the Free Hypnosis Social Network
Social Hypnosis and ADHD- "Can you smell, that smell?"
=^..^=
Many hypnosis professionals actually believe that "All Hypnosis Is Self-hypnosis -- Let's imagine that's true for a moment:
QUESTION: Is this kind of Social Marketing a form of Mass- Self-hypnosis?
For example: A pharmaceutical company hires a Public Relations firm to market the belief that a "newly" discovered "condition" like "Infant Depression" or "ADD/ADHD" requires diagnosis and treatment. The PR firm actively markets the belief to doctors in training via medical schools, doctors in practice via their "scientific" journals and government officials via lobbying and "expert" opinion and finally, you and me via the major news outlets and media. In a relatively short period of time most doctors, teachers, parents and children are socially, self-hypnotized to believe and act as if, normal childhood behaviors are evidence of a mental disease that requires extreme medication...
http://www.ahrp.org/cms/content/view/139/29/
Disease Mongering_Conference / PLoS Special Issue
Monday, 10 April 2006
"Are we becoming patients for profit? That is the question knowledgeable observers are asking.
An Inaugural Conference on Disease-Mongering, April, 11 to 13, is being hosted by the Newcastle Institute of Public Health and School of Medicine and Public Health at the University of Newcastle, Australia. Dr. David Henry, professor of clinical pharmacology, is the spokesperson for this Conference.
An international group of experts will address the commercialization of disease and medical conditions, and such public policy issues as: When does legitimate promotion of public health become mongering of disease for profit?”
Speakers will also discuss non-medical implications—such as economic and social ramifications of medicating developmental “conditions” and medicalizing normal life experiences. Drug manufacturers have been hugely successful in expanding the market for lifestyle drugs by playing on peoples fears, fantasies and cravings to be forever young and sexually better than well. See, conference program and speaker roster at: http://www.diseasemongering.org/downloads/program.pdf
We would add several important overarching issues that were left out of the discussion:
Big Pharma money and advertising not only influence the perception of illness, the demand for drugs, and the practice of medicine, but government budgets, including health service and oversight agencies have become dependent on Big Pharma money. An out of the box analysis opened our eyes to a fundamental conflict of interest that has never been discussed. Public health policies are not merely influenced by Big Pharma; they are formulated so as to increase industry’s profits because GOVERNMENT BUDGETS are tied to this industry’s profits.
It happened when Congress passed the Prescription Drug Users Fees Act (PDUFA) in 1992 which ushered in a "fast track" drug approval process. In the first ten years following the passage of PDUFA the FDA has received $825 million in industry “user fees.” Other government agencies have similarly become financially dependent on Big Pharma and its marketing gimmicks such as the government approved TMAP prescribing guidelines.
With increased use of patented prescription drugs—more than 50% of Americans are taking at least one drug—and increased speed with which these drugs are being approved and marketed, the number of people killed or harmed from adverse drug reactions (ADRs) has skyrocketed. More than two million hospitalized patients in the U.S. suffered a serious ADR within a 12-month period and, of these, 106,000 died as a result of non-error ADR. “The researchers found that over 75 per cent of these ADRs were dose-dependent, which suggests they were due to the inherent toxicity of the drugs rather than to allergic reactions [1] [2].
Prescription drug abuse—the federal Substance Abuse and Mental Health Services Administration reports that prescription medication has become the fastest-growing category of drugs being abused, with the biggest growth of abuse among people ages 12 to 24. According to SAMHSA, after marijuana, prescription drugs are the drugs most commonly abused by teenagers. Nationally, an estimated 14% of high school seniors have used prescription drugs for non-medical reasons according to a 2004 University of Michigan survey.
But in a brilliant original analysis, Jim Amrhein shows what the crass brass knuckle economic facts are behind FDA's inaction in "Buying The Parma:"
"It would make no fiscal sense for the FDA to derail the money train by blowing the whistle about some drugs' dangers -- even if it costs a few hundred thousand American lives each year to look the other way…" [Stay tuned]
Underscoring the importance of the issues addressed at this conference—and the fact that most of us could not attend—PLoS Medicine has published a special issue in conjunction with the conference devoted to Disease Mongering. Eleven articles presented at the conference are accessible free at: http://collections.plos.org/diseasemongering-2006.php
References:
Medical Errors - A Leading Cause of Death by Dr Barbara Starfield, MD, MPH, of the Johns Hopkins University, Journal of the American Medical Association (JAMA) July 26th 2000, Vol 284, No 4.; See also, Jason, et al. (Lazarou et al), Incidence of Adverse Drug Reactions in Hospitalized Patients, JAMA, Vol. 279. April 15, 1998, pp. 1200-05. Also Bates, David W., Drugs and Adverse Drug Reactions: How Worried Should We Be? JAMA, Vol. 279. April 15, 1998, pp. 1216-17.
