America's mental health problems may be more than a matter of some "unadjusted" individuals. The entire culture might well need adjusting.
For many Americans who gain their information solely from television, all critics of psychiatry are Scientologists, exemplified by Tom Cruise spewing at Matt Lauer, "You don't know the history of psychiatry. ... Matt, you're so glib." The mass media has been highly successful in convincing Americans to associate criticism of psychiatry with anti-drug zealots from the Church of Scientology, the lucrative invention of science fiction writer L. Ron Hubbard.
However, Americans who gain their information outside of television and beyond the mass media may be aware of a secular, progressive tradition that is critical of how psychiatry has diverted us from examining societal sources of our malaise. This secular, humanistic concern was articulated, perhaps most famously, by the psychoanalyst Erich Fromm (1900-1980).
In The Sane Society (1955), Fromm wrote, "Yet many psychiatrists and psychologists refuse to entertain the idea that society as a whole may be lacking in sanity
. They hold that the problem of mental health in a society is only that of the number of 'unadjusted' individuals, and not of a possible unadjustment of the culture itself."
Is American society a healthy one, and are those having difficulties adjusting to it mentally ill? Or is American society an unhealthy one, and are many Americans with emotional difficulties simply alienated rather than ill?
For Fromm, "An unhealthy society is one which creates mutual hostility (and) distrust, which transforms man into an instrument of use and exploitation for others, which deprives him of a sense of self, except inasmuch as he submits to others or becomes an automaton." Fromm viewed American society as an increasingly unhealthy one, in which people routinely experience painful alienation that fuels emotional and behavioral difficulties.
Unlike Tom Cruise, Fromm would not have been terribly upset that actress Brooke Shields found happiness in antidepressants. No genuinely humanistic critic of psychiatry believes that adults who choose prescription psychotropic drugs should be mocked or shamed, or prohibited from using them. Rather, humanist critics of establishment psychiatry advocate for informed choice about all treatments.
The essential confrontation for Fromm is not about psychiatric drugs per se (though he would be sad that so many Americans nowadays, especially children, are prescribed psychotropic drugs in order to fit into inhospitable environments). His essential confrontation was directed at all mental health professionals -- including non-prescribers such as psychologists, social workers and counselors -- who merely assist their patients to adjust but neglect to validate their patients' alienation from society.
Those comfortably atop societal hierarchies have difficulty recognizing that many American institutions promote helplessness, passivity, boredom, fear, isolation, alienation and dehumanization for those not at the top. One-size-fits-all schools, the corporate workplace, government bureaucracies and other giant, impersonal institutions routinely promote manipulative relationships rather than respectful ones, machine efficiency rather than human pride, authoritarian hierarchies rather than participatory democracy, disconnectedness rather than community, and helplessness rather than empowerment.
In The Sane Society, Fromm warned, "Today the function of psychiatry, psychology and psychoanalysis threatens to become the tool in the manipulation of man
. The specialists in this field tell you what the 'normal' person is, and, correspondingly, what is wrong with you; they devise the methods to help you adjust, be happy, be normal."
In the "adjust and be happy" sense, there is commonality between establishment mental health professionals and Scientologists. Neither Dr. Phil nor Tom Cruise are exactly rebels against the economic status quo; and their competing self-help programs, though different, are similar in that they instruct people on how to adjust, be happy and be normal within our economic system.
The source of the mutual hostility between psychiatry and the Church of Scientology, as depicted by the mass media, centers around psychotropic drug use; but my sense is that the root cause of their feud is a fierce competition between them. Both establishment psychiatry and Scientology are competing for the same people -- those more comfortable with authority, dogma and insider jargon than with critical thinking.
Both the teachings of L. Ron Hubbard and psychiatry's DSM (the official diagnostic manual in which mental illnesses are voted in and out by elite psychiatrists) have much more to do with dogma than science. Both Scientology and psychiatry embrace science fiction technobabble that poses as scientific fact. In Scientology's "auditing," the claim is that the Hubbard Electropsychometer (E-Meter) can assess the reactive mind of the "preclear" by passing a small amount of voltage through a pair of tin-plated tubes that look like empty soup cans wired to the E-Meter and held by the preclear. But psychiatry is no more scientifically relevant, as its trendy chemical-imbalance theories of mental illness have shelf-lives of about a decade, with establishment psychiatry most recently having retreated from both its serotonin-deficiency theory of depression and the excessive-dopamine theory of schizophrenia.
While Scientology can claim auditing adherents, and psychiatry can claim even more antidepressant advocates, neither treatment has been shown to be consistently superior to a placebo. And rather than validating their treatments with legitimate science performed by independent, financially unbiased scientists, both Scientology and psychiatry rely on what amounts to a well-funded public relations apparatus.
Scientology and establishment psychiatry have something else in common. They are both orthodoxies that deal harshly with their ex-insiders who have come to reject them. Currently, psychiatry is the more prevailing orthodoxy, and, as George Orwell explained, the mainstream press does not challenge a prevailing orthodoxy. Orwell wrote, "At any given moment there is an orthodoxy, a body of ideas which it is assumed that all right-thinking people will accept without question. ... Anyone who challenges the prevailing orthodoxy finds himself silenced with surprising effectiveness. A genuinely unfashionable opinion is almost never given a fair hearing, either in the popular press or in the highbrow periodicals."
It is my experience that psychiatry, Scientology and fundamentalist religions are turnoffs for genuinely critical thinkers. Critical thinkers are not so desperate to adjust and be happy that they ignore adverse affects -- be they physical, psychological, spiritual or societal. Critical thinkers listen to what others have to say while considering their motives, especially financial ones; and they discern how one's motivation may distort one's assumptions.
A critical thinker would certainly not merely accept without analysis Fromm's and my conclusion that American society is insane in terms of healthy human development. Perhaps a society should not be labeled insane just because it is replete with schools that turn kids off to reading, for-profit prisons that need increasingly more inmates for economic growth, a mass media that is dishonest about threats to national security, trumped-up wars that so indebt a society that it cannot provide basic health care, a for-profit health care system that exploits illness rather than promoting health, et cetera.
A critical thinker would most certainly point out that there have been societies far less sane than the United States -- and Erich Fromm made himself absolutely clear on this point. In the barbaric German society that Fromm fled, disruptive children who couldn't fit into one-size-fits-all schools were not forced to take Adderall and other amphetamines, but instead their parents handed them over to psychiatrists to be euthanized. Fromm, however, knew that just because one could point to societies less sane than the United States, this did not make the United States a sane, humanistic society.
Bruce E. Levine, Ph.D., is a clinical psychologist and author of Surviving America's Depression Epidemic: How to Find Morale, Energy, and Community in a World Gone Crazy (Chelsea Green, 2007).