All Your Brains Are Belong To Us

Psychiatry and the pharmaceutical industry have taken a lot of criticism in recent years for diagnosing large numbers of people with newly invented disorders and prescribing unnecessary drugs to many folks who, in the not-so-distant past, would not have been regarded as having any sort of illness or disorder. Some argue that it's all a clever conspiracy to line the pockets of a scheming cabal of psychiatrists and drug company executives. (The title of this post, for those who may be wondering about the ungrammatical language, comes from the gloating of an evil character in a poorly translated video game that has become an Internet legend.)

The other side of the argument can be found in an article in last week's New York Times, which defends the psychiatrists and drug companies by pointing out that many people always have used mind-altering substances of one sort or another. Alcohol, cigarettes, and other products were commonly used throughout history to reduce anxiety and other unpleasant conditions. The author also notes that we can't accurately compare the percentage of the population now taking psychiatric drugs to the percentage that had depression and other serious problems in the past, given the fact that today's diagnostic categories lack historical equivalents. Also, very few people choose to take psychiatric drugs for trivial reasons.

All of these points are based on solid historical fact. They're also quite irrelevant, in my view, to what is wrong with psychiatry. It's probably true that many of the people now taking Prozac or Paxil would've medicated themselves in saloons or opium dens a century or two ago; and if psychiatrists were nothing more than legal drug dealers, occupying the same social niche as bartenders, I wouldn't have any objection. But there is a major difference that the article never mentions: Psychiatry, unlike other types of substance use, always involves coercion, whether directly or indirectly.

When the medical profession broadly applies the narrative of disorder and illness to human cognitive diversity, it causes society to view the people so labeled as tragic sufferers, in urgent need of treatment and/or cure. Instead of being advised to make careful decisions and to exercise moderation, as with alcohol and other potentially harmful substances, a psychiatric patient is expected to take whatever medications the doctor prescribes and never to question the doctor's authority. And if a person who has a psychiatric label is reluctant to use drugs, that decision (unlike the choice to abstain from alcohol or street drugs) will get no support from society; rather, he or she is likely to be condemned as foolish, noncompliant, and irresponsible for not obeying the doctor.

And that's only the indirect coercion. Applying medical labels to cognitive differences also results in forcible use of drugs in many cases; after all, our society considers anyone who does not want treatment for an "illness" to be dangerously irrational. Ginger just posted a blog entry describing the ordeal of Nate Tseglin, an autistic teenager in California who was taken from his parents because they were seen as neglectful for not giving him medications to prevent self-injury. Although the parents explained that he had a history of strong negative reactions to psychiatric drugs, the authorities ignored their concerns and placed their son in a group home where he was forcibly drugged, as described in the Orange County Register:


… the parents were cut out of any decision-making regarding their son. They were given only short visits with him. After he ran away from the group home, the government transferred Nate to a mental hospital. The Tseglins say the drugs the hospital gave Nate caused him to have a "grand mal" seizure, and his health has continued to deteriorate while he languishes in a government mental facility. When they visited him over the summer, they found his face swollen. He faded in and out of consciousness and was suffering from convulsions. They believe he has been beaten and are worried about sexual abuse, given that he is housed with the criminally insane.

The Tseglins claim Child Protective Services has told them they have the "wrong set of beliefs" and even threatened to force them to undergo court-ordered psychological evaluation. The agency at one point suspended the parents' visitations as a way "to assist them in coming to grips regarding their son." The Tseglins, as former citizens of the Soviet Union, have good reason to be fearful of the authorities. But they tell me that they experienced nothing of this sort in the former communist nation. If their descriptions are correct, then the Soviets weren't the only ones who know how to create a totalitarian bureaucracy.


Ginger is asking autism bloggers to write about this case in the hope of shaming the authorities into letting Nate go home. We need to be aware, however, that this is by no means an isolated incident. Children in the foster care system are routinely given strong psychiatric medications to keep them docile, and this has been going on for many years. I used to know a woman who was a licensed foster parent. When she got a new kid placed in her home, the first thing she did was throw away the kid's meds. That was her way of fighting back against a broken system that was destroying children's lives.

That was 25 years ago.

We now have a society that spends vast sums waging a largely ineffectual "war on drugs" while, at the same time, enforcing a psychiatric regime that routinely uses powerful drugs for the purpose of "combating" autism and other neurological variations. Millions of American citizens are stigmatized, coerced in various ways, and sometimes locked up because they are using illicit drugs to change the functioning of their brains. Millions more are stigmatized, coerced in other ways, and sometimes locked up because they have not altered their brains enough to meet with society's approval. And the ever-shrinking group of "normal" people in the middle has to live in fear of what might happen if, at some point, they or their family members were to be judged "abnormal."

The fault lines in our cultural landscape run a lot deeper than any recent conspiracy between the psychiatrists and the pharmaceutical companies. We are dealing with unresolved issues of social class and eugenics that go back more than a hundred years. We still have a frighteningly high number of influential people shaping social attitudes (such as a professor who told his students last week that aborting babies with Down syndrome is "the moral thing" to do) who think in terms of controlling and eradicating the undesirables and perfecting the gene pool. In short, we are dealing with a very complex situation, and we oversimplify it at our own peril when we treat it like a video game battle against evil cartoon conspirators.

Update, Feb. 29: For more information about Nate Tseglin visit http://www.getnatehome.com/