See also, Death by Medicine By Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD, 2004 http://www.lef.org/magazine/mag2004/mar2004_awsi_death_02.htm
Extracts from the PLoS compilation of provocative and timely articles follow:
Contact: Vera Hassner Sharav
212-595-8974
veracare@ahrp.org
1. Bigger and Better: How Pfizer Redefined Erectile Dysfunction by Joel Lexchin
The Rise of Lifestyle Drugs An important emerging issue in health care is the availability of medications to treat what until recently have been regarded as the natural results of aging or as part of the normal range of human emotions. Thus, we now see treatments widely advertised for male pattern baldness and shyness. Deviating even further, drug therapy is moving out of treating diseases to providing enhancements to what had hitherto been seen as normal functioning. This evolution in the use of medications has introduced dilemmas and controversies about what are legitimate conditions and treatments for those concerned with prescription medications: is any deviation from normality fair game for treatment? What about people who have nothing medically wrong with them, but just want to feel better? Who will pay for these therapies, and what are the implications for the way we use health-care resources?
This article will examine the strategies used by Pfizer, the maker of Viagra, to ensure that the drug was seen as legitimate therapy for almost any man. Pfizer took steps to make sure that Viagra was not relegated to a niche role of just treating men who had ED due to organic causes, such as diabetes or prostate surgery.
~~~~~~~~~~~~~~~~~
2. Medicine Goes to School: Teachers as Sickness Brokers for ADHD by Christine B. Phillips
Much of the polemic for and against psychostimulants is concerned with the part played by doctors, the prescribers of medication, in diagnosing or discounting ADHD. ADHD is, however, a disorder of educational performance, and so teachers have a critical role in advocating for the illness, and its medical treatment the roles of teachers as brokers for ADHD and its treatment, and the strategies used by the pharmaceutical industry to frame educators’ responses to ADHD.
The teacher participates in the diagnosis, and may broker different forms of treatment, or rejection of treatment. Brokerage is not a disinterested activity: teachers may have a vested interest in detecting and managing disruptive children, or they may adhere to beliefs about learning disorders which lead them to dissuade parents of the need for treatment. The role of the teacher as the sickness and treatment broker for ADHD has been elaborated more clearly for ADHD than for any other childhood disorder. Teachers often agree to administer psychostimulant medication during the school day, although there is in Australia, the UK, and the US no legal compulsion to do so. A subtle incentive for teachers to administer medication in the middle of the day may be the assurance of a tractable child in the afternoon.
An informal role also exists for teachers as “disease-spotters.” There appears to be considerable difference internationally in the alacrity with which teachers engage in disease-spotting. In a study of 491 physicians in Washington, D. C., almost half of the diagnoses of ADHD in their patients had been suggested first by teachers [9]. In the UK, on the other hand, parental concerns that a child has ADHD may be discounted by teachers [10].
How Drug Companies Influence Teachers
As teachers have some agency in diagnosing ADHD, and may in fact contest the diagnosis, the pharmaceutical industry has an interest in directing teachers toward medical treatment. Pharmaceutical companies have been able to exploit the Internet to access teachers and to influence their brokerage role. The approach to teachers tends to mirror strategies used to familiarise doctors with pharmaceuticals.
The organised penetration of the pharmaceutical industry associated with ADHD into the education domain is a new phenomenon. While there has been extensive discussion about the ethics of fast-food marketing within schools [24,25], there has been little about the consequences of the pharmaceutical industry’s infiltration of schools.
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3. Female Sexual Dysfunction: A Case Study of Disease Mongering and Activist Resistance by Leonore Tiefer
….“The pharmaceutical industry has taken an aggressive interest in sex”…..
The creation and promotion of “female sexual dysfunction” (FSD) is a textbook case of disease mongering by the pharmaceutical industry and by other agents of medicalization, such as health and science journalists, healthcare professionals, public relations and advertising fi rms, contract research organizations, and others in the “medicalization industry.” False expectations set the stage for disease mongering, a process that encourages the conversion of socially created anxiety into medical diagnoses suitable for pharmacological treatment.
Dramatic liberalization occurred after World War II as purity campaigns failed to hold back the sex-promoting impact of changes in longevity, leisure, employment and childrearing, new technology, and mass media [4]. Effective oral contraceptives and medical treatments for venereal diseases removed sexual inhibitions due to fear of pregnancy and disease. A youth culture of charged eroticism developed. Taking advantage of post-1980s deregulatory policies, the pharmaceutical industry began to redirect its pipeline to new “lifestyle drugs” and its marketing to consumer advertising. Science and medicine journalists played key roles in whetting the public’s appetite for medical news about sex by breathlessly covering each new discovery and treatment.
