country.’

4. ‘Hostility. Authoritarian aggression is one of the defining characteristics of authoritarian followers. Do Tea Partiers seem particularly aggressive? […] They angrily called people who disagreed with them at the town halls “Liars,” “Communists,” and “Traitors.” They booed and booed until opposing speakers simply gave up. They lashed out at elected representatives who tried to engage in dialogue. If you look at some of the videos of last August’s protests, you can see veins bulging in the necks of some of the Tea Partiers as they vented their fury.’

5. ‘A lack of critical thinking. Authoritarian followers have more trouble thinking logically than most people do. In particular, they tend to agree with sayings and slogans, even contradictory ones, because they have heard them a lot. Thus Tea Partiers reflexively, patriotically thump that the United States is the best country on earth, but as well that it is now an Obama dictatorship. They also have extra trouble applying logic to false reasoning when they like the conclusion. A ready example can be found in Tea Partiers‟ assertion that Obama is a socialist. They have heard this over and over again from Rush Limbaugh, etcetera, and “so it must be true.” But Obama has never advocated state ownership of an industry. He certainly did not advocate state ownership of health insurance, and eventually even backed away from the “public option” (that most Americans wanted) which would have let the government as well as private companies offer health insurance.’

6. ‘Our “biggest problem.” Authoritarian followers will readily believe that lots of things are our “biggest problem.” It can be drugs, the decline of religion, the breakdown of the family, you name it. Thus it was not hard to get Tea Partiers worked up about, of all things, a plan to improve health care to the levels found in other industrialized countries. Yet Tea Partiers believe the passage of the health care bill marks the end of liberty. But they could just as easily have been led to believe that climate change legislation, nuclear disarmament, gay marriage, or taking “In God we trust” off the money would sound the death knell for America. In earlier eras it could have been sex education, Sunday shopping, the 40-hour week, or a Catholic president that would lead to our doom.’

7. ‘Compartmentalized thinking. Authoritarian followers can have so many contradictory beliefs and “biggest problems” because their thinking is highly compartmentalized. Ideas exist independently of the other ideas in their head. Their thinking is so unintegrated because they have spent their lives copying what their authorities say, without examining whether the ideas fit together sensibly. And Tea Partiers say over and over that the Democrats are installing a dictatorship, but they demonstrate every time they demonstrate that Americans still have all the freedom of speech they ever had. And one notes the health care reforms bear a striking resemblance to Social Security and Medicare—which many of the protestors happily enjoy and would never give up.’

8. ‘Double Standards. Highly compartmentalized thinking makes it easy for authoritarian followers to employ double standards in their judgments. One finds many examples of this among the Tea Partiers. […] Tea Partiers also protested about the federal deficit growing by unprecedented leaps and bounds under Obama. But it grew by unprecedented leaps and bounds during George W. Bush‟s presidency, and demonstrations against that were few and far between. […] It’s pretty clear that many, many Tea Partiers aren’t really against the things they say they’re against. For them, it‟s OK when Republicans do these things. But that is pure hypocrisy, which one finds in abundance among authoritarian followers. And in their leaders, such as the various governors who condemned the stimulus package, said they would refuse such funds, but then accepted them and had their picture taken at project announcements that followed.’

9. ‘Feeling empowered when in groups. Authoritarian followers seem to want to disappear as individuals. They‟re not comfortable taking stands on their own, or acting alone. Instead they seem fulfilled simply by being part of a large, powerful movement on the march. Thus the insult-hurling Tea Partiers probably would have been quiet, even deferential, had they met with their member of the House one-on-one last August. But experiments have shown that authoritarian followers are highly conforming. When they are in a group of like-minded persons they are much more likely to do things, especially aggressive things, that they would not do alone. They make a good mob, winding each other up by hearing each other yell.’

10. ‘Dogmatism. We also know that authoritarian followers lead the league in being dogmatic. When their leaders set their opinions for them, those opinions are set in stone. Experiments show that nothing (aside from their authorities) can convince them they are wrong. If overwhelmed by logic and evidence, they simply “castle” into dogmatism. This is probably because they don‟t really know why they believe what they believe. They didn‟t figure it out for themselves; they Xeroxed what their authorities said.’

11. ‘Ethnocentrism. Authoritarian followers are notably ethnocentric, constantly judging others and events through “Us versus Them” lenses. They largely choose their friends according to their beliefs. They stick to news outlets that tell them what they want to hear. They live in a polarized world, divided into their in-group, and out-groups consisting of everybody else. They stress in-group loyalty, and try to keep their distance from the out-groups. […] This fierce in-group orientation, along with the followers‟ need for external confirmation of their beliefs, explains why Fox News has such a big audience compared with other outlets, why Sarah Palin‟s, Glenn Beck‟s, and Ann Coulter‟s books leap to the top of the best sellers lists, and why “hate radio” is so popular. Authoritarian followers have to get their ideas “validated” by others more than most people do. So they constantly seek out sources of information that will tell them they‟re right. It amounts to in-group in-breeding of the intellect. Research shows that less authoritarian people are more likely to consider different sides of an issue, and figure things out more for themselves.’

12. Prejudice. Studies have found that authoritarian followers are among the most prejudiced people in society. It is the nastiest aspect of their ethnocentrism, and one they insistently deny—to others and to themselves. And they really do not realize how prejudiced they are, compared with others, because they associate so much with other prejudiced people. So their prejudices seem normal and perfectly justified to them.

Racial prejudice appeared at many of the Tea Party demonstrations, in the form of signs, banners, and tee-shirts—just as it did during the 2008 campaign after Sarah Palin energized the social conservatives.

Social Dominance Orientation (also Altemeyer’s words)

‘Because the Tea Partiers display so many “classic” signs of authoritarian followers, I think it‟s safe to conclude that a lot of the members have such personalities. But another sizeable group swells the ranks who would seem to have little tendency to follow anyone: libertarians. And while the two contingents may agree on many economic issues, they appear to have fundamentally different views of government and liberty.

[…]

Poor people are poor, they say, simply because they are lazy. We should not extend unemployment benefits to the people laid off now because it will just encourage them to watch TV instead of looking for work. The poor people who accepted the banks’ invitation to buy nice houses for their families at low interest rates were “reaching beyond their class” and deserved to lose them. The rich are rich simply because they worked harder than everybody else, and deserve their wealth. Obama is taking money from those who work hard to buy votes from people demanding hand-outs.

