I found this interesting. I hope you will as well. Not new arguments, but
still worth pondering (even with the oversimplifications).
Jeff Nagelbush
[EMAIL PROTECTED]
Ferris State University
Tuesday, August 21, 2001 12:01
a.m. EDT
I have a confession to make: I have a mental illness, and
it is called Psychobabble Defiance Disorder. Since at this
moment I am also afflicted with Ranter's Syndrome, I
intend to have my say on a topic that troubles me. No,
let me put that more strongly, a topic that makes me
flood the room with rage.
My boy, who turned two last month, will start to go to
the local church school in the middle of September. His
class, which will convene twice a week for two hours
each time--short and sweet, which is how it should be
for one so young--is called "Early Twos." I send him with
mixed feelings, of course: How could I not? On the one
hand, there is pride in his having grown up enough to go
out in "the world," even if it is only to the assiduously
controlled cocoon of an Episcopal school,
three-and-a-half minutes by foot from our home.
On the other hand, once out in the world, the little mite
will be exposed to the vagaries of the benighted
educational-medical complex, which regards it as its
business to label all our children as being sufferers of
some disorder or other. This won't happen at his church
school, for sure--it's much too sensible and old-fashioned
for that--but my boy will move on, by the time he's five,
to another school, where the teachers, like most
teachers of young children in this country, will be on ADD
watch.
Oops, sorry, forgive me. I should have said ADHD watch.
The American psychiatric establishment now refers to
Attention Deficit Disorder as Attention
Deficit/Hyperactivity Disorder. Why the change? Beats
me, but it's just as much nonsense-on-stilts as ADHD as
it was pure poppycock as ADD. And I'd bawl out any
teacher who said to me, "Mr. Varadarajan, I think your
boy has an attention disorder," and then suggested
Ritalin, or Adderall, or Metadate CD.
Sunday's New York Times carried a front-page story on
ADHD, and on how lawmakers in some states--Arizona,
Connecticut, New Jersey, New York, Utah and
Wisconsin--have introduced bills that would prohibit
schoolteachers from playing shrink in their classrooms by
telling parents that they must put their children on drugs
to combat "attention deficit." Such instruction, the bills
declare, must only come from doctors.
This is good news, and to be vigorously lauded. Teachers
must be stopped from playing God. Above all, they must
be stopped from shirking their disciplinary duties and
seeking to "fix" every boisterous child with a dose of
drugs.
What stops this legislative pattern from being excellent
news, however, is that the doctors can't be trusted.
After all, it was they who invented ADD and foisted it on
a generation of American children. Twelve percent of all
American boys between six and 14 have been diagnosed
with "attention deficit" problems. (I get these figures
from the International Narcotics Control Board, a United
Nations agency.) These children all take
medication--Schedule II drugs, which share the
pharmacological effects of amphetamine,
methamphetamine and cocaine--to sharpen their
short-term attention span. Four million American children
take such medication. Toddlers, and children under five,
are being prescribed such medication. Ninety percent of
all Ritalin popped in the world is popped in America.
What is ADD/ADHD? According to the fourth (and latest)
edition of the "Diagnostic and Statistical Manual of
Mental Disorders"--DSM for short, the "bible" of the
American Psychiatric Association--it is a disorder with
nine diagnostic criteria. If your child shows six or more of
the following behavior patterns, he's liable to be labeled:
a.Often fails to give close attention to
details or makes careless mistakes in
schoolwork, work, or other activities
b.Often has difficulty sustaining
attention in tasks or play activities
c.Often does not seem to listen when
spoken to directly
d.Often does not follow through on
instructions and fails to finish school
work, chores, or duties in the
workplace (not due to oppositional
behavior or failure to understand
instructions)
e.Often has difficulty organizing tasks
and activities
f.Often avoids, dislikes, or is reluctant to
engage in tasks that require sustained
mental effort (such as schoolwork or
homework)
g.Often loses things necessary for tasks
or activities (e.g., toys, school
assignments, pencils, books, or tools)
h.Is often easily distracted by
extraneous stimuli
i.Is often forgetful in daily activities
Easily distracted? Does not seem to listen when spoken
to? Makes careless mistakes? Has difficulty sustaining
attention in tasks? Is often forgetful? Often avoids
homework? Homework, for Nora's sake! These are
children they're talking about. Show me a child who
doesn't avoid homework and I'd say he's not normal. Are
these people for real? Are we to take this hysterical
gibberish seriously?