In the 1980s and 1990s, urologists created organizations, journals, and “sexual health clinics” that focused on men’s erection problems. In 1992, a US National Institutes of Health consensus conference on “impotence” legitimized this work. Its outcome was a 34-page document that mentioned factors involved in etiology, maintenance, and treatment such as culture, partners, and sexual techniques, but, for the most part, it reified “erection” as the essence of men’s sexuality, and called for new treatments and vastly expanded research into physiological details and treatments [8].
Creating FSD
Although journalists began calling for a “female Viagra” only days after the March 1998 US Food and Drug Administration (FDA) approval of Viagra (examples of journalists’ calling for a “pink Viagra” are collected on http:⁄⁄www.fsd-alert.org/press.html), it was far from clear what medical condition Viagra was supposed to treat in women. Urologists had used the term “female sexual dysfunction” as early as 1997, referring to aspects of
genital pathophysiology that might be akin to erectile dysfunction. For the first few years, the key players in the medicalization of women’s sexual problems were a small group of urologists who capitalized on their relationships with industry and recruited many sex researchers and therapists as allies. Irwin Goldstein of Boston University, an active erectile dysfunction researcher, opened the first Women’s Sexual Health clinic in 1998 [11]. He convened the first conference on female sexual function (called “New Perspectives in the Management of Female Sexual Dysfunction”) in October 1999 in Boston. Goldstein is the editor of a journal that launched in 2004—the Journal of Sexual Medicine (http:⁄⁄jsm.issir.org)—which has already published an industry-supported supplement on FSD [12].
Pfizer, the world’s largest pharmaceutical company, was the main promoter of FSD from 1997 to 2004, when its quest to have Viagra approved to treat “female sexual arousal disorder” ended because of consistently poor clinical-trial results. In its public statement, Pfizer said that that several large-scale, placebo-controlled studies including about 3,000 women with female sexual arousal disorder showed inconclusive results on the efficacy of the drug [14]. Commenting on these trial results on Viagra, John Bancroft, director of the Kinsey Institute, told the BMJ: “The recent history of the study of female sexual dysfunction is a classic example of starting with some preconceived, and non-evidence based diagnostic categorisation for women’s sexual dysfunctions, based on the male model, and then requiring further research to be based on that structure. Increasingly it is becoming evident that women’s sexual problems are not usefully conceptualised in that way” [14]. Nevertheless, Viagra (and the idea that it must work for women) has been so successfully branded that it continues to be prescribed off-label for women [15].
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4. The Latest Mania: Selling Bipolar Disorder by David Healy
…“The Bipolar Child made all the difference to Heather Norris, whose mother, after reading it, challenged her physician to correct Heather’s diagnosis from ADHD, treatment of which had made her daughter worse, to the correct diagnosis of bipolar disorder. As a result, Heather, at the age of two, became the youngest child in Tarrant County, Texas, to have a diagnosis of bipolar disorder.”….
….Robert Post in the 1980s suggested that anticonvulsants might stabilize moods by a comparable quenching of the kindling effect of an episode of mood disorders on the risk of further episodes [10]. It was this idea that provided a pharmacological rationale for treatment of bipolar disorders that was so attractive to pharmaceutical companies, and, in their hands, the growth of awareness of mood stabilization and of bipolar disorders was sensational. Bipolar disorders entered the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 1980. At the time, the criteria for bipolar I disorder (classic manic-depressive illness) involved an episode of hospitalization for mania.
Since then, the community based disorders bipolar II disorder, bipolar disorders NOS (not otherwise specified), and cyclothymia have emerged. With their emergence, estimates for the prevalence of bipolar disorders have risen from 0.1% of the population having bipolar I disorder (involving an episode of hospitalization for mania) [11] to 5% or more when the definition of bipolar disorders includes the aforementioned community disorders [12]. A range of academic institutions has also grown more interested in the condition.
Lilly, Janssen, and Astra-Zeneca, the makers of the antipsychotics olanzapine, risperidone, and quetiapine (Seroquel), respectively, marched in on the new territory to market these drugs for prophylaxis of bipolar disorder. This, in turn, greatly expanded the number of companies with an interest in making the “bipolar market.”
Increased prevalence estimates were based on community surveys that had no clear disability criterion, while acute treatment trials of antipsychotics for mania, and prophylactic trials of lithium for manic-depressive illness, have for the most part been conducted on bipolar I disorder. This necessarily raises the prospect that increased efforts to detect and to treat people risks crossing the line where the benefits of treatment outweigh its risks.
A slew of bipolar societies, and annual conferences, many heavily funded by pharmaceutical companies. There is a growing amount of patient Web site and patient support materials that in the case of Zyprexa state that “bipolar disorder is often a lifelong illness needing lifelong treatment; symptoms come and go, but the illness stays; people feel better because the medication is working; almost everyone who stops taking the medication will get ill again and the more episodes you have, the more difficult they are to treat” [17]. Information available from Janssen (the makers of Risperdal) states “medicines are crucially important in the treatment of bipolar disorders. Studies over the past twenty years have shown beyond the shadow of doubt that people who receive the appropriate drugs are better off in the long term than those who receive no medicine.”
