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Let me tell you about the
American Psychiatric Association. Until, I think, the late 1970s, they listed
homosexuality as a disease requiring psychiatric treatment, with promises of
cures to heterosexuality. A common treatment here and in the UK -- involuntarily
when a "sufferer" ran afoul of criminal laws against homosexuality --
were hormone injections. The British mathematician Alan Turing had this
treatment forced on him in the mid-1950s, grew breasts among other
treatment-associated torments, and shortly afterwards committed
suicide.
For decades, Soviet
psychiatrists -- I've seen them interviewed, they were entirely sincere healers,
this is the professional culture in which they were educated -- viewed
opposition to the Soviet government and the Communist Party as severe
psychiatric disease. They routinely treated those involuntarily committed
patients with insulin and electric shock and with wet canvas shrinking
straitjackets. They were horrified when their colleagues in Western nations
threatened to throw them out of international psychiatric
associations.
The distinction between
the trendiness of psychology and psychiatry and the trendiness of musical styles
is that when the world chooses to spend a decade at the Disco, no one is harmed
beyond a little musical embarrassment.
Unhappily, psychiatry
can't say the same thing. Lobotomy used to be a popular cure for psychiatric
disorders, and electric shock is still a hotly debated (and readily available)
procedure, particularly in the dubious area of "informed consent,"
where patients have not been candidly warned of the well documented possibility
of permanent memory impairment. In general, psychiatry has been slow and
reluctant to embrace the notion of fully informed consent.
I'm not at all hostile to psychiatry.
For all its trendy historical harm, these are still by far the best people to
flee to in an authentic crisis.
But Asperger's is one of psychiatry's
periodic imaginary crises, remarkably and evasively resistant to quantitative,
objective diagnosis. As far as I can see, the wholly untreated -- like Gould --
seem to do just about as well as, or fare even better than the professionally
treated.
But the history of psychiatry is
unhappily rich with ghastly junk science mistakes. Most of them had to be
corrected by outsiders, lawyers, human-rights NGOs, and very angry victims. Only
those innocent of these historical aspects of psychiatry in our times can feel
as confident as you in citing their publications and pronouncements du jour as
Gospel.
Canada is a wonderful place. It honored
Glenn Gould from childhood to grave and beyond, and to the best of my knowledge
never threatened Gould in his most eccentric moments with involuntary
psychiatric commitment or treatment. That's the subtext of your strident defense
of this Asperger's diagnosis -- you're disturbingly confident about the
propriety of saddling goofy people who reside well within the range of
intellectual, social and emotional activity with pathological
diagnoses.
As we speak, the intimate and largely
unexamined and unchallenged relationship between the pharmaceutical industry and
American psychiatry is treating hundreds of thousands of public school children,
almost all of them males, often under threat of expulsion, with powerful
psychotropic drugs, Ritalin and Prozac the most famous. Wholly unsupported by
clinical study, Ritalin has moved aggressively into mass distribution to
pre-adolescents and even toddlers.
Prozac, under a trendy, Smiley-Face new
name, is now being aggressively marketed to women for treatment of routine
symptoms associated with menstruation. The women on this list are far more
qualified than I to document the common severity of these symptoms, but the
question is the medical propriety of routine prescription of Prozac for these
symptoms, which is undergoing a lot of healthy and skeptical scrutiny.
I'm a Big Fan of the development and
appropriate application of these newish drugs; in particular they have produced
a revolutionary miracle in our times for the treatment of the most severe
chronic psychiatric disorders, particularly the previously hopeless
schizophrenia. These medications have turned the lives of many of our shelter
guests from nightmares on the streets to functional lives with long-term windows
of happiness and community integration.
But a decade from now -- forgive me for
lapsing into prophesy -- there will be a very different and embarrassed public
view of the last two decades' enthusiastic and often corrupt romance between
psychiatry and the pharmaceutical industry, particularly as it skews the
ultimate objective of medicine -- first, to do no harm, and second, never to
subordinate considerations of profit to care of the patient.
As Mr Maloney was quick to point out at the beginning of his paper, people
with Asperger Syndrome often are leaders in their field, albeit a bit strange
socially.
Who judges strange? Mr. Maloney? Who
the hell is he? Does he have enough time on his hands to judge me? You? The
musicians on this list? Isaac Newton? Who judges strange? What are the objective
criteria for strange? I wouldn't want to run afoul of this Committee.
At least until the 1980s, perhaps to
this moment, the American Psychiatric Association listed more than two tattooes
as positive diagnostic indication of psychiatric disorder. If you've looked at a
springtime college campus or rock concert audience lately, we seem to have a
sudden mysterious epidemic of psychiatric illness. I hadn't previously suspected
these sorts of things were contagious.
Again, you came in late with your Son
of Asperger's thread, so again, apologies to all for repeating things I posted
months ago. My only defense is that I sincerely believe this whole thing is junk
science nonsense; GG's posthumous diagnosis is patently unsupported and
ridiculous; and I don't think the issue ought to be allowed to rest based on the
volume of ink one champion has the capacity to devote to it.
In a healthier age, Gould's lifelong
relentless quest for artistic and intellectual perfection would be celebrated
for its rarity, not referred to mental health professional for treatment. I
admit to a hostility for the Celebration of Normal so characteristic of our
times, and the inevitable colorless, predictable, impoverished and unhealthy
uniform world it will condemn us all to. Of our particular interests and
passions, it promises a more comforting standardization of the interpretations
of Bach and Mozart; a Normal musical future may also finally get rid of that
damn humming once and for all!
Thanks for the helpful tip about List
etiquette! Now I know whom to turn to for these things, as well as for
psychiatric expertise! Mr. Elevator
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