These attitudes come right out of the catechism of the other authoritarian personality that research has discovered, the social dominators. Their defining characteristic is opposition to equality. They believe instead in dominance, both personal (if they can pull it off) and in their group dominating other groups. They endorse using intimidation, threats, and power to enrich themselves at the expense of others. This is the natural order of things, they believe. “It is a mistake to interfere with the law of the jungle,‟ they argue. “Some people were meant to dominate others.” “It’s a dog eat dog world in which the superior people get to the top.”

Such people may want government to stick to running fire departments so they can rise/stay above others unimpeded. Research shows that social dominators are power-hungry, mean, amoral, and even more prejudiced than the authoritarian followers described earlier. They want unfairness throughout society. Barack Obama, and the ludicrous perception that he is going to lead African-Americans in “taking over America” would be their worst nightmare. So the hypothesis that the Tea Party movement has more than its fair share of social dominators may have merit.’

The authoritarian and social dominance personality types and fascism

The above descriptions of personality in the Tea Party by Dr Bob Altemeyer, the leader in his social science field, show us how personality can define a social movement. I would have confidence in the conjecture that the rise of the Nazis and many other fascist totalitarian empires probably started with a similar spectrum of personality traits coming together and forming a movement which through its emotive force became unstoppable. The sheer power of a movement comprised of a mass of aggressive people who do not think for themselves and simply follow their saviour, combined with a leadership that knows only too well how to push their buttons, this should give us all pause. It is the reason I try to inform people about the very real dangers of fascism taking hold in a time of uncertainty. Fear and the need for self protection and selfish opportunism is probably the core driver in the nexus of publicly organised RWA and SDO behaviour, and we are now in an age where this emotion can easily be set running in the population much more widely. We need to be aware of what the politics of fear is doing in our institutions in order to find ways of countering it.

Want to help spread the word? See Bob Altemeyer’s website, there is an email discussion list for those interested in RWA psychology, and a Facebook group Authoritarian Watch.

1. All quotes from “Comment on the Tea Party Movement,” Altemeyer.

Ablechild (Parents for A Label and Drug-Free Education), is a national non-profit founded in 2001, by these two mothers who each had personal experiences with being coerced by the public school system to label and drug their children for ADHD. Patty and Sheila went from being victims to become national advocates for the fundamental rights of all parents and children in the US.

Now with thousands of members, Ablechild acts as an independent advocate on behalf of parents whose children have been subjected to mental health screening and psychiatric labeling and drugging, and as a proponent for children in foster care who are improperly treated with psychotropic drugs, many times off-label, without informed consent.

Long Battle Against Coerced Drugging

Roughly eight years ago, on September 26, 2002, then Chairman the US House Government Reform Committee, Congressman Dan Burton (R-IN), held a hearing on the “Overmedication of Hyperactive Children,” prompted by a series in the New York Post.

“It’s estimated that 4 to 6 million children in the United States take Ritalin every single day,” Burton said in his opening statement. He pointed out that Ritalin was a Schedule II stimulant under the Federal Controlled Substances Act, that research showed it was a more potent transport inhibitor than cocaine, and use in the US had increased over a 500% since 1990. The Schedule II category also includes drugs such as cocaine, morphine, and Oxycontin.

On one side of the issue, Burton said, they would hear from the associations of psychiatrists and an organization known as Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD), and they believed 13% of the US population suffered from an attention disorder and it should be treated with medication.

At the other end of the discussion, he said, was the Citizens Commission for Human Rights (CCHR), and concerned parents, who challenged the legitimacy of calling ADHD a neurobiological disorder and raised questions about giving psychiatric drugs to children. Two of these “concerned parents” were Patty Weathers and Neil Bush, the brother of then President Bush, who was pressured by a private school in Houston to drug his son with Ritalin after he was misdiagnosed with ADHD by the school.

Unsung Hero: Patty Weathers

At the hearing, Patty testified about the ordeal she and her son, Michael, went through in a public school in New York State that began in 1997. When Michael entered first grade, the teacher told Patty his learning development was not normal and he would not be able to learn without medication.

“Near the end of first grade, the school principal took me into her office and said that unless I agreed to put Michael on medication, she would find a way to transfer him to a special education center,” Patty told the committee.

At this point, his teacher filled out an actor’s profile for boys, an ADHD checklist, and sent it to his pediatrician, she said. “This checklist, along with a 15-minute evaluation by the pediatrician, led to my son being diagnosed with ADHD and put on Ritalin.”

Michael was not given a physical exam prior to the prescribing of Ritalin and no exams were conducted during appointments when refills for prescriptions were written.

“I would never have subjected my son to being labeled with a mental disorder if I had known that it was a subjective diagnosis,” Patty told the panel. “I would not have allowed my son to be administered drugs if I had been given full information about the documented side effects and the risks.”

“At no time was I offered any alternatives to my son’s needs, such as tutoring or standard medical testing.” she said. “The school’s one and only solution was to have my child drugged.”

Early on, Michael experienced the common side effects of Ritalin, such as sleep problems and loss of appetite, and by the third grade, Michael became withdrawn, stopped socializing with other children, and began chewing on pencils and other objects. He was then put on Dextrostat, an amphetamine, which only worsened the problems.

But instead of recognizing the drug side effects, the school psychologist then claimed Michael had either bipolar or social anxiety disorder and needed to see a psychiatrist. The psychologist gave Patty the number for a psychiatrist to call and the psychiatrist talked to her and Michael for a short time, and “again, with the aid of school reports, diagnosed him with social anxiety disorder,” she recalled.

Without telling her it was not approved for children, the psychiatrist prescribed the antidepressant, Paxil, saying it was a “wonder drug for kids.” “Those were her exact words,” Patty told the committee.

The drug cocktail caused even more horrendous side effects, until Michael’s behavior became so out of character that Patty could not even recognize her own son. “Through this whole ordeal, the school psychologist’s favorite saying was that it was trial and error,” she said. “If one drug didn’t work, try another.”

After watching Michael become violent, psychotic, hear voices and hallucinate, Patty stopped giving him the drugs. Not recognizing that he was going through withdrawal, the psychiatrist wanted to hospitalize Michael and try different sedatives and antipsychotics until they found “the right one,” but Patty refused to allow it.

After she became unwilling to give Michael the drugs, “the school threw him out,” she told the panel. “As a final blow, they proceeded to call Child Protective Services on my husband and I, charging us with medical neglect for refusing to drug our child,” she said.