What Lies Beneath
There is, however, much less evidence than many might think to support these claims for the prophylactic drug treatment of manic-depressive illness (bipolar I). And there is almost no evidence to support such claims in the case of whatever community disorders (bipolar II, bipolar NOS, cyclothymia) are now being pulled into the manic depressive net by the lure of bipolar disorder.
With the possible exception of lithium for bipolar I disorder, there are no randomized controlled trials to show that patients with bipolar disorders in general who receive psychotropic drugs are better in the long term than those who receive no medicine [19].
One short-term, randomized, placebo controlled trial (in which patients were only followed for up to 48 weeks) that some see as a basis for claiming that olanzapine may be prophylactic in bipolar disorder [2] has been regarded by others as indicating that this drug produces a withdrawal-induced decompensation when stopped [20].
The benefit for one more (olanzapine) must be weighed against two harms associated with use of antipsychotics:
(1) a consistent body of evidence indicates that regular treatment with antipsychotics in the longer run increases mortality [22–26]; and (2) there is evidence that in placebo controlled trials of antipsychotics submitted in application for schizophrenia licenses there is a statistically significant excess of completed suicides on active treatment [27]. A range of problems associated with antipsychotics, from increased mortality to tardive dyskinesia, never show up in the short-term trials aimed at demonstrating treatment effects in psychiatry.
In North Wales before the advent of modern pharmacotherapy, patients with bipolar I disorder had on average four admissions every ten years. In contrast, against a background of a constant incidence of bipolar I disorder, and dramatic improvements in service provision, bipolar I patients show a 4-fold increase in the prevalence of admissions despite being treated with the very latest psychotropic medications [11].
This is not ordinarily what happens when treatments “work,” but quite often is what happens when treatments have effects.
The best available evidence shows that unmedicated patients with bipolar disorder do not have a higher risk of suicide. Storosum and colleagues analyzed all placebo-controlled, double-blind, randomized trials of mood stabilizers for the prevention of manic/depressive episode that were part of a registration dossier submitted to the regulatory authority of the Netherlands, the Medicines Evaluation Board, between 1997 and 2003 [28]. They found four such prophylaxis trials. They compared suicide risk in patients on placebo compared with patients on active medication.
Two suicides (493/100,000 person- years of exposure) and eight suicide attempts (1,969/100,000 person-years of exposure) occurred in the group given an active drug (943 patients), but no suicides and two suicide attempts (1,467/100,000 person-years of exposure) occurred in the placebo group (418 patients). Based on these absolute numbers from these four trials, I have calculated (see Figure S1 showing calculation, and see Figure 2) that active agents are most likely to be associated with a 2.22 times greater risk of suicidal acts than placebo (95% CI 0.5, 10.00). Based on these absolute numbers I have calculated that active agents are most likely to be associated with a 2.22 times greater risk of suicidal acts than placebo (95% CI 0.5, 10.00).
There is already the potential for creating an “epidemic” of bipolar disorder, because people are being diagnosed with the condition based on operational criteria that depend upon subjective judgements (rather than an objective criterion of disability, such as hospitalization or being off work for a month). The potential is compounded in the pediatric domain by the fact that the diagnosis is based on caregiver reports with little scope in most clinical practice for critical scrutiny of the social forces that may lead to these reports. Experts that appear willing to go so far as to accept the possibility that the first signs of bipolar disorder may be patterns of overactivity in utero [32] can only further compound these problems.
If the resulting diagnoses were provisional, aimed at researching the natural history of childhood irritability, rather than reaching diagnoses that lead on to pharmacotherapy, there might be little problem. However, drugs such as Zyprexa and Risperdal are now being used for preschoolers in America with little questioning of this development.
What might once have been thought of as sober institutions, such as Massachusetts General Hospital, have run trials of Risperdal and Zyprexa on children with a mean age of four years old [34,35]. Massachusetts General Hospital in fact recruited trial participants by running its own television adverts featuring clinicians and parents alerting parents to the fact that difficult and aggressive behavior in children aged four and up might stem from bipolar disorder. This does more than recruit patients with a clear disorder; it suggests that everyday behavioral difficulties may be better seen in terms of a disorder.
Given that bipolar disorder in children is all but unrecognised outside the US, it seems likely that a significant proportion of these children will not meet conventional DSM criteria for bipolar I disorder. And given that it is all but impossible for a short-term trial of sedative agents in pediatric states characterized by overactivity not to show some rating scale changes that can be regarded as beneficial, the outcomes of this research are likely to appear to validate the diagnosis and increase the pressure for treatment.
