This post is about an issue that is by now a bit dated (though the topic as such certainly isn’t), but we have only just become aware of it and it seemed to us worth rescuing it from the memory hole. In late 2013, the then newest issue of the American Diagnostic and Statistical Manual of Mental Disorders (DSM for short) defined a new mental illness, the so-called “oppositional defiant disorder” or ODD.
As TheMindUnleashed.org informs us, the definition of this new mental illness essentially amounts to declaring any non-conformity and questioning of authority as a form of insanity. According to the manual, ODD is defined as:
[…] an “ongoing pattern of disobedient, hostile and defiant behavior,” symptoms include questioning authority, negativity, defiance, argumentativeness, and being easily annoyed.
Every time a new issue of the DSM appears, the number of mental disorders grows – and this growth is exponential. A century ago there were essentially 7 disorders, 80 years ago there were 59, 50 years ago there were 130, and by 2010 there were 374 (77 of which were “found” in just seven years). A prominent critic of this over-diagnosing (and the associated over-medication trend) is psychologist Dr. Paula Caplan. Here is an interview with her:
As MindUnleashed notes:
“Are we becoming sicker? Is it getting harder to be mentally healthy? Authors of the DSM-IV say that it’s because they’re better able to identify these illnesses today. Critics charge that it’s because they have too much time on their hands.
New mental illnesses identified by the DSM-IV include arrogance, narcissism, above-average creativity, cynicism, and antisocial behavior. In the past, these were called “personality traits,” but now they’re diseases. And there are treatments available.”
Edward Abbey on what happens when no-one ever stirs things up
There is an obvious danger involved with such loose definitions such as the one employed in identifying the alleged illness of “ODD”. A chilling example was provided by the Soviet Union in the 1960s and 1970s. In a 1959 speech, Nikita Khrushchev made the following remark:
“Can there be diseases, nervous diseases among certain people in the communist society? Evidently there can be. If that is so, then there also will be offenses which are characteristic of people with abnormal minds. To those who might start calling for opposition to communism on this ‘basis,’ we say that now, too, there are people who fight against communism, but clearly the mental state of such people is not normal.”
Obviously, questioning the best socio-economic system ever devised had to be a sign of insanity, and after Khrushchev’s speech Soviet psychiatrists immediately went to work to discover and institutionalize all those mentally ill “communism deniers”.
The road to what followed had already been paved in 1951, when in a joint session of the USSR Academy of Medical Sciences and the Board of the All-Union Neurological and Psychiatric Association, several leading neurologists and psychiatrists were accused of pursuing an “anti-Marxist and reactionary” deviation from the teachings of Pavlov. The session took place on Stalin’s behest so as to “free Soviet psychiatry of Western influences”.
The psychiatrist who wrote the policy report associated with this purge was Andrei Snezhnevsky, who invented (err, “discovered”) a new mental illness, which he termed “sluggish schizophrenia”. After Khrushchev’s 1959 speech, the term was widely adopted and the illness was diagnosed throughout the Eastern Bloc. The symptoms of the alleged “illness” were such that even the slightest change in behavior patterns could henceforth be interpreted as a sign of mental derangement. Political dissent was for instance considered to by a symptom of “sluggish schizophrenia with delusions of reform”.
Snezhnevsky personally signed a decision declaring several prominent dissidents legally insane – among them also neurophysiologist Vladimir Bukovsky, who was the first to expose and criticize the abuse of psychiatry in the Soviet Union and spent altogether 12 years in prisons, forced labor camps and locked up in psychiatric hospitals for his efforts.
Snezhnevsky’s theories became the only ones acceptable in Soviet psychiatry, and it was obviously held to be quite dangerous to oppose them. Ironically, in 1970, one year before Vladimir Bukovsky managed to smuggle out 150 pages that documented the silencing of political dissenters with the aid of psychiatry in the Soviet Union, the American Psychiatric Association named Snezhnevsky a “distinguished fellow” for his “outstanding contribution to psychiatry and related sciences” at its annual meeting in San Francisco.
