Al Galves, Ph.D.

What are the forces that have driven the dramatic increase in the use of psychotropic drugs by the American public?  The most common candidates are the drive of the pharmaceutical companies to make money and mainstream psychiatrists to finally become “real medical practitioners.”

This article suggests that there are larger historical and cultural forces that are behind this phenomenon, among them the following:

• The age of reason.
• The rise of scientism.
• The cult of professionalism.
• The industrial and technical revolutions.
• The myth of the heroic American.
• The myth of equal opportunity.
• The myth of progress.

The forces are briefly described and an argument made for addressing them.

The power and speed with which Americans have embraced psychotropic drugs as the response to troubling emotions and thoughts is dramatic and arguably without precedent.  The combined sales of antidepressant and antipsychotic drugs jumped from $500 million in 1986 to nearly $20 billion in 2004, a 40-fold increase.¹

The frequency of antipsychotic prescriptions for children increased from 8.6 per 1000 children in 1995-96 to 39.4 per 1000 children in 2001-2.²

The use of methylphenidate, a stimulant similar to cocaine, was more than 7 doses per 1000 persons in 2004.  This compares with less than 1 dose per 1000 persons in the United Kingdom, Germany and Australia.³

This fact is all the more amazing in view of the evidence that the drugs are very harmful to human beings, causing impairment of the ability to walk and control muscles, heart disease, diabetes, mania, psychotic symptoms, impaired immune function and early death⁴; and that they disable the fine-tuned emotional faculty that has been evolving over millions of years to enable humans to know what is important, what is threatening, what is precious and what needs to be protected.

What are the forces that have driven this phenomenon?  Can it be attributed wholly to the drive of pharmaceutical companies to make money and of mainstream psychiatrists to finally become “real medical practitioners?”   Or are there other forces at work here?   

This article is an attempt to name and describe some of the historical and cultural forces behind the zeal and credulousness with which consumers are using mind-altering drugs and which might explain how a newspaper editor would fashion the following headline for a story about a randomized, double-blind clinical trial which found a placebo to be more effective in treating depression than either Zoloft or St. John’s wort: “Antidepressant Outdoes St. John’s Wort in Treating Depression.”

First, there is the Age of Reason, which has been ascendant with minor eclipses for the past 800 years.  This movement that celebrates and honors the rational faculty has dishonored and discounted the emotional and intentional faculties that are just as crucial to healthy human functioning.  If you want proof of this, spend some time in a typical American public school.  You will find almost total focus on developing the rational faculty.  Some lip service is paid to emotional development but it consists mainly of browbeating children into believing that certain emotions – love, happiness and kindness – are good and should be favored and others – anger, jealousy and sadness – are bad and should be extinguished.   And you’ll find virtually no attention paid to the development of the intentional faculty, the wills of children.  In fact, you would think that human beings didn’t have wills, at least not ones worthy of attention or development.

I propose that this overvaluing of the rational faculty and discounting of the emotional and intentional faculties makes it easier for people to use drugs that impair their emotional processing.  Since they don’t value the intricate, fine-tuned emotional processing mechanism that has been evolving over millions of years, there is little resistance to disabling it with drugs.  One wonders if consumers would be as ready to take drugs which impaired their rational functioning.

Second, there is the Rise of Scientism.  “Scientism” is defined by Webster’s New Collegiate Dictionary as “an exaggerated trust in the efficacy of the methods of natural science to explain social or psychological phenomena, to solve pressing human problems, or to provide a comprehensive unified picture of the meaning of the cosmos.”  Scientism has convinced us to discount anything that can’t be quantified, measured, touched, seen or physically manipulated.  No wonder then that we put so much faith in a pill and are so skeptical of the value of learning to manage our emotions, integrate the parts of ourselves we don’t like, become more objective in our thinking, use the stress response to address things that are threatening us and develop our assertiveness skills.

Along with the Rise of Scientism has come the Cult of Professionalism, the idea that people with degrees and credentials are smarter and more effective than we are, that they have a mysterious hold on a fount of knowledge and skill to which we are not privy.  This has caused people to lose faith in their bodies and their minds.  It has taken away their sense of agency, of being able to figure things out for themselves.  It has caused them to become overly dependent on experts.

In his book The Coming of Post-Industrial Society, Daniel Bell predicted that the major conflict of the 21st century would be between professionals and non-professionals.⁵   That it appears there will be no such contest is testimony to the power of credentialism and the higher education industry and the inability of non-professionals to organize in any meaningful way.

And there’s the Industrial Revolution, which turned people from craftsmen who took responsibility for an entire piece of work from start to finish to assembly line workers who are small cogs in a big machine.  Again, a force that takes away the sense of agency and dependence on oneself.

And the Technological Revolution which reinforced the belief that the important things are the things outside of ourselves – machines and computers.

The combination of these forces has caused people to lose faith in their bodies and minds.  Since they can’t see their immune system and understand how it functions, they would rather depend on an antibiotic, which they can see and understand.  Instead of understanding that fever and vomiting and mucous build-up are evidence of healing mechanisms, they use substances to counteract them.  Instead of appreciating the value of shutting down for a while and using an internal focus to take a look at their lives, do a mid-course appraisal and, perhaps, adopt a creative change of course, they take an antidepressant.  Instead of trusting themselves and their organisms, they trust the expert.