The use of psychotropic medication for bipolar disorders was based on an analogy with epilepsy, rather than on demonstrations of proven clinical benefits over the long term or on the basis of a correction of a known pathophysiology. The absence of a solid theoretical or empirical basis for using psychotropic medication as “mood stabilizers” raises questions as to what lies in store for the Heather Norris’s and others of this world exposed to these complex psychotropic agents from such a young age.
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5. Disease Mongering in Drug Promotion: Do Governments Have a Regulatory Role? By Barbara Mintzes
One aspect of disease mongering: activities financed by drug companies to promote sales by expanding the pool of patients potentially treated by their products, when no benefit in terms of reduced morbidity is likely. In theory, these activities are covered by national laws governing drug promotion that forbid misleading or deceptive advertising. However, enforcement is piecemeal and largely ineffective. Drug regulation remains limited in many parts of the world. In 2004, fewer than one-sixth of countries had a well-developed system of drug regulation, and one-third had little to no regulatory capacity [2]. Although 89 countries (46%) reported active regulation of drug promotion, resources devoted to this work may be limited [3].
Full direct-to-consumer advertising (DTCA) of prescription drugs is legal in only the United States and New Zealand. However, in many other countries, unbranded disease-oriented advertising (in which no drug names are mentioned, but patients are often advised to “see your doctor”) is increasingly common. A market analyst reports that drug companies spent US$85 million on unbranded DTCA in Europe in 2004 [5]. Spending is expected to reach US$345.5 million by 2008. In 2005, the Australia–US free trade agreement allowed unbranded advertising in Australian media to be linked to branded information on Web sites [6]. Canada introduced more lenient policies on unbranded advertising in 1996, a shift that has occurred without legislative change [7].
A claimed benefit of disease awareness campaigns is that the public becomes more aware of untreated health problems and seeks effective care at an earlier stage, leading to better health [8].
The United Kingdom Medicines Health-Care Products Regulatory Agency has issued guidelines stating that the primary purpose of disease-awareness advertising must be health education on a disease and its management, not product promotion Paradoxically, although these newer drugs were promoted for greater gastrointestinal safety, Mamdani and colleagues found that approximately 650 more hospitalizations for gastrointestinal bleeds occurred per year after the drugs’ introduction. In their conclusion, the authors stated the following: “Although we cannot prove causation, we believe that the striking temporal correlation, biological plausibility, and lack of any other trends that would explain the association strongly suggest that the two events are directly related” [21].
Questionable New Indications
Regulatory agencies have differed in their response to manufacturers’ bids to market selective serotonin reuptake inhibitor (SSRI) antidepressants for “premenstrual dysphoric dysfunction” (PMDD). Business analysts linked the launch of the first drug in the US for this indication, fluoxetine (Sarafem), to Eli Lilly’s pending loss of patent protection for Prozac (also fluoxetine) [24]. The European Medicines Evaluation
Agency refused to approve drugs for PMDD… Soon after Sarafem’s launch, the FDA judged a TV advert to violate US law because it failed to distinguish clearly between PMDD and premenstrual syndrome [27].
A US community survey Lacasse and Leo reviewed the evidence supporting the hypothesis that depression is caused by a serotonin defi ciency, concluding that a lack of evidence exists to support this hypothesis [31]. They questioned the FDA’s lack of attention to the claims in SSRI adverts for antidepressants that depression and anxiety disorders are caused by a chemical imbalance in the brain. The Irish regulatory agency has prohibited GlaxoSmithKline from making similar claims to support the use of paroxetine (Paxil) [32]. Kravitz and colleagues found more broadly that patient requests for advertised medicines could lead to off-label antidepressant prescribing for “adjustment disorder,” a disorder involving temporary distress due to a troubling life situation that rarely requires drug treatment [33].
Disease mongering by definition creates erroneous impressions of the condition a product aims to treat and the merit and safety of treatment, and frequently provokes undue anxiety or exaggerates prevalence rates. Many of the activities in Box 1 are off-label promotions. A key question is whether there is sufficient political will among government regulatory agencies to better enforce existing regulations governing drug promotion or to introduce new solutions. Most regulatory agencies fail to treat regulation of drug promotion as a public health concern. Unless this changes, the public can expect more unfettered disease mongering warning them that without the latest treatment, life will be grim indeed……….
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6. Combating Disease Mongering: Daunting but Nonetheless Essential Iona Heath
The rhetoric surrounding disease mongering suggests that it will promote health, but the effect is in fact the opposite. Much disease mongering relies on the pathologising of normal biological or social variation and on the portrayal of the presence of risk factors for disease as a disease state in itself. When pharmaceuticals are used to treat risk factors, the vicious circle is completed because “anyone who takes medicines is by defi nition a patient” [5].
Human societies are riven by the effects of greed and fear. The rise of preventive health technologies has opened up a new arena of human greed, which responds to an enduring fear. The greed is for ever-greater longevity; the fear is that of dying. The irony and the tragedy is that the greed inflates the fear and poisons the present in the name of a better, or at least a longer, future. Ultimately, the only way of combating disease mongering is to value the manner of our living above the timing of our dying.
