Confusion has its uses
Are you shy? Introverted? Reserved? Hostile? Easily bored? Hypercritical? Tightly wound? Quarrelsome? High maintenance? Have you considered medication? It could be that KlineGlasgowSmith has just the pill for you. Do you have restless legs? A limp dick? Flat hair? Do you get hungry several times a day? Do you scratch a lot? You could have a treatable syndrome: please turn on your tv, and the right ad for your condition will appear sooner than you expect.
Frederick Crews looks at the wonderful interplay between Big Pharma and middle-class hypochondria.
Most of us naively regard mental disturbances, like physical ones, as timeless realities that our doctors address according to up-to-date research, employing medicines whose appropriateness and safety have been tested and approved by a benignly vigilant government. Here, however, we catch a glimpse of a different world in which convictions, perceived needs, and choices regarding health care are manufactured along with the products that will match them…Clearly, the drug companies’ publicists couldn’t exercise their consciousness-shaping wiles so fruitfully without a prior disposition among the populace to strive for self-improvement through every legal means…Americans have required little prodding to believe that a medication can neutralize their social handicaps and supply them with a better personality than the one they were dealt by an inconsiderate fate.
See, that’s where I elude their clutches; I’ve never wanted a better personality, even though I would never describe my personality as the ideal personality for everyone to aspire to. I just happen to like mine, that’s all. I like being grouchy and surly and difficult; it suits me; I’m used to it. I’m bemused by people who want to be warmer and more gregarious. What an odd thing to want, I always think, pounding another nail into the board over the window.
I didn’t know about this though – drug companies concealed the side effects of SSRIs and argued in court that there was insufficient evidence for them – until –
Eli Lilly bought the marketing rights to a near relative of its own patent-lapsed Prozac. According to the new drug’s damning patent application, it was less likely than Prozac to induce “headaches, nervousness, anxiety, insomnia, inner restlessness…, suicidal thoughts and self mutilation”.
Fascinating, isn’t it? Deny the side effects until the patent lapses and it’s time to sell a new one, and then mention the side effects. Don’t I feel clever and vindicated for having no urge to take pills to make me Nicer.
Then there’s the way the DSM is geared to validating ‘disorders’ so that psychiatrists can treat them and insurance companies will treat them. (This is US of course, not relevant to other places.)
As for psychiatry’s inability to settle on a discrete list of disorders that can remain impervious to fads and fashions, that is an embarrassment only to clear academic thinkers like these two authors. For bureaucratized psychological treatment, and for the pharmaceutical industry that is now deeply enmeshed in it, confusion has its uses and is likely to persist.
Great phrase, that: confusion has its uses. It does indeed.
The pathology-identification approach to clinical psychology has flaws that temporally – and in my opinion logically – precede the pharmacology industries exploitation of it. Nowhere in the history of psychology, from that fraud Freud onward, is there a proper theory of health or homeostasis by which pathology can be properly judged. The fairly recent “positive psychology” movement has started trying to fill that void, but frankly the field is rather too tainted by pop psychology self-help nonsense to qualify as science in any meaningful sense.
Psychology in terms of neuropsychology or perception studies or any of a dozen subfields is rich in well-substantiated (if somewhat narrow) bits of scientific knowledge, but psychology as a coherent endeavor and clinical psychology especially… not so much.
Just started reading that article and so far I’m unimpressed. It is true that in the US, where direct to patient advertising is the norm, Big Pharma liks to disease monger. But that doesn’t make thinks like social anxiety disorder any less real or distressing.
The claim that the “WHO would appear to have bought Big Pharma’s line of goods” is crap – the problem is that the WHO is using patients’ subjective ratings of quality of life to rate severity – funnily enough depressed people, major depression or otherwise, rate their quality of life much lower than people with physical illness.
I’m also unhappy with the implications contained in “bothersome states that the drug makers want us to regard as chemically reparable. They range from excitability and poor concentration to menstrual and menopausal effects and “female sexual dysfunction” – gynaecology is almost completely concerned with bothersome but non-fatal, even physiological conditions, should we ignore women with severe, life disrupting, menopausal symptoms, mennorhagia, or PMS?
