My biorhythms were doing whatever it is they do when I strolled into Mad in America and read about Robert Whitaker’s presentation at NAMI. Or really, its aftermath.
Whitaker, as you may or may not know, is taking all sorts of flack for his research into the current state of psychopharmacological research and marketing, which you can find out more about in the books Mad in America and Anatomy of an Epidemic. I have read both of them and although they are not without their rhetorical excesses (and of course I adore rhetorical excess but not usually mixed with science unless for artistic effect), the research Whitaker has put into them is thorough and very hard to argue with without resorting to very very tired canards about the plight and safety and whatever-tugs-your-heartstrings about the “mentally ill” as long as you don’t have to actually talk to any of them.
One day I will explain why I always put that term in scare quotes. Unless I already have, in which case I will probably do it again even so. But not just now. The short version of Whitaker’s message is something like: we–or those of us not involved in or with pharmacology industries–have no idea how little information we have been given about psychiatric medications, nor how much of what we think we do have is completely without empirical support. Whitaker has unearthed repressed research, inadequate methodologies, and a number of not-too-surprising instances where profit has short-circuited the scientific skepticism that is necessary to keep us from proclaiming that our knowledge is complete when it is in fact completely unmoored from any empirical observations because the money is nowhere near them.
Whitaker has made some enemies, of course. Many of them seem to think that the complexities of reality need to be hidden from some of us for our own good: specifically, those mental patients currently taking antipsychotics who truly need them. As you might suspect, precisely who needs their antipsychotics can vary depending on their relationship to the person you are asking.
A summary of this whole argument would take more energy than I want to expend at the moment, but Whitaker is currently living a snapshot moment that illustrates it, to my rickity mind, particularly well. So a link, and then the comment that those aforementioned biorhythms told me I had to leave after pouring one more cup of coffee, but with the part stuck back on the end that I cut out for the sake of not covering someone else’s blog page with my ranting. If you have time, read the comments (you can skip mine, I am reproducing it right here!); they shed quite a bit of light on the scene and had a great deal to do with whatever induced me to stop everything else I was going to do today to write what follows.
My comment, plus extra bonus words:
No, you don’t have blood on your hands–and wouldn’t have even if Earley’s son had fared worse.
My very honest opinion, given the information given/linked here? Mr. Earley, I have no doubt, believes that he is trying to do the right thing for his son, and believes that “tough love” is a perfectly useful tool in motivating people to live up to their families’ and cultures’ expectations of them. But what I think I see is not at all unusual in the culture I live in (US, western, anglo-american–lots of names and none of them sufficient): our emphasis on individualism and personal responsibility often passes into brutality and abuse despite good intentions and in spite of every bit of love we believe we hold for those close to us.
Take your meds or get out of my house? It looks to me that Earley’s son was given a choice between two barely tenable alternatives, and the son took the one that he himself considered less painful, less risky, less likely to cause him great harm: he left home, alone, knowing what he surely knows about his capacity to handle difficult situations.
Being diagnosable with mental illness does not render us incapable of looking out for our own interests. Not knowing anything about Earley’s son, I can only speculate about why he chose to leave home rather than continue treatment when those were the only options available to him, but if I were going to analyze the situation further, I sure would want to know why he made that choice. I suspect the answer as to how best to serve his son could be found by listening to his son–for Earley, for anyone else.
Earley instead blames you for daring to uncover empirical facts and pointing them out where his son could see them. Controlling information access is a display of power. Possibly an abusive one. But it is endemic in our paternalistic culture and, for too long, has been an acceptable practice in caring for those whom we deem incapable of caring for themselves.
And yet Earley’s son did care for himself. He left home. This seems plain to me from here.
I suppose it might be a relief to be told that one’s child is suffering from a brain disorder and not reacting to, say, inhospitable conditions at home, using whatever means they can. But what I dearly wish could happen in public dialog would be for us to recognize that not only can no human behavior can be explained so simplistically, but there exists little evidence for those explanations we are given–or that we receive–as though they were studied, nuanced scientific conclusions.
We do not have to make a choice, when trying to explain emotional or neurological distress, between blaming refrigerator mothers and attributing it to well-documented brain disorders. Both of those figures are mythological and completely divested of any attention to the reality we ourselves live. But we do need to recognize that upbringing–and this is not a process confined to the traditions of any nuclear family, but a cultural and sociological process that continuously changes its focus–cannot be untangled from the physiological structures we inherit, in whatever shape, and which then develop in response to everything we ever perceive.
And, now apparently, we hear that we are shaped by many of the things our parents and grandparents perceived before any of us had begun to be iterated and reiterated by our own experiences. Take even the briefest critical look at our current understanding of neurological change and the mechanisms of inheritance: less comprehensive, less efficacious than our level of knowledge of these processes is only the degree of control we have achieved over any of them. We fancy ourselves master wizards when we are the neo-ist of neophytes.
My sense of what is called mental healthcare in the US is that, at the level of public discourse, it remains stuck in the positivist, enlightenment-era myth that not only will we be able to categorize and analyze any problem to complete resolution if we apply the briefest effort, but that we are always just on the verge of doing so, or that the last discovery finally put us over the top and now we have the magic key!
You know. Like Zyprexa, the wonder drug, showed us the way to cure psychosis. And a whole bunch of other disorders that we didn’t even know were disorders, much less similar enough to psychosis to be treatable with the same drugs!
I understand why we want these sorts of answers, and why we want them to be easy and without any implications for those considered normal, well-adjusted, and in need of nothing but their own self-sufficient selves. But as complex, intelligent, sensitive, and intensely social creatures, we are all implicated in each other and have been for millennia. Our relations are so complex we might never be able to name them all, but like our old Freudian unconscious, they will make themselves known whether or not we recognize them when they show up.
The desire to assign blame is tempting, I suppose. The more quickly the singular, locatable culprit can be found and punished, the earlier we can forget our own implications with what goes on nearby and return our self-image to its unblemished, untouched ideal. But it almost always leads us to overlook a great deal of detail and a great deal of what could be useful information.
And of course, a compassionate practice aimed at sorting out connections rather than offloading guilt onto the nearest neighbor might also stand some chance of making our multiple connections with our world much less painful.
It is apparent that many of us find those connections painful, is it not?