For complete text of all 11 articles see:http://collections.plos.org/diseasemongering-2006.php
FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit.
Many hypnosis professionals actually believe that "All Hypnosis Is Self-hypnosis -- Let's imagine that's true for a moment:
QUESTION: Is this kind of Social Marketing a form of Mass- Self-hypnosis?
For example: A pharmaceutical company hires a Public Relations firm to market the belief that a "newly" discovered "condition" like "Infant Depression" or "ADD/ADHD" requires diagnosis and treatment. The PR firm actively markets the belief to doctors in training via medical schools, doctors in practice via their "scientific" journals and government officials via lobbying and "expert" opinion and finally, you and me via the major news outlets and media. In a relatively short period of time most doctors, teachers, parents and children are socially, self-hypnotized to believe and act as if, normal childhood behaviors are evidence of a mental disease that requires extreme medication...
http://www.ahrp.org/cms/content/view/139/29/
Disease Mongering_Conference / PLoS Special Issue
Monday, 10 April 2006
"Are we becoming patients for profit? That is the question knowledgeable observers are asking.
An Inaugural Conference on Disease-Mongering, April, 11 to 13, is being hosted by the Newcastle Institute of Public Health and School of Medicine and Public Health at the University of Newcastle, Australia. Dr. David Henry, professor of clinical pharmacology, is the spokesperson for this Conference.
An international group of experts will address the commercialization of disease and medical conditions, and such public policy issues as: When does legitimate promotion of public health become mongering of disease for profit?”
Speakers will also discuss non-medical implications—such as economic and social ramifications of medicating developmental “conditions” and medicalizing normal life experiences. Drug manufacturers have been hugely successful in expanding the market for lifestyle drugs by playing on peoples fears, fantasies and cravings to be forever young and sexually better than well. See, conference program and speaker roster at: http://www.diseasemongering.org/downloads/program.pdf
We would add several important overarching issues that were left out of the discussion:
Big Pharma money and advertising not only influence the perception of illness, the demand for drugs, and the practice of medicine, but government budgets, including health service and oversight agencies have become dependent on Big Pharma money. An out of the box analysis opened our eyes to a fundamental conflict of interest that has never been discussed. Public health policies are not merely influenced by Big Pharma; they are formulated so as to increase industry’s profits because GOVERNMENT BUDGETS are tied to this industry’s profits.
It happened when Congress passed the Prescription Drug Users Fees Act (PDUFA) in 1992 which ushered in a "fast track" drug approval process. In the first ten years following the passage of PDUFA the FDA has received $825 million in industry “user fees.” Other government agencies have similarly become financially dependent on Big Pharma and its marketing gimmicks such as the government approved TMAP prescribing guidelines.
With increased use of patented prescription drugs—more than 50% of Americans are taking at least one drug—and increased speed with which these drugs are being approved and marketed, the number of people killed or harmed from adverse drug reactions (ADRs) has skyrocketed. More than two million hospitalized patients in the U.S. suffered a serious ADR within a 12-month period and, of these, 106,000 died as a result of non-error ADR. “The researchers found that over 75 per cent of these ADRs were dose-dependent, which suggests they were due to the inherent toxicity of the drugs rather than to allergic reactions [1] [2].
Prescription drug abuse—the federal Substance Abuse and Mental Health Services Administration reports that prescription medication has become the fastest-growing category of drugs being abused, with the biggest growth of abuse among people ages 12 to 24. According to SAMHSA, after marijuana, prescription drugs are the drugs most commonly abused by teenagers. Nationally, an estimated 14% of high school seniors have used prescription drugs for non-medical reasons according to a 2004 University of Michigan survey.
But in a brilliant original analysis, Jim Amrhein shows what the crass brass knuckle economic facts are behind FDA's inaction in "Buying The Parma:"
"It would make no fiscal sense for the FDA to derail the money train by blowing the whistle about some drugs' dangers -- even if it costs a few hundred thousand American lives each year to look the other way…" [Stay tuned]
Underscoring the importance of the issues addressed at this conference—and the fact that most of us could not attend—PLoS Medicine has published a special issue in conjunction with the conference devoted to Disease Mongering. Eleven articles presented at the conference are accessible free at: http://collections.plos.org/diseasemongering-2006.php
References:
Medical Errors - A Leading Cause of Death by Dr Barbara Starfield, MD, MPH, of the Johns Hopkins University, Journal of the American Medical Association (JAMA) July 26th 2000, Vol 284, No 4.; See also, Jason, et al. (Lazarou et al), Incidence of Adverse Drug Reactions in Hospitalized Patients, JAMA, Vol. 279. April 15, 1998, pp. 1200-05. Also Bates, David W., Drugs and Adverse Drug Reactions: How Worried Should We Be? JAMA, Vol. 279. April 15, 1998, pp. 1216-17.