The complaint filed by the school stated in part: “[Michael's] behavior at school is bizarre: He hears voices and appears delusional, he chews on his clothes and paper, he talks to himself and rambles when he talks.”

A month-long investigation cleared the charges and independent psychiatrists determined the bizarre behaviors were caused by the drugs and Michael did not need hospitalization. Medical testing by Dr Mary Ann Block, a Texas osteopathic physician, later showed that Michael suffered from anemia, hypoglycemia and allergies. When those conditions were treated, any attention problems disappeared.

On August 7, 2002, the New York Post ran a front-page article featuring Patty’s story. Within a few days, over 65 parents came forward to describe similar stories of coercion and intimidation used by school districts to strong arm them into drugging their kids.

Unsung Hero: Sheila Matthews

Connecticut mom, Sheila Matthews, turned on the TV one day and saw Patty testifying on C-Span at a hearing titled, “Behavioral Drugs in Schools,” on September 29, 2000, before the US House Subcommittee on Oversight and Investigations, Committee on Education and the Workforce.

Sheila immediately related with Patty because she was then going through what she would later call the “ADHD nightmare,” of being pressured to put her 7-year-old son on Ritalin, after he was screened and diagnosed with ADHD by a school psychologist, with claims he would “self-medicate” and end up a drug addict if she did not medicate him.

While testifying at this hearing, Patty explained that being labeled made Michael feel worse about himself and “like a freak” because he “had to be drugged to go to school.”

She also voiced her concerns for other families over the intimidation tactics used by schools to coerce parents into drugging their children. “If I didn’t have family members who were willing to financially back my son and I in my son’s cause, it is entirely possible that my son would have ended up in a psychiatric ward,” she told the panel.

That very day, Sheila made up her mind to expose the misleading information being given to parents about so-called mental disorders in public schools and expose the coercive tactics being used on parents who refused to label and drug their children.

She wanted to meet Patty so she contacted the Congressional office and they put her in touch with Marla Filidei, Vice President of CCHR International. Marla hooked her up with Patty, and together, they founded Ablechild.

National Spokespersons

Over the past ten years, Patty and Sheila have become national spokespersons. The normally shy, quiet Patty has made appearances on more than two dozen media programs including ABC’s Good Morning America, the Today Show on NBC, Hannity & Colmes, on Fox, CNN’s Lou Dobbs, A&E’s Investigative Reports, and Montel Williams.

She has also been interviewed for stories in major newspapers including the New York Times, New York Post, USA Today, and Christian Science Monitor, as well as Time, People, and Redbook magazines, and has been interviewed by Gary Null, Sean Hannity, Michael Regan, and other popular radio talk show hosts.

In February 2001, Patty received a “Human Rights Award,” from CCHR, and was recognized for standing up against the injustice of psychiatric labeling and drugging of children in public schools at the group’s annual banquet. Sheila received an award from CCHR in 2002, and was recognized for her hard work and role as national spokesperson.

Sheila has also appeared on TV numerous times including shows on CNN, NBC and Fox, and has been interviewed on many talk radio programs. Her story has also been featured in major newspapers and magazines.

In her home state of Connecticut, Sheila worked with State Representative, Lenny Winkler (a nurse by trade), to secure passage of the first state law in the country that restricts schools from suggesting psychiatric diagnosing and drugging of any child as a condition of attending school. She testified before the Connecticut State Assembly about her own personal experience with the school trying to pressure her to put her son on Ritalin and the lack of validity of the disorders children are being labeled with.

Sheila was with the Connecticut Governor when he signed the bill into law in 2001 and told USA Today that she was thrilled “because it gives parents an awareness that there should be a clear difference between education and medication.”

“No other industry has total access to our children the way the psychiatric community does, and I think this new law is just the beginning of changes to come,” she told Kelly Patricia O’Meara, in an interview for Insight News.

“Kids should be off-limits as targets of convenience for the drug industry,” Sheila said. “I want the mental-health industry out of our schools.”

However, any victory celebration was short lived because in September 2001, a number of family orientated magazines began running the first ever ads for ADHD drugs. “It seems like every time we take a step forward, they come back and hit us harder,” Patty told Time magazine.

After the Connecticut law was passed, Sheila continued to work with other parents on state and federal levels to pass similar bills. By 2003, seven states had passed laws against schools coercing parents to drug their children or expelling students whose parents refused to medicate them.

On a national level, both Sheila and Patty made many trips to Washington to educate lawmakers. In September 2001, Patty and CCHR’s Bruce Wiseman and Marla Filidei, briefed legislators at a national congress of the “National Foundation of Women Legislators,” and gained their unanimous approval of a model law in the “Child Medication Safety Act (CMSA),” which mandates that: “State educational agencies develop and implement policies and procedures that will prohibit school personnel from requiring a child to obtain a prescription for a controlled substance such as Ritalin as a condition of attending school or receiving services.”

In both October and November of 2001, Sheila traveled to Washington with Marla and Lawrence Smith, whose 11-year-old son died of a heart attack caused by Ritalin, to meet with key lawmakers and discuss the crisis of children being diagnosed and drugged in schools and the need for federal legislation to end it. They also worked with Congressional staff to get co-sponsors for the CMSA

In July 2002, the nationally syndicated columnist and radio show host, Armstrong Williams, featured Sheila, Patty and Lawrence Smith in a radio show on safeguarding children from being labeled and drugged in public schools.

The next month, Patty appeared on NBC’s Today Show, on August 8, 2002, and the same day, the New York Post ran an article reporting that Patty was calling for a state wide tracking system to determine how widespread forced drugging was in schools.

Strongest Foe Funded by ADHD Drug Makers

In March 2003, Patty, Michael, and Sheila appeared on a Montel Williams show on promoting “A Parents Right to Choose,” along with Connecticut Rep, Lenny Winkler, Bruce Wiseman, Patricia Marks, Dr Mary Ann Block, and Vicky and Steve Dunkle, whose 10-year-old daughter died from Desipramine toxicity, after the antidepressant was prescribed for ADHD as a result of pressure from school officials to medicate the child.

The guests covered everything from the subjective diagnosis of mental disorders, with no confirming medical testing, to the many side effects of psychiatric drugs, to the fact that most children involved in school shootings were on psychiatric drugs. They warned that due to coercion in schools, parents all over the country were losing the right to choose whether their kids would take powerful drugs, including stimulants, referred to as “kiddie cocaine.” At the end of the program, Montel asked the audience to write to Congress asking for federal legislation against the coerced drugging of school children.