Here is Theodore Roszak’s description of the forces at hand:

“The same revolutionary movement that made the universe safe for democracy made it no fit home for such archaic superstitions as “sanctity” of any kind, because sanctity is no empirical finding, no verifiable hypothesis.  Rather, it is an intuition of the sacramental.  We are dealing here in political mysteries that trace back to the charisma of kings, the taboo of tribal priests…. Whenever humanistic spirits rush forward to defend our personal dignity from invasion or insult, though they may not know it, they invoke an authority which we inherit from priest and prophet.  They are asserting the personality as a locus of magical powers.  But the idea has been cut off at its historical and psychological roots, because the severely logical eye, obedient to the best scientific standards, finds no place for magic in the universe; it simply cannot admit the legitimacy of sacramental experience…. In this, then, we find the darkest irony of the revolutionary tradition.  The justified anticlericalism of the Age of Reason has become a sweeping rejection of all sacramental experience.”⁶

One of the pieces of “magic” that is being ignored and discounted is the self-healing power of the human organism.

There are also some uniquely American forces at work.  One is the Myth of the Heroic American.  We have received a barrage of messages telling us that we are a favored people, the greatest country on earth, anointed by God as the only remaining superpower on the planet, the shining city on the hill.  This puts pressure on us – pressure to be successful, happy, rich and prosperous.  It’s really not OK to be sad, down, depressed, unhappy and upset.  What’s wrong with us?  We live in the greatest country on earth.  What more do we want?   So, if we’re not rich, exalted, famous or outstanding we attribute it to our shortcomings.  I guess I’m just not good enough.  I couldn’t make it. We get down on ourselves, become anxious and depressed and grab for the quickest and easiest remedy - psychotropic drugs.

There’s another force which reinforces that pressure: The Myth of Equal Opportunity.  We are constantly told that Americans are equal before the law, that, unlike other, more traditional societies, we all have an opportunity to be rich, famous, good-looking, happy and successful.  If we aren’t, it’s our own fault.  We just aren’t good enough.  There’s something wrong with us.  We’re deficient.  

In other societies, there are explanations which are less pejorative.  If I am not doing well in India, it is because of the caste I was born into.  If I am dissatisfied with my status in Great Britain, I can attribute it to the class, neighborhood, family into which I was born.  What do you expect from me?  I don’t even speak with the right accent.

This is the message of Michael Moore’s film Bowling for Columbine.  Moore asks why there is so much violence in the United States.  He dismisses the pat answer – more guns – by disclosing that there are more guns per capita in Canada and the murder rate in Canada is one-twentieth of the murder rate in the United States.  After considering other explanations, he comes down to the insight that this is not a very compassionate country.  And the compassion that is lacking is not so much for other people as it is for ourselves.  People who lack compassion for themselves are prone to violence.

Because of these two myths, Americans are allergic to “blaming” themselves for their “shortcomings.”  They are especially reluctant to take responsibility for whatever deficiencies or doubts they might have about themselves.  So if they are feeling sad, agitated, upset, angry, anxious, down, discouraged it’s much easier to blame it on chemical imbalances that result from genetic inheritance than it is to blame it on anything they have control over.  Instead of taking a good look at myself, doing some self-reflection and some repair work, I’ll just take this pill that will correct my chemical imbalance.

Finally, there is the Myth of Progress.  These psychotropic drugs fit nicely into that myth.  Isn’t scientific medicine wonderful?  Look, we cured malaria and polio.  We do heart transplants and artificial hips.  Now there are medicines that cure mental illnesses.  Amazing.  What will they come up with next?

This is my short list of historical and cultural forces:

• The Age of Reason
• The Scientific Revolution
• The Cult of Professionalism
• The Industrial and Technological Revolutions
• The Myth of the Heroic American
• The Myth of Equal Opportunity
• The Myth of Progress

There may be other, more important forces at work.  Something is going on that is bigger than the power of the pharmaceutical companies and mainstream psychiatry.  I encourage readers to wonder and search.

But suppose it is true that these forces are driving the movement to embrace psychotropic drugs as the answer to these painful states which, being devoid of clear physiological etiology, are called “mental illness.”  What can we do about the forces?  They are large and inchoate.  

How do we counter them?  I think we chip away at them little by little in the same way that dissidents chipped away at the former Soviet Union.  When the Soviet Union collapsed in 1989, it seemed to happen rapidly, almost overnight.  But the seeds of that demise were being planted and fertilized over the previous 60 years by ordinary Russians telling jokes about the system, talking to each other behind closed doors and, in some courageous cases, protesting in public.   I think that is how the biopsychiatric juggernaut will eventually be brought down – through a constant, even if often dim, shining of light on the harm done by psychotropic drugs and their lack of effectiveness and through the slow, steady development of more safe, humane and effective ways of helping people who want help in their effort to overcome suffering.

Morris Berman describes the characteristics of American culture that mark it as a culture in the process of dying, dying because we have lost track of what is important, we have allowed unconscionable inequalities to exist, we are squandering our resources on killing people, we are losing our common sense, our wisdom and our spiritual awareness.  And he asks: what recourse is available to those who see what is happening and who want to protect and nurture what is being lost?

His answer is that they should do what the monks did in their monasteries during the Dark Ages.  During that period between the Greek and Roman empires and the Renaissance, the monks scribed the works of the great Greek and Roman philosophers, clerics and scientists so they would be available to future generations.  Berman suggests that those who are aware of what is happening and who want to protect what is being lost do so by living their lives according to what they know to be true and by continuing to speak that truth in all the ways they can.⁷

Organizations like the International Society for Ethical Psychology and Psychiatry, the International Society for Psychological and Social Approaches to Psychosis, and MindFreedom International are important and valuable mediators and repositories of that truth.

The other thing people can do is reform our public schools so they become places in which young persons can learn to use their wills, emotions and critical faculties to make up their own minds, find their own answers and pursue their own truth free from the oppressive mantle of the educational establishment, an establishment which is the paradigmatic reflection of,  and a major propagator of the Age of Reason, the Rise of Scientism, and the Cult of Professionalism.

¹Whitaker, R. (2003). Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill. Cambridge, MA: Perseus Publishing Group.