See also, Death by Medicine By Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD, 2004 http://www.lef.org/magazine/mag2004/mar2004_awsi_death_02.htm
Extracts from the PLoS compilation of provocative and timely articles follow:
Contact: Vera Hassner Sharav
212-595-8974
veracare@ahrp.org
1. Bigger and Better: How Pfizer Redefined Erectile Dysfunction by Joel Lexchin
The Rise of Lifestyle Drugs An important emerging issue in health care is the availability of medications to treat what until recently have been regarded as the natural results of aging or as part of the normal range of human emotions. Thus, we now see treatments widely advertised for male pattern baldness and shyness. Deviating even further, drug therapy is moving out of treating diseases to providing enhancements to what had hitherto been seen as normal functioning. This evolution in the use of medications has introduced dilemmas and controversies about what are legitimate conditions and treatments for those concerned with prescription medications: is any deviation from normality fair game for treatment? What about people who have nothing medically wrong with them, but just want to feel better? Who will pay for these therapies, and what are the implications for the way we use health-care resources?
This article will examine the strategies used by Pfizer, the maker of Viagra, to ensure that the drug was seen as legitimate therapy for almost any man. Pfizer took steps to make sure that Viagra was not relegated to a niche role of just treating men who had ED due to organic causes, such as diabetes or prostate surgery.
~~~~~~~~~~~~~~~~~
2. Medicine Goes to School: Teachers as Sickness Brokers for ADHD by Christine B. Phillips
Much of the polemic for and against psychostimulants is concerned with the part played by doctors, the prescribers of medication, in diagnosing or discounting ADHD. ADHD is, however, a disorder of educational performance, and so teachers have a critical role in advocating for the illness, and its medical treatment the roles of teachers as brokers for ADHD and its treatment, and the strategies used by the pharmaceutical industry to frame educators’ responses to ADHD.
The teacher participates in the diagnosis, and may broker different forms of treatment, or rejection of treatment. Brokerage is not a disinterested activity: teachers may have a vested interest in detecting and managing disruptive children, or they may adhere to beliefs about learning disorders which lead them to dissuade parents of the need for treatment. The role of the teacher as the sickness and treatment broker for ADHD has been elaborated more clearly for ADHD than for any other childhood disorder. Teachers often agree to administer psychostimulant medication during the school day, although there is in Australia, the UK, and the US no legal compulsion to do so. A subtle incentive for teachers to administer medication in the middle of the day may be the assurance of a tractable child in the afternoon.
An informal role also exists for teachers as “disease-spotters.” There appears to be considerable difference internationally in the alacrity with which teachers engage in disease-spotting. In a study of 491 physicians in Washington, D. C., almost half of the diagnoses of ADHD in their patients had been suggested first by teachers [9]. In the UK, on the other hand, parental concerns that a child has ADHD may be discounted by teachers [10].
How Drug Companies Influence Teachers
As teachers have some agency in diagnosing ADHD, and may in fact contest the diagnosis, the pharmaceutical industry has an interest in directing teachers toward medical treatment. Pharmaceutical companies have been able to exploit the Internet to access teachers and to influence their brokerage role. The approach to teachers tends to mirror strategies used to familiarise doctors with pharmaceuticals.
The organised penetration of the pharmaceutical industry associated with ADHD into the education domain is a new phenomenon. While there has been extensive discussion about the ethics of fast-food marketing within schools [24,25], there has been little about the consequences of the pharmaceutical industry’s infiltration of schools.
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3. Female Sexual Dysfunction: A Case Study of Disease Mongering and Activist Resistance by Leonore Tiefer
….“The pharmaceutical industry has taken an aggressive interest in sex”…..
The creation and promotion of “female sexual dysfunction” (FSD) is a textbook case of disease mongering by the pharmaceutical industry and by other agents of medicalization, such as health and science journalists, healthcare professionals, public relations and advertising fi rms, contract research organizations, and others in the “medicalization industry.” False expectations set the stage for disease mongering, a process that encourages the conversion of socially created anxiety into medical diagnoses suitable for pharmacological treatment.
Dramatic liberalization occurred after World War II as purity campaigns failed to hold back the sex-promoting impact of changes in longevity, leisure, employment and childrearing, new technology, and mass media [4]. Effective oral contraceptives and medical treatments for venereal diseases removed sexual inhibitions due to fear of pregnancy and disease. A youth culture of charged eroticism developed. Taking advantage of post-1980s deregulatory policies, the pharmaceutical industry began to redirect its pipeline to new “lifestyle drugs” and its marketing to consumer advertising. Science and medicine journalists played key roles in whetting the public’s appetite for medical news about sex by breathlessly covering each new discovery and treatment.