After the show aired, CHADD, the main front group for the stimulant makers, organized a letter writing campaign to Montel, who they said “mocked” ADHD, as part of responding to “offensive media depictions” of ADHD, they claimed in CHADD’s 2002-2003 Annual Report.

The group also published an open letter to Montel, saying no one would “dispute that unnecessarily placing a child on medication is deplorable.”

“But the greater travesty is delaying proper diagnosis and effective treatment for those who truly need it,” CHADD said. “The sad truth is that many more children with mental disorders slip unrecognized past the gatekeepers of mental health services than those who are improperly diagnosed.”

In April 2003, Ablechild issued a press release blasting CHADD for lobbying against the CMSA with claims that only a “handful” of incidents had occurred involving parents being coerced by schools to drug their children.

In lobbying to CHADD’s membership, the group’s CEO, E Clarke Ross, used the electronic newsletter, “News from CHADD,” to raise questions about whether the problem was common enough to require federal legislation and called such cases “isolated and highly publicized.” Because a number of states and school boards had passed laws or resolutions, Ross claimed the federal bill was “legislative overkill.”

However, for a May 13, 2003 investigative report on the CMSA published in Insight magazine, in which Ross again referred to “a few highly publicized cases,” Kelly Patricia O’Meara interviewed Mike Stokke, deputy chief of staff to the Speaker of the House at the time, and found cases of school personnel demanding that parents drug children as a condition of staying in school were far from isolated in numbers or areas.

In case after case, Stokke told Insight, “when we started meeting some of these families who have been through this problem, such as in New York, New Jersey and Connecticut, we saw the coercive action of the state come in and say that the teacher says you have to take these drugs.”

“And if you don’t it’s child neglect and the child is taken away from the parents,” he said.

“Many of the parents that we talk to are people who have the means to fight back but what is troubling,” he said, “is that there are many families out there in similar situations who don’t have the means to fight the system.”

In the press release, Ablechild noted that CHADD was only opposing the CMSA because its livelihood was at stake being the group was funded by stimulant makers. Complaints about the funneling of money through CHADD, to increase drug sales and the diagnosis of ADHD, were discussed at length during the September 29, 2002, hearing on the use of behavioral drugs in schools. Portions of a 1995 report on the matter, by the US Drug Enforcement Administration, were even read into the record.

“It has recently come to the attention of the DEA that Ciba-Geigy, the manufacturer of Ritalin, marketing under the brand name Ritalin, contributed $748,000 to CHADD from 1991 to ’94,” the agency reported. “The DEA has concerns that the depth of the financial relationship with the manufacturer was not well known to the public, including CHADD members, that have relied upon CHADD for guidance as it pertains to the diagnosis and treatment of their children,” it wrote.

The agency was particularly concerned that most of the ADHD material prepared for public consumption by CHADD, and made available to parents, did not address the potential or actual abuse of Ritalin. Instead, it was portrayed as a benign, mild substance that’s not associated with abuse or any serious side effects.

CHADD received $848,000 from Novartis in 2001, according to testimony at the hearing.

Kids Disabled for Cash

On its website, CHADD provides a link to a webpage on “Disability Benefits,” and tells parents that some kids with ADHD can be declared disabled and receive benefits including “cash payments,” under the federal Supplemental Security Income program.

“Children under age 18 who have disabilities, including some children with AD/HD, can receive SSI if they meet eligibility criteria,” CHADD says. “The SSI program can provide monthly cash payments based on family income, qualify the child for Medicaid health care services in many states, and ensure referral of a child into the system of care available under State Title V programs for Children with Special Health Care Needs.”

At the congressional hearing ten years ago, Colorado Representative, Bob Schaffer, reported concerns about Federal cash incentives to label children with ADHD, and specifically the two that resulted in cash payments to parents and schools.

In 1990, the SSI program made low-income parents eligible for a cash benefit of more than $450 a month for each ADHD child, and in 1991, the Department of Education made it so schools could receive more than $400 a year for students with ADHD, under the Individuals With Disabilities Education Act (IDEA).

Both cash incentives coincided with a dramatic rise in the number of children labeled with ADHD. In 1989, children citing mental impairments, including ADHD but not retardation, made up only 5% of disabled kids on SSI. But that figure rose to nearly 25% by 1995. Between 1990 and 1992, the number of ADHD diagnoses jumped from about one million to over three million, Schaffer informed the committee.

The IDEA also had a “child find” provision which required states to actively seek out kids who may qualify for special education in order to receive Federal special education funds, Patti Johnson, a member of the Colorado State Board of Education, told the panel. In many states, schools had also become authorized Medicaid providers and collected funds for children labeled with one of the learning or behavior disorders, she reported.

“Between SSI, Medicaid and IDEA, we have turned schools into aggressive identifiers of disabled children,” Schaffer told the panel. “Without a doubt we are subsidizing the aggressive pursuit of children with disabilities.”

“It is not resulting in accurate diagnosis,” he said. “It is resulting in an over diagnosis.”

Roughly a decade after the hearing, the new book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker, reports that the number of kids receiving SSI checks due to mental illness increased 35-fold between 1987 and 2007, from 16,200 to 561,569.

Drug Money Pours In

Despite non-stop criticism over being in the pocket of the pharmaceutical industry, money from ADHD drug makers continues to pour into CHADD year after year.

The group’s Income & Expense Reports, show CHADD received $507,000 in 2002, $674,000 in 2003, and five years later, the amounts nearly tripled. For the fiscal year of July 1, 2007 to June 30, 2008, CHADD received a total of $1,205,000, from Eli Lilly, J&J’s McNeil division, Novartis, Shire US, and UCB. In addition, 64% of sales and advertising, or $466,104, came from drug companies.

The next year’s report shows CHADD received a total of $1,174,626, from Lilly, J&J’s McNeil division, Novartis, and Shire, and 57.2 % of sales and advertising, or $412,500, was from drug companies.

For the year 2008, Lilly’s full year grant report lists a $200,000 donation to CHADD. The 2008 IRS filing for the Eli Lilly Foundation also shows a $50,000 gift, a drop from the $100,000 given to CHADD in 2007. Lilly’s 2009 grant report lists a $130,000 donation and the first quarter report for 2010 shows a $50,000 grant for CHADD. Lilly is the only ADHD drug maker required to post grant reports online, so there is no way to break down how much money is pouring into CHADD from the other companies.