Soviet psychiatrist Andrei Snezhnevsky, hero of socialist labor, owner of two Orders of Lenin as well as four Orders of the Red Star and USSR state prize.
Money and the Invention of new Categories of Disease
There is a basic problem with psychiatry and psychology: they are largely thymological, as opposed to natural sciences. If you break your arm and visit 10 different medical doctors, you will get the same diagnosis from every single one of them – they will all tell you that your arm is broken. A standardized treatment exists for dealing with a broken arm.
Make a list of psychological problems you are experiencing and visit ten different psychiatrists, and chances are very good that you will receive 10 different diagnoses coupled with 10 different proposals for treatment (including prescriptions for very powerful psychotropic drugs). Genuine severe mental disorders may be connected with chemical imbalances in the brain to some extent (no conclusive proof for this actually exists), but by and large there is little that can be objectively “measured”. The psychologist or psychiatrist must largely rely on the same ability that also characterizes the work of the historian – i.e., what Mises called “understanding”. They can only judge behavior.
So why have so many former “personality traits” been transformed into symptoms of mental illness? One major reason is money. Here are a few data points that shed light on the monetary side of the psychiatry business; the data are by now slightly dated, but they suffice to get the point across. As of 2010:
Global sales of anti-depressants, stimulants, anti-anxiety and anti-psychotic drugs had reached more than $76 billion per year.
Globally, 54 million people were taking anti-depressants that are known to cause addiction, and often violent and homicidal behavior.
In the US, 20% of all women were taking mental health medication in 2010. Essentially every fourth female is prozac’d into quietude.
20 million children worldwide had been diagnosed with mental disorders and were prescribed stimulants and/or powerful anti-depressants.
In 2002, more than 100 million prescriptions were written for anti-depressants alone (cost: $19.5 billion nominal)
In France, one in seven prescriptions is for a psychotropic drug and more than 50% of the employed were taking such drugs (as of 2010, 1.8 million people).
Between 1986 and 2004, combined spending on anti-psychotic drugs and anti-depressants jumped from $500 million to $20 billion.
In the US, the mental health budget, adjusted for inflation, has soared from $33 billion in 1994 to $ 80 billion in 2010 (similar increases have occurred elsewhere).
Stefan Molyneux whom we got the above data from also reports that according to the US National Institute of Mental Health (in 2010) “26% of Americans suffer from mental illness” and “nearly 58 million Americans will suffer from an episode of mental illness in any given year”. There you have it – we’re literally surrounded by lunatics. As Molyneux rightly points out: if there is a disease for which we have effective cures, then application of this cure should reduce the prevalence of the disease.
For instance, a number of infectious diseases have been nearly, or completely exterminated by effective vaccines. We should therefore expect that with the arrival of psychiatric medications that allegedly “correct chemical imbalances in the brain”, there should be a decline in the number of mentally ill people. The first such medications were introduced in the mid 1950s. So what happened? In 1955, there were 355,000 adults confined to mental hospitals all over the US on account of being diagnosed as mentally ill by psychiatrists. After 50 years of medical treatment with anti-psychotic drugs, that number has risen to more than 4 million patients (as of 2007). Some success!
While the prescription of psychiatric medications to children soared from the mid 1980s to today, so did the number of youth receiving disability payments from the government for mental disability. It rose from 16,200 in 1986 to 561,569 in 2007 (a 35 fold increase). It appears that all those meds prescribed to “ODD” and “ADHD” children have had the exact opposite effect from that advertised.
Number of Americans disabled by mental illness since Prozac was introduced.
