big pharma and schizophrenia
I've been wanting to blog about Robert Whitaker's book, Mad in America, and this is as good a time as any. This sobering study of the history treatment of schizophrenia in the United States makes a few points about the formation of the American attitude toward mental illness that translates to all forms of psychic life. From a psychoanalytic point of view, Whitaker's criticism of the very diagnosis of schizophrenia makes absolute sense -- the symptoms of schizophrenia are so vague and so unscientific that it may very well apply to anyone who has ever been deeply depressed or had intensely anti-authoritarian impulses,
Cold baths, straight jackets, solitary confinement, lobotomy, electric shock and the battery of drugs (from the neuroleptics liek Thorazine to the new atypicals) available for the "treatment" of schizophrenia are actually treating the symptoms in the same way -- they have the goal the pacification of the mentally ill -- but with the drugs that are now available, they have the added incentive of creating great profit margins for pharmaceutical companies. New drugs like Eli Lilly's olanzapine marketed under the name Zyprexa are hailed as medical "breakthroughs" and priced accordingly, but in an atmosphere when drug testing is increasingly taking place in for profit laboratory environments, side effects, long term consequences and rates of remission are left out of the picture.
What does this have to do with the recent posts about USA Next? Well, it seems that Big Pharma has really had a very successful track record in the past two decades at maximizing its profits and gaining government support for its less than above board business practices.
But the successes of Eli Lilly and Pfizer in hijacking public discussions of national healthcare has also had its effects on our understanding of mental health. Those most marginal to the public sphere, the mentally ill have had few advocates (with the exception of NAMI) the marketing of the drug solution has exploited our national intolerance for symptom in general -- total medication-induced pacification is offered as the solution to mental health disturbances and national security concerns. When R.D. Laing offered his systematic critique of anti-psychiatry, he proposed that in order to treat a schizophrenic, you had to look at the entire family system. This hardly seems radical, but in our trust in pharmacological solutions to psychic life, this kind of attitude is completely marginalized.
Whitaker shows that humane treatment of schizophrenics without drugs produced better rates of recovery during the nineteenth century. Treatment of schizophrenia in the US today has worse outcomes than treatment of the mentall ill in countries like Thailand where the mentally ill tend to be much less medicated.
Foucault wrote passionately about the institutionalization of the mentally ill and described its historical significance: Deleuze and Guattari drew upon the figure of the schizo as an allegory of experience under capitalism. Whitaker is no theorist, but his examination of American treatments of schizophrenics does not make for any easy generalizations -- the mid-nineteenth century turned out to support "humane treatment" of the mentally illy from a paternalistic point of view, but early twentieth century attemtps at modernization introduced a whole set of "improvements" that created the mare's nest of problems endemic at the massive state institutions we know as hulking ruins or terrifying brick buildings on the outskirts of large cities.
Contemporary students, theorists and clinicians have to go further in order to challenge the absolute exploitation of mental illness: we have to wonder why we as Americans are so intolerant of the symptom. Pierre Fedida wrote in last book, The Benefits of Depression (that I am hoping to translate into English) that psychopharmacology wants to destroy psychic life in order to master the symptom -- which will be eliminated from consideration in treatment as imbalances are treated as purely chemical matters.
Cold baths, straight jackets, solitary confinement, lobotomy, electric shock and the battery of drugs (from the neuroleptics liek Thorazine to the new atypicals) available for the "treatment" of schizophrenia are actually treating the symptoms in the same way -- they have the goal the pacification of the mentally ill -- but with the drugs that are now available, they have the added incentive of creating great profit margins for pharmaceutical companies. New drugs like Eli Lilly's olanzapine marketed under the name Zyprexa are hailed as medical "breakthroughs" and priced accordingly, but in an atmosphere when drug testing is increasingly taking place in for profit laboratory environments, side effects, long term consequences and rates of remission are left out of the picture.
What does this have to do with the recent posts about USA Next? Well, it seems that Big Pharma has really had a very successful track record in the past two decades at maximizing its profits and gaining government support for its less than above board business practices.
But the successes of Eli Lilly and Pfizer in hijacking public discussions of national healthcare has also had its effects on our understanding of mental health. Those most marginal to the public sphere, the mentally ill have had few advocates (with the exception of NAMI) the marketing of the drug solution has exploited our national intolerance for symptom in general -- total medication-induced pacification is offered as the solution to mental health disturbances and national security concerns. When R.D. Laing offered his systematic critique of anti-psychiatry, he proposed that in order to treat a schizophrenic, you had to look at the entire family system. This hardly seems radical, but in our trust in pharmacological solutions to psychic life, this kind of attitude is completely marginalized.
Whitaker shows that humane treatment of schizophrenics without drugs produced better rates of recovery during the nineteenth century. Treatment of schizophrenia in the US today has worse outcomes than treatment of the mentall ill in countries like Thailand where the mentally ill tend to be much less medicated.
Foucault wrote passionately about the institutionalization of the mentally ill and described its historical significance: Deleuze and Guattari drew upon the figure of the schizo as an allegory of experience under capitalism. Whitaker is no theorist, but his examination of American treatments of schizophrenics does not make for any easy generalizations -- the mid-nineteenth century turned out to support "humane treatment" of the mentally illy from a paternalistic point of view, but early twentieth century attemtps at modernization introduced a whole set of "improvements" that created the mare's nest of problems endemic at the massive state institutions we know as hulking ruins or terrifying brick buildings on the outskirts of large cities.
Contemporary students, theorists and clinicians have to go further in order to challenge the absolute exploitation of mental illness: we have to wonder why we as Americans are so intolerant of the symptom. Pierre Fedida wrote in last book, The Benefits of Depression (that I am hoping to translate into English) that psychopharmacology wants to destroy psychic life in order to master the symptom -- which will be eliminated from consideration in treatment as imbalances are treated as purely chemical matters.
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