And what makes a child liable to be dubbed
"hyperactive"? Here we go, again, from the DSM:
a.Often fidgets with hands or feet or
squirms in seat
b.Often leaves seat in classroom or in
other situations in which remaining
seated is expected
c.Often runs about or climbs excessively
in situations in which it is inappropriate
(in adolescents or adults, may be
limited to subjective feelings of
restlessness)
d.Often has difficulty playing or engaging
in leisure activities quietly
e.Is often "on the go" or often acts as if
"driven by a motor"
f.Often talks excessively
Fidgets? Squirms? Runs about? Leaves seat in classroom?
Talks excessively? Has difficulty playing quietly? It is
almost as if the psychiatric establishment wants to snuff
the life, the joy, out of childhood, rendering our children
robotic and docile.
Teachers have latched onto this with alacrity. In part,
they have an excuse: Denied access to more traditional
forms of punishment, it is increasingly hard to maintain
discipline in class. Ritalin, in many cases, has taken the
place of discipline. How else can one explain that
previous generations got by without recourse to such
labeling and such medication?
The label ADHD and the medication are, to quote Thomas
Szasz--author of "The Myth of Mental Illness" and a
professor of psychiatry--perfect examples of "the
pharmacratic control of a social problem: how to educate
children." Thomas Armstrong, author of "The Myth of the
A.D.D. Child" cut right through the bull when he wrote:
"ADD is a disorder that cannot be authoritatively
identified in the same way as polio, heart disease or
other legitimate illnesses."
So how have we come to be saddled with this spurious
syndrome? One reason might be that ADHD is but one
example of a dangerous trend in our society, which is to
pathologize everything. In the mid-19th century, in the
days before the DSM and the APA, the U.S. government
recognized only one category of mental illness:
"idiocy/insanity." That, while hardly satisfactory, at least
had the virtue of brevity. But now, in the grip of a dogma
that holds that all troubles in people are the product of
some internal dysfunction, we have had a veritable
proliferation of madness. The ascendancy of this view
can be linked, among other things, to a decline in the
belief in individual responsibility.
I cannot resist deploying a pithy quote here, from
"Making Us Crazy," a book published three years ago and
written by Herb Kutchins and Stuart Kirk, both psychiatry
professors: "There is a growing tendency in our society
to medicalize problems that are not medical, to find
psychopathology where there is only pathos, and to
pretend to understand phenomena by merely giving them
a label." The latest edition of DSM lists more than 300
mental syndromes. Only two decades ago, an earlier
edition listed a mere 106. Are we galloping toward
madness? Or is the APA nuts? Judge for yourselves.
Alongside ADHD, we have such new syndromes as these:
"frotteurism" (defined in the manual as the irresistible
urge to rub oneself against "a non-consenting person"),
Asperger's syndrome (a pompous label for shyness),
"dissociative fugue" (the urge to travel without clear
plan, often under an assumed identity), "hypo-active
sexual desire disorder" (found in people not at all keen on
sex, and not to be confused with mere "sexual aversion
disorder"), and "paranoid personality disorder" (the
hallmark of someone who bears grudges).
Children can suffer from "mathematics disorder" (you
don't believe me, do you? It's Code 315.1 of the DSM),
"disorder of the written expression," and "oppositional
defiance disorder" (which my parents, bless them, would
have called "disobedience" when they were raising me).
The jewel in the APA's crown is "generalized anxiety
disorder," from which 12 million Americans, or 5% of
adults, suffer. And what is this? Well, silly of you to ask!
Why, it's excessive worry, of course, and restlessness,
and anxiety, and tension, and the feeling of being keyed
up. Bring on the Prozac. One for mommy, one for dad,
and for you, son, a nice bit of Ritalin for dessert.
Before I go, let me add another twist. According to Drs.
Kutchins and Kirk, the psychiatric establishment is
foisting these invented illnesses on us in a bid to lay
claim to handsome reimbursements from insurance
companies. For psychiatrists to receive payment from
health insurance companies, they must find a way to
label a patient with a recognized condition--which is why
they recognize more, and more, and more conditions.
Wait for the next DSM, and there will be at least another
50 conditions added to the existing list. According to Drs.
Kutchins and Kirk, "the unlabeled masses are a vast
untapped market, the virgin Alaska oilfields of mental
disorder."
As I was saying, my son goes to school next month, for
the first time . . .
Mr. Varadarajan is deputy editorial features editor of
The Wall Street Journal. His column appears Tuesdays.
_________________________________________________________________
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