Again, there exists no convincing proof as of yet for any chemical, biological or genetic causes of mental illness. The categorizations found in the DSM are arrived at by “peer consensus”, not by any objective measurements. And yet, drugs that alter chemical balances in the brain are prescribed as treatment. The greater the number of new diseases manufactured by said consensus, the more treatments can be prescribed. As Dr. Thomas Dorman, internist and member of the Royal College of Physicians of the UK, and Fellow of the Royal College of Physicians of Canada, put it:
“In short, the whole business of creating psychiatric categories of ‘disease,’ formalizing them with consensus, and subsequently ascribing diagnostic codes to them, which in turn leads to their use for insurance billing, is nothing but an extended racket furnishing psychiatry a pseudo-scientific aura. The perpetrators are, of course, feeding at the public trough.”
It is not too difficult to see the enormous monetary incentives that are driving this business of declaring as many people as possible to be mentally ill. There no longer is such a thing as a harmless “eccentric”. Any deviation from the norms laid out by the psychiatric profession mean one is in need of treatment. Only the sheeple are sane.
Stefan Molyneux’s podcast on mental illness from which we have taken most of the statistics presented above can be seen here:
Freethinkers Medicated Into Silence by Good Serfs
However, there may be another reason why anti-authoritarianism specifically has made it onto the list of behaviors held to be symptomatic of mental illness. Psychologist Dr. Bruce Levine has laid the problem out in an article entitled “Why Anti-Authoritarians are Diagnosed as Mentally Ill”. A few pertinent excerpts follow below. First Dr. Levine explains why there seem so few anti-authoritarians in the US. The reason in his opinion is that many have been medicated into silence:
“Anti-authoritarians question whether an authority is a legitimate one before taking that authority seriously. Evaluating the legitimacy of authorities includes assessing whether or not authorities actually know what they are talking about, are honest, and care about those people who are respecting their authority. And when anti-authoritarians assess an authority to be illegitimate, they challenge and resist that authority—sometimes aggressively and sometimes passive-aggressively, sometimes wisely and sometimes not.
Some activists lament how few anti-authoritarians there appear to be in the United States. One reason could be that many natural anti-authoritarians are now psycho-pathologized and medicated before they achieve political consciousness of society’s most oppressive authorities.”
But why does this happen, apart from the monetary incentives discussed above? Why are psychiatrists so eager to medicate anti-authoritarians into a stupor? In Dr. Levine’s opinion, the reason is that the career of most psychiatrists involves an extraordinary degree of compliance with authorities, to the point where they are not even aware anymore of how obedient they have become. When confronted with patients who aren’t exhibiting a similar degree of obedient behavior, they immediately suspect that there is something to diagnose and treat:
“The selection and socialization of mental health professionals tends to breed out many anti-authoritarians. Having steered the higher-education terrain for a decade of my life, I know that degrees and credentials are primarily badges of compliance. Those with extended schooling have lived for many years in a world where one routinely conforms to the demands of authorities. Thus for many MDs and PhDs, people different from them who reject this attentional and behavioral compliance appear to be from another world—a diagnosable one.
I have found that most psychologists, psychiatrists, and other mental health professionals are not only extraordinarily compliant with authorities but also unaware of the magnitude of their obedience. And it also has become clear to me that the anti-authoritarianism of their patients creates enormous anxiety for these professionals, and their anxiety fuels diagnoses and treatments.
In connection with ODD diagnoses, Dr. Levine not unreasonably asks “Do we really want to diagnose and medicate everyone with “deficits in rule-governed behavior”?”. As he points out, many of the people who have enriched humanity with revolutionary new scientific concepts, inventions or works of art, would have been diagnosed as mentally ill anti-authoritarians in today’s day and age and may well have been medicated into a such a daze that their creations would never have seen the light of day. He cites Albert Einstein as a pertinent example:
“Albert Einstein, as a youth, would have likely received an ADHD diagnosis, and maybe an ODD one as well. Albert didn’t pay attention to his teachers, failed his college entrance examinations twice, and had difficulty holding jobs. However, Einstein biographer Ronald Clark (Einstein: The Life and Times) asserts that Albert’s problems did not stem from attention deficits but rather from his hatred of authoritarian, Prussian discipline in his schools.