The group’s 2008 IRS filing lists CHADD’s most significant activity as, “provides support for individuals with Attention Deficit/Hyperactivity Disorders.” Yet the non-profit blew $330,000 on its annual conference and another $114,950 on a 20th Anniversary Gala that same year, according to the 2008 I&E report.

Also, in sharp contrast to the yearly SSI income of about $8,000 for persons disabled by ADHD, the group’s 2008-2009 tax forms lists compensation for CEO Ross as $187,747, and the next two highest paid officials of this “non-profit” earn $130,217 and $121,095.

Landslide Vote

On May 21, 2003, the CMSA passed by a landslide vote of 425-1 in the House. On May 27, 2003, Sheila and Patty appeared on the national radio show Scams and Scandals, for a program about the need for the Act to end the abuse of parents by schools. During the show, they asked all parents who had experienced abuse similar to theirs to go online and sign Ablechild’s petition.

The next month, Sheila was featured in her hometown newspaper, The New Canaan Advertiser, in a front-page article on June 5, 2003 with the headline: “Mother pushing Congress to prevent schools from ADD testing,” with details of her campaign to enact federal legislation. The article profiled AbleChild, and criticized CHADD for its industry funding and opposition to the CMSA.

When public health officials in the UK and US announced that Paxil increased the risk of suicide in children in June 2003, Sheila pushed her Governor’s office to issue a press release warning against the use of Paxil with kids. In July 2003, the Associated Press reported that the Department of Children and Family Services in Connecticut planned to stop using Paxil to treat young people with depression.

The New American published an article titled, “Drugging Our Kids,” by William Norman Gregg in August 2003, and covered Patty and Michael’s story in depth, along with similar cases reported by other parents including Neil Bush and two families in which children died as a result of coerced drugging.

On February 20, 2004, Patty spoke on the nationally syndicated Joyce Riley radio show, and discussed the need for the CMSA in the wake of recent FDA hearings on the link between antidepressants and suicide, including Paxil, the drug Michael was prescribed.

Patty and Michael were both on CNN’s Lou Dobbs on April 15, 2004. Patty noted the need for the CMSA, evidenced by nearly 1,000 signatures on Ablechild’s website from parents with similar stories. Michael described how bad it felt to be on medications and Patty warned about the lack of informed consent given to parents regarding both the diagnoses of mental disorders and the drugs used as treatment.

The next month, Patty led a protest of hundreds of parents, children and human rights activists at the opening of the American Psychiatric Association’s annual conference in New York City, saying parents were fed up with psychiatrists telling them their children’s behavior was a “mental disorder” requiring dangerous drugs.

Sheila was again featured in her hometown newspaper on May 10, 2004, in an article about the need for an investigation by the Connecticut Attorney General into the drugging of children in foster care. Sheila was quoted throughout and promoted passage of CMSA.

Another federal bill that was introduced as a “Prohibition on Mandatory Medication,” amendment to the IDEA in April 2003, was passed by the House and Senate on May 13, 2004, and banned state and local educational agency personnel from requiring a child to take a drug covered by the Controlled Substance Act as a condition of attending school, receiving an evaluation, or receiving services. Key wording from the CMSA was included in the amendment.

On September 13, 2004, Patty testified at an FDA advisory panel hearing on the need for black box warnings on antidepressants about the risk of suicide and violence. “The FDA had enough evidence 14 years ago to issue these warning labels,” she told the committee.

She also testified about the lack of science behind psychiatric labels given to children. “Parents are told that their child has a chemical imbalance or a neurobiological illness,” she testified. “We risked our child’s life based on this fundamental lie.”

“The FDA is well aware that there are no x-rays, biopsies, blood tests or brain scans that verify these mental disorders as a disease or illness,” she said. “The FDA should not be condoning or approving these drugs without evidence of disease, illness or physical abnormality that would justify risking our children’s lives with a harmful and potentially lethal drug.”

The hearing ended with a vote by the panel in favor of black box warnings.

In November 2004, Patty was interviewed by a French TV producer for a news program in France, similar to 60 Minutes, focused on the pressuring of parents by schools in American to put children on psychiatric drugs. Other guests included Vicky Dunkel and Tom Woodward, whose daughter committed suicide after being prescribed an SSRI.

On February 17, 2005, Patty testified at a hearing titled, “ADHD Diagnosis, Treatment & Consequences,” in New York City, and told the story of what happened when Michael was labeled mentally ill in a public school and she refused to keep drugging him.

“The irony of the whole ordeal was that I was charged with medically neglecting my son, when there was no proof that anything was medically wrong with him,” she testified.

The next month, the Ladies Home Journal ran an article titled, “A Generation out of Control,” with a sub-heading that read: “A record four million children — some as young as 2 — are being diagnosed with ADHD and many are being put on powerful medications, perhaps for life.”

The article featured Sheila, and Patricia Marks, another Connecticut mom whose son was misdiagnosed with ADHD. The article discussed the dangers of teachers diagnosing kids in schools to solve classroom problems and warned parents to make sure and rule out undiagnosed medical conditions that might manifest as ADHD.

Also in March, in letters to the US Attorney for the District of Minnesota and the FDA, Ablechild called for an investigation into the role of antidepressants in a school shooting by Jeff Weise in Red Lake, Minnesota, who was on Prozac when he went on a rampage, killing his grandfather first, and then fellow students and teachers at his school, before committing suicide with the same gun.

In a press release, Ablechild expressed outrage and frustration with the FDA for “continuing to turn a blind eye to the all so obvious link to violence and mania that these drugs are having on our youth, and even more, their deadly link to uncontrolled school terror that has occurred from coast to coast.”

In October 2005, Sheila issued a statement from Ablechild strongly opposing TeenScreen, a program aimed at screening kids for mental illness in schools. “TeenScreen is nothing more than the bio-behavioral health industry’s attempt to garnish big government funding for useless programs that profitably promote a course of recommended psychotropic drug “treatment” which has been clearly liked to suicide and violent behavior,” she warned.

In October 2006, Sheila appeared on The Big Story with John Gibson on Fox, in a segment titled “Investigating the Link: Antidepressants & Violence,” based on recent school shootings in Pennsylvania and Colorado, and spoke of the need to investigate the correlation between psychiatric drugs and school shooters, and toxicology tests to determine whether shooters were on drugs. As the founders of Ablechild, parents came to them all the time, Sheila said. “Their children are committing suicide on these drugs and we’re very concerned.”