And can we really “…exaggerate…legitimate worries over cardiovascular disease, osteoporosis,…”? Osteoporosis is a massive health risk for women, and cardiovascular disease is a massive killer where medication hs made a real tangible difference to survival.
And the insinuation that the DSM is the result of some financial self-interest by American psychiatrists is somewhat inconsistent with the existence of the ICD-10.
Bar two of course, (naturally) I am suffering with all of the symptoms you describe, OB, in the first paragraph. But, suffice it to add, I do not possess a telly so how do I go about treating these god darn awful ailments? How can KlineGlasgowSmith persuade me, otherwise – to buy its lifesaving pills? I am in a bit of a dither and restlessly scratching away and wondering what is the best course of action to take! :-)!!!
Marie-Therese –
You are suffering from Refusal to Have a Telly syndrome – you must phone KlineGlasgowSmith and they will send a representative to harangue you in person about their new pill which cures this terrible tellyphobia disorder.
Off topic, but feel free to brag about the Dawkins top hundred.
It’s like having Johnny Cash cover one of your songs.
Aye, OB, but this introspective, timid, reserved nature of mine prevents me from being able to communicate with people properly so for that purpose I do not have a phone. I am also very changeable as well and when I feel tightly wound up I have no self control and therefore have the propensity to be dreadfully hypercritical and quarrelsome. Only God knows how I would react to people on the phone. Now, the last thing I need, I am sure you can see – is an agent from KlineGlasgowSmith coming to my door trying to sell me their wares for my telly phobia. Am I crazy – or what? Can you please, for B&W sake, tell me? :-)!
Heh – I know, isn’t that fun? (Dawkins 100, not M-T’s visit from Big Pharma!) I’m so proud of Edmund…
:- )
The comments when that article first appeared at Dawkins’s site were quite amazing – people doing handsprings and saying this was the best thing they’d ever read.
Edmund and I are grinning like clowns!
Pharmexec 1: “Hey, I have an idea! Let’s advertise our drugs like those Geico and Hummer dudes”!
Pharmexec 2: “What a brilliant idea, I’ll get P.R. on it right away!, we can make it resemble a laundry detergent commercial”!
Pharmexec 1: “I wonder if people will find it distasteful? I mean, what if they view us as ‘pushers'”?
Pharmexec 2: “Nah, don’t worry, that’s not usually the focus of our target consumers. Make the adverts as ‘normal’ appearing as you need to to disguise the fact that we are hocking drugs in the name of profits, and we will just watch the dollars roll in! (as if we need any more profits, wink wink)”.
Pharmexec 1: “OK, let’s give Big Oil a run for their money”.
Disgust-O-Rama
(coming soon: ambulance chasers discussing how to make tv adverts for drug reaction victims)
Kill your television.
“Notice numero uno…”
Fantastico! Meravigliosi! Uno successo!
Buona notte!
I looked at Dawkins’ list, very long but limited in scope isn’t it? I’m sure my top 100 (if I had the time and inclination to collate one) would include science, philosophy, religion, opera, literature, anything that made me say along the lines of, “Yep, I hadn’t thought of that, now I’ve learned something really interesting, maybe even useful”. There would probably be a few songs and poems on the list as well.
It’s the top 100 from that site, not in the universe – of course it’s limited in scope! That’s not anybody’s list of favorite articles of all time from anywhere. It’s local. Still good.
Being paranoid doesn’t preclude that They might, indeed, be out to get you; likewise, advertising a drug on TV doesn’t mean that it isn’t actually useful for some people.
As someone who carries on with life held together by the pharmaceutical equivalent of duct tape and baling wire, I suggest that the objections to the ads, as well as the ads themselves, be accepted with more than a few grains of salt. (And no, I never heard of the medicines prescribed for me before my doctor recommended them — though some of them have since crept into the telly.)
Dr Helen wears a T-shirt
“Death. Been There. Done That.”
She and her family have only praise for what Big Pharma have done for them.