In the 1980s and 1990s, urologists created organizations, journals, and “sexual health clinics” that focused on men’s erection problems. In 1992, a US National Institutes of Health consensus conference on “impotence” legitimized this work. Its outcome was a 34-page document that mentioned factors involved in etiology, maintenance, and treatment such as culture, partners, and sexual techniques, but, for the most part, it reified “erection” as the essence of men’s sexuality, and called for new treatments and vastly expanded research into physiological details and treatments [8].
Creating FSD
Although journalists began calling for a “female Viagra” only days after the March 1998 US Food and Drug Administration (FDA) approval of Viagra (examples of journalists’ calling for a “pink Viagra” are collected on http:⁄⁄www.fsd-alert.org/press.html), it was far from clear what medical condition Viagra was supposed to treat in women. Urologists had used the term “female sexual dysfunction” as early as 1997, referring to aspects of
genital pathophysiology that might be akin to erectile dysfunction. For the first few years, the key players in the medicalization of women’s sexual problems were a small group of urologists who capitalized on their relationships with industry and recruited many sex researchers and therapists as allies. Irwin Goldstein of Boston University, an active erectile dysfunction researcher, opened the first Women’s Sexual Health clinic in 1998 [11]. He convened the first conference on female sexual function (called “New Perspectives in the Management of Female Sexual Dysfunction”) in October 1999 in Boston. Goldstein is the editor of a journal that launched in 2004—the Journal of Sexual Medicine (http:⁄⁄jsm.issir.org)—which has already published an industry-supported supplement on FSD [12].
Pfizer, the world’s largest pharmaceutical company, was the main promoter of FSD from 1997 to 2004, when its quest to have Viagra approved to treat “female sexual arousal disorder” ended because of consistently poor clinical-trial results. In its public statement, Pfizer said that that several large-scale, placebo-controlled studies including about 3,000 women with female sexual arousal disorder showed inconclusive results on the efficacy of the drug [14]. Commenting on these trial results on Viagra, John Bancroft, director of the Kinsey Institute, told the BMJ: “The recent history of the study of female sexual dysfunction is a classic example of starting with some preconceived, and non-evidence based diagnostic categorisation for women’s sexual dysfunctions, based on the male model, and then requiring further research to be based on that structure. Increasingly it is becoming evident that women’s sexual problems are not usefully conceptualised in that way” [14]. Nevertheless, Viagra (and the idea that it must work for women) has been so successfully branded that it continues to be prescribed off-label for women [15].
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4. The Latest Mania: Selling Bipolar Disorder by David Healy
…“The Bipolar Child made all the difference to Heather Norris, whose mother, after reading it, challenged her physician to correct Heather’s diagnosis from ADHD, treatment of which had made her daughter worse, to the correct diagnosis of bipolar disorder. As a result, Heather, at the age of two, became the youngest child in Tarrant County, Texas, to have a diagnosis of bipolar disorder.”….
….Robert Post in the 1980s suggested that anticonvulsants might stabilize moods by a comparable quenching of the kindling effect of an episode of mood disorders on the risk of further episodes [10]. It was this idea that provided a pharmacological rationale for treatment of bipolar disorders that was so attractive to pharmaceutical companies, and, in their hands, the growth of awareness of mood stabilization and of bipolar disorders was sensational. Bipolar disorders entered the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 1980. At the time, the criteria for bipolar I disorder (classic manic-depressive illness) involved an episode of hospitalization for mania.
Since then, the community based disorders bipolar II disorder, bipolar disorders NOS (not otherwise specified), and cyclothymia have emerged. With their emergence, estimates for the prevalence of bipolar disorders have risen from 0.1% of the population having bipolar I disorder (involving an episode of hospitalization for mania) [11] to 5% or more when the definition of bipolar disorders includes the aforementioned community disorders [12]. A range of academic institutions has also grown more interested in the condition.
Lilly, Janssen, and Astra-Zeneca, the makers of the antipsychotics olanzapine, risperidone, and quetiapine (Seroquel), respectively, marched in on the new territory to market these drugs for prophylaxis of bipolar disorder. This, in turn, greatly expanded the number of companies with an interest in making the “bipolar market.”
Increased prevalence estimates were based on community surveys that had no clear disability criterion, while acute treatment trials of antipsychotics for mania, and prophylactic trials of lithium for manic-depressive illness, have for the most part been conducted on bipolar I disorder. This necessarily raises the prospect that increased efforts to detect and to treat people risks crossing the line where the benefits of treatment outweigh its risks.
A slew of bipolar societies, and annual conferences, many heavily funded by pharmaceutical companies. There is a growing amount of patient Web site and patient support materials that in the case of Zyprexa state that “bipolar disorder is often a lifelong illness needing lifelong treatment; symptoms come and go, but the illness stays; people feel better because the medication is working; almost everyone who stops taking the medication will get ill again and the more episodes you have, the more difficult they are to treat” [17]. Information available from Janssen (the makers of Risperdal) states “medicines