At the end of the show, the reporter noted particular concern about the fact that 30 million Americans were taking antidepressants, and being that 5% would develop mania, there could be “a million and a half potential maniacs waiting to explode.”

Focus On Drug Side Effects

Over the years, Ablechild has also focused on educating the pubic on drug side effects and MedWatch, the FDA’s adverse drug reaction reporting system. On December 13, 2006, Sheila testified at the FDA advisory hearing on the risk of suicide with adults on SSRIs and presented the results of two surveys showing a lack of public knowledge about Medwatch, and asked the FDA to initiate campaigns to let consumers know where and how to report ADRs, as consumers detect adverse effects sooner than providers.

In June 2007, Shelia, along with two CCHR representatives, met with Washington lawmakers regarding the renewal of the “Prescription Drug User Fee Act.” The new Act was signed into law in September 2007, with key measures to help increase public knowledge about prescription drug risks, as well as better safety monitoring by the FDA.

On November 6, 2007, Ablechild issued a news alert to warn that despite the black box warnings, the mental health industry was continuing to downplay the suicide risk of antidepressants. Based on information posted within the MedWatch system, “an estimated 63,000 suicides have been committed by people under the influence of antidepressants,” the alert reported.

It also noted that most parents were not aware that at least eight school shooters “were under the influence of antidepressants documented to cause not only suicidal ideation but also mania, psychosis, hostility, hallucinations and even ‘homicidal behavior.’”

With 1.5 million children on antidepressants in the US alone, “Ablechild is deeply concerned about the number of children being prescribed the powerful and potentially lethal drugs,” the alert stated.

In December 2007, Sheila called into a National Public Radio program, when the topic was the recently passed FDA reform bill, and discussed a new requirement that all print ads include an 800 number and information on reporting side effects to MedWatch. She also noted the importance of the new clinical drug trial registry that would be available on the internet, and the elimination of conflicts of interest on FDA advisory committees.

Protect Youngest Victims

In 2008, Ablechild teamed up with Amy Philo’s “Unite for Life” coalition of advocacy groups in efforts to protect unborn children and nursing infants from forced drugging through their mothers’ ingestion of drugs, by lobbying against a bill called the “Mothers Act,” for short, aimed at screening pregnant women and new mothers for mental illness.

The Act “quite simply is a feeder line for the psycho-pharmaceutical industry and will result in more mothers and infants being put at risk for being prescribed antidepressants and other dangerous psychiatric drugs,” AbleChild warned in a letter made available on its website for persons to sign and send to members of Congress.

In April 2008, Patty, Amy Philo, Marla Fidili from CCHR, Mathy Downing, whose 12-year-old daughter committed suicide after being given Zoloft off-label for test anxiety, and about 40 more advocacy allies, went to Washington to lobby against the Mother’s Act.

The latest evidence of infants being harmed by psychiatric drugs ingested by their mothers was reported on July 2, 2010, with a Medscape Today headline, “Psychotropic Medications Linked to Serious Adverse Drug Reactions in Children,” for a study by Danish researchers of 4,500 adverse drug reactions (ADRs), in children younger than 17, listed in the national Danish ADR database between 1998 and 2007.

The results showed 429 reports were from psychotropic drugs, with the largest share from stimulants at 42%, followed by antidepressants with 31%, and antipsychotics at 24.5%.

Almost 19%, or 80 of the ADRs, were for children between the age of birth and 2. All but one was serious, with two deaths associated with the SSRIs Celexa and Prozac. These findings were “probably due to the mothers’ intake of psychotropic medicine, primarily antidepressants and antipsychotics, during pregnancy,” the study authors wrote.

Sheila and Patty, along with Amy Philo, Mathy Downing, and Vicky Dunkle, received an “Outstanding Achievement Award for Children’s Rights,” in February 2009, at CCHR’s annual banquet, highlighted by a video tribute featuring much of their work.

In April 2009, Sheila drafted a petition in support of the “Parental Consent Act,” and made it available on Ablechild’s website for persons to sign and send to members of Congress. Introduced by Texas Congressman and physician, Ron Paul, the bill prohibits federal funds from being used to establish or implement any universal or mandatory mental health screening program for public school students and establishes a parent’s right to refuse screening of a child without fear of being charged with child abuse or neglect. In an April 30, 2009 speech, Paul pointed out that “parents are already being threatened with child abuse charges if they resist efforts to drug their children.”

“Imagine how much easier it will be to drug children against their parents’ wishes if a federally-funded mental-health screener makes the recommendation,” he said.

Million Kids Misdiagnosed With ADHD

After a decade of work by Sheila and Patty to expose the fraud behind labeling kids with ADHD, on August 17, 2010, USA Today reported that a new study from Michigan State University found nearly 1 million children may have been misdiagnosed with ADHD, not because of any real behavioral problems, but because they were the youngest in the class.

Children who are the youngest in their grades are 60% more likely to be diagnosed with ADHD than the oldest kids, according to the study published in the Journal of Health Economics. In fifth and eighth grade, the youngest children were more than two times as likely to be on Ritalin compared with the oldest students, the study found.

This is not to say that the Democratic Party is capable of reversing America’s downward slide socio-economically. Both parties are owned by powerful corporate interests. The two political parties are the subservient members of the “devil’s marriage” that produced America’s corpocracy in the early 70s.

The Devil’s Marriage and the Cons

It wasn’t a shotgun wedding. Both political parties lusted for it. Each got their own unending dowries. Corporations get favorable legislation, favorable regulations and deregulations, privatization rights, favorable judicial verdicts, welfare handouts, impunity from lawlessness, military help in global exploitation, and laissez-faire capitalism. The other side gets much less, but it’s more than enough. The Capital Hill bunch (aka “Corporate Hill”) gets well-paying, usually lifetime jobs. The Oval Office puppets get brief prestige and mostly military power. And the robed bench sitters guaranteed for life get to pontificate and then rule in favor of the corporate interests that helped to get them appointed.

While the marriage is clearly one-sided, neither side can afford a divorce. They will stick together through thick and thin, especially the cons. While they rail against the government partner, they are diehard supporters of the corporate partner.

The aim of this piece is to examine the cons’ allegiance to the corporate part of the marriage, to show how that allegiance has shredded their tie to the Constitution, a set of principles and law to which they give lip service, and how a turn to the right would accelerate America’s deterioration unless the cons, if ever in control, surprisingly decide otherwise.