Einstein said, “The teachers in the elementary school appeared to me like sergeants and in the Gymnasium the teachers were like lieutenants.” At age 13, Einstein read Kant’s difficult Critique of Pure Reason—because Albert was interested in it. Clark also tells us Einstein refused to prepare himself for his college admissions as a rebellion against his father’s “unbearable” path of a “practical profession.” After he did enter college, one professor told Einstein, “You have one fault; one can’t tell you anything.” The very characteristics of Einstein that upset authorities so much were exactly the ones that allowed him to excel.”
It is probably a good bet that a Haldol-addled Einstein wouldn’t have excelled at much. Well, he even looked crazy: theoretical physicist and reputed anti-authoritarian Albert Einstein, who invented a few unimportant little formulas like E=mc2. Rumor has it he also invented gravity, which we have been struggling against ever since.
As Dr. Levine points out, once they are diagnosed as mentally ill, anti-authoritarians are especially likely to become victims of a vicious cycle:
“Many anti-authoritarians who earlier in their lives were diagnosed with mental illness tell me that once they were labeled with a psychiatric diagnosis, they got caught in a dilemma. Authoritarians, by definition, demand unquestioning obedience, and so any resistance to their diagnosis and treatment created enormous anxiety for authoritarian mental health professionals; and professionals, feeling out of control, labeled them “noncompliant with treatment,” increased the severity of their diagnosis, and jacked up their medications.”
Dr. Levine then concludes that the direction in which the system has evolved is indeed reminiscent of a “Sovietization”; just as the ruling classes once employed an authoritarian religious establishment to enforce compliance with the status quo, they can nowadays rely on psychiatry to do the job:
“What better way to maintain the status quo than to view inattention, anger, anxiety, and depression as biochemical problems of those who are mentally ill rather than normal reactions to an increasingly authoritarian society.
So authoritarians financially marginalize those who buck the system, they criminalize anti-authoritarianism, they psychopathologize anti-authoritarians, and they market drugs for their “cure.”
Evidently the system provides ample scope for both intentional and unintentional abuse.
In order to prevent misunderstandings, we should point out that we don’t want to assert here that there exists no such thing as mental illness, or that psychiatry is completely useless in diagnosing it or providing effective treatment. The same holds for psychotropic medication: there certainly exist medications that can be helpful in alleviating symptoms of severe mental conditions and allow people to lead fairly normal lives that would otherwise be out of reach for them (i.e., we don’t fully agree with Stefan Molyneux’s conclusions; this is simply based on the fact that we personally know of two cases in which appropriate medication helped people exhibiting severe symptoms associated with schizophrenia).
However, it is important to realize that the sciences dealing with the human mind are thymological in nature and cannot make claims based on objectively measurable physical quantities. And yet, the field has turned into a “growth industry” in every respect; the number of behaviors regarded as “abnormal”, as well as the number of medications prescribed for treating such behaviors has grown exponentially. This is a dangerous development and the fact that almost every quirky personality trait is suddenly deemed a sign of disease is certainly giving one pause (it is dangerous in several respects: consider for instance the great number of mass murderers who were prescribed psychotropic drugs. Correlation is not always causation of course, but still…)
The psychopathologizing of anti-authoritarian behavior is yet another step on what looks like an increasingly slippery slope and it strikes us as especially harmful. As Dr. Levine inter alia points out: “It has been my experience that many anti-authoritarians labeled with psychiatric diagnoses usually don’t reject all authorities, simply those they’ve assessed to be illegitimate ones.”
In other words, the term “anti-authoritarian” does not necessarily stand for a blanket rejection of all authorities, but rather a healthy questioning of the legitimacy of existing authorities. This seems all the more necessary today, when governments in the name of providing all-encompassing security (a task at which they are predictably failing) are seeing fit to let individual liberty die a death of a thousand cuts.