The Cons’ Allegiance to Corporate Interests

Why is it that the cons have sold their soul to the company store? In his book, Cracking the Code, Thom Hartmann explains that conservatives distrust government’s ability to control the darker, immoral side of human nature and so trust the amoral nature of powerful corporate interests to keep society civilized. If his explanation is correct, it shows that the cons, besides ignoring corporate abuse of power, totally misunderstand Adam Smith, the putative founder of capitalism. Smith was a moral philosopher who believed morality was manifested in a person’s sympathy for others. He would have recoiled at the very idea of the corpocracy and its capitalism, for he thought the emerging corporations of his time posed threats emanating from the freedom given them to operate as they saw fit.

Giving American corporations the freedom to do what they see fit is precisely what our laissez-faire government has been doing for many decades, and the consequences have been extremely costly to America. I’ll return to this point momentarily.

Hartmann’s explanation of the conservative’s bondage to the corporate state doesn’t really delve into the cons’ personality, which is absolutely necessary to understand why they are so hateful toward government, especially in its efforts to ameliorate the deplorable conditions of the downtrodden. Nobel laureate Paul Krugman said in one of his columns that “the modern conservative movement, which dominates the modern Republican Party, has the emotional maturity of a bratty 13-year-old.”

His characterization may tickle a liberal but obviously doesn’t come close to capturing the cons’’ personality. To do this I searched the literature looking for the cons’ psychological makeup (PMU) and found it in a big study of many smaller studies spanning 50 years and several countries that was reported in the journal, Psychological Bulletin a few years ago. Cons, the findings suggest, resist change, are fearful, are aggressive, are tolerant of inequality to the extent of even endorsing it, are dogmatic, are intolerant of ambiguity and uncertainty, are hostile to outsiders, and are more comfortable with simplicity than with complexity. If this PMU is really true and comes to dominate Congress, even my young grandsons could probably understand what could be next for America.

The Cons’ and the U.S. Constitution

It’s so ironic that the cons bleat about reclaiming the U.S. Constitution while simultaneously repudiating it through their ideology and policies. Hartmann reminds us that nearly all of our nation’s founders were liberal “children of the Enlightenment” and that of the purposes stated in the Constitution’s preamble. Only one had to do with defense; the others were about promoting the general welfare. Moreover, and what is really astonishing, the corporatized U.S. Supreme Court’s recent fallacious ruling aside, neither the word nor idea of corporation is mentioned in the Constitution. Its framers weren’t about to turn their new America into another corpocracy like the one ruled over by the King and his chartered corporations that had so plundered and oppressed the colonists.

The Cons and Our Corporate Welfare State

Try telling the cons what ‘promote the general welfare’ means and that corporations really have no constitutional rights. The cons are all for welfare, their own, for corporate welfare, and for Constitutional rights for corporations. They perpetuate the myth that people on the dole want to be on the dole and like staying there. They apparently want public services that benefit only them tangibly and want to be barely taxed for them. They regard any government efforts to improve our general welfare as totalitarianism or socialism. They ignore – or don’t know – that corporate welfare in all its varieties absolutely dwarfs social welfare. The cons’ rants against taxation (Justice Oliver Wendell Holmes once said “I like paying taxes. With them I buy civilization”) might be muzzled or muted if someone told them convincingly that their taxes would be less if corporate welfare were eliminated. And they ignore the fact that corporations consistently abuse their constitutional rights at the expense of the common good.

The Cons and U.S. Militarism

The most costly part of corporate welfare is warfare welfare. I don’t know of very many cons who will acknowledge that. They usually are the most hawkish of all Americans save perhaps the Christian right, and the two aren’t mutually exclusive.

The U.S. has been the most warring nation since WWII. Why? As best as I can determine the answer is that the corpocracy’s militarism fattens the defense industry, including beefing up its sale of arms (the U.S. is the world’s top arms seller); opens up, protects, and expands corporations’ foreign markets and exploitation of natural resources (oil and minerals) and cheap labor; gives the military something to do; keeps politicians in office; and distracts the American public from growing socio-economic deterioration at home. In his book, “Regime Change Begins at Home”, Charles Derber contends that to survive a corpocracy one “must practice a foreign policy of bad faith, [namely, that of] ‘marry-your-enemy.’”

By my calculations corporate warfare welfare since 1948 has cost the American taxpayer, including the cons, roughly 20 trillion dollars. If we define warfare welfare as any military expenditure not necessary to defend ourselves against foreign invasions, then again by my calculations, 10 trillion dollars and thousands of lives went down a sinkhole. That amounts to a huge cost in lost opportunities, not to mention lost lives. Opportunities lost to trim taxes while at the same time making America healthier, more educated and employable, and certainly more at peace with the world.

Whither America?

After visiting America in the early 1800s the French political thinker and historian, Alexis De Tocqueville, concluded that “The nation ceased to exist.” He was referring to the nation of Native Americans. But will the same be said about America as a nation some day in the future? I’m convinced that if America continues her course of endless, winless, homicidal wars, America will not stay endless.

An Appeal to the Con’s

The cons started out just like the rest of us as innocent babies. The biggest difference was in the upbringing and circumstances. But our ideologies and our personalities aren’t cemented. Every one of us is malleable, whether we ourselves or someone else wields the mallet.

The cons might be able to make all the difference in the world, and for the better, if they vented their anger and aimed their strategies at curbing corporate welfare in all of its varieties. If they should take control and turn Congress into the House of the Cons, they would have an opportunity handed to them through the ballot box to start turning America upward instead of downward. Their mantra, “starve the beast” could become a policy that starts with starving corporations of their welfare handouts from government.

We should say to the cons, “Tell the rest of us the PMU findings are hogwash and then go on to prove it.”

Recently, Secretary of State Hillary Clinton and Secretary of Health and Human Services Kathleen Sebelius profusely apologized for a study conducted by the US Public Health Service in which nearly 700 incarcerated people and soldiers in Guatemala were, without their knowledge, deliberately infected with syphilis and other sexually transmitted diseases in order to test if penicillin could prevent infection. In a statement the two Cabinet secretaries expressed their outrage at “such reprehensible research.” In fact, so disturbed is the US government at this research that President Obama reportedly will call the Guatemalan president to apologize again.

This research violated the basic ethical principles that were supposed to guide research done on people — “human subjects research” in the professional lingo — since World War II. These principles were codified in the Nuremberg Code internationally and in the Common Rule guiding most research on people conducted or funded by US government agencies, including the Department of Health and Human Services of which the Public Health Service is a part as well as the Defense Department and the CIA. Fundamental to these and all other recent codes of research ethics are two basic principles: informed consent and minimization of harm. Thus, the Nuremberg Code, containing principles developed for the trials of German doctors who conducted horrific experiments in the Nazi concentration camps, begins with the principle of informed consent:

The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision. This latter element requires that before the acceptance of an affirmative decision by the experimental subject there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonable to be expected; and the effects upon his health or person which may possibly come from his participation in the experiment.

A little later the Nuremberg Code states the obligation of medical researchers to minimize harm resulting from experimental procedures:

The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.

No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the experimental physicians also serve as subjects.

The Guatemalan study egregiously violated both these principles and deserves opprobrium. Rather than informed consent, the purpose of the study was deliberately hidden from those infected. These individuals were infected with dangerous, often deadly, illnesses. This research was awful, reprehensible, even horrific, and should never have been contemplated, let alone, conducted. I am glad that it only took a short time since historian Susan M. Reverby of Wellesley College revealed the abuses in a soon-to-be-published paper — available in preprint form on Reverby’s website — until US government officials vociferously condemned it.

But the US government does not need to look back nearly 65 years to find horrific research conducted by US government researchers. In June 2010, Physicians for Human Rights (PHR) issued a report, Experiments in Torture: Human Subject Research and Experimentation in the “Enhanced” Interrogation Program, that documented research and experimentation conducted in this century by CIA physicians and psychologists related to the abusive techniques used as part of the CIA’s “enhanced interrogation” torture program.

These researchers observed the torture of CIA prisoners in the so-called “black sites” and recorded the tortured prisoners’ responses. They paid special attention to the possibility that the torture would kill the prisoners. At times they recommended changes in torture techniques, such as the addition of salt to the water used for the partial drowning techniques that have come to be known as “waterboarding” so as to prevent possible death from induced electrolyte imbalance. This change in procedure allowed the prisoners to be waterboarded many dozens of times while preventing their escape into death. As PHR argued, the main reason for this apparent safety-related research was not the protection of prisoners, but to provide legal cover for the torturers and torture policy-makers by allowing them to claim that medical professionals were assuring the prisoners’ safety.

These abuses were reported by PHR in its peer-review report back in June. (I am one of the authors of that report.) Secretary of Health and Human Services Secretary Kathleen Sebelius was notified by letter of these abuses, abuses that violate the same research ethics principles — informed consent and minimization of harm — that were violated by the Guatemalan STD research. But, rather than express her outrage at this “reprehensible research,” Secretary Sebelius maintained her silence, as did every government official, other than a CIA press spokesman who denied our claims without presenting the slightest bit of evidence. Secretary Sebelius’ department referred an official complaint regarding unethical CIA research to the very same CIA that had already publicly denied the charges. So far, no government agency has committed to investigating these CIA abuses, which occurred far more recently than the Guatemalan horrors.

In response to the over 60 year old Guatemalan abuses, the Secretaries of HHS and State announced the creation of a commission that will undertake to assure that all human subjects research conducted by US researchers meets the highest ethical standards. As NBC News reported:

In addition to the apology, the U.S. is setting up commissions to ensure that human medical research conducted around the globe meets ‘rigorous ethical standards.’ U.S. officials are also launching investigations to uncover exactly what happened during the experiments.

If the purpose of the commission is really “to ensure that human medical research conducted around the globe meets ‘rigorous ethical standards,’” there cannot be a double standard. The same rules must apply to all researchers, everywhere, and to all research subjects, whoever they are. Ethics are there to protect the despised and powerless, not just those deemed deserving. Those researchers aiding CIA or other classified activities cannot get a free pass. We are at an important juncture, either unethical CIA research is investigated and those responsible are held accountable or the whole regime preventing unethical research that has been developed since the world became aware of Nazi horrors will collapse in hypocrisy. We cannot afford to let that happen.

The corporate class stole its trillions from us, by exploiting workers at home and abroad – paying us less than our labor is worth – and by laying off workers and squeezing the rest to work a lot harder for much less.

They also steal from our children.

Exploitation and deprivation cause parents to be distressed, depressed, angry, anxious and overwhelmed. An estimated 15 million American children (one in five) live with an adult who suffered a major depression in the previous year. Children respond to parental distress with symptoms and behaviors. The greater the parent’s distress, the greater the child’s distress.

Instead of using some of the corporate treasury to invest in families, distressed children are being labeled with mental disorders and drugged into submission. These children are being robbed of their health and the hope of any real improvement in their lives.

For several decades, researchers like Peter and Ginger Breggin have documented the shocking extent to which American children are being drugged with stimulants and anti-depressants.

Now, thanks to the power of drug-company marketing, distressed children are being drugged with powerful anti-psychotics. In adults, these toxic compounds increase the risk of stroke, cardiovascular disease, obesity, diabetes, suicide, seizures, infection, kidney failure, nervous-system damage and sudden death. The effects on children are unknown.

Last September, an FDA report found that the number of anti-psychotic prescriptions dispensed to children (0-17 years) had risen 22 percent over the previous five years.

The FDA examined six anti-psychotic drugs: Seroquel® (quetiapine); Zyprexa® (olanzapine); Risperdal® (risperidone); Abilify® (aripiprazole); Geodon® (ziprasidone); and Invega® (paliperidone).

In 2008, of the 32 million prescriptions dispensed for these drugs, 4.8 million were dispensed to children (15 percent of the total).

That same year, one million individual children were prescribed these anti-psychotics (19 percent of the total of 5.5 million individuals). Here are the numbers, by age group:

1,770 children aged 0-2
64,664 children aged 3-6
414,451 children aged 7-12
540,760 children aged 13-17

Diagnoses applied to the infants and toddlers (aged 0-2) included: Attention Deficit Disorder; Mental/Behavior Problems, Behavioral
Problems; Other Emotional Disturbances, and Residual Schizophrenia, a diagnosis that can be made on the basis of “odd beliefs and unusual perceptual experiences.”

A more accurate diagnosis for these children’s symptoms and behaviors would be “Parental Distress due to Heartless Social Policies.”   A recent report from the Urban Institute found that 7 percent of all 9-month-old infants live with severely depressed mothers, and 41 percent of 9-month-old infants live with mothers who suffer some form of depression. These rates are higher among mothers living in poverty, who are also more likely to suffer domestic violence.

Only a sick social system would enrich the few by stealing the present lives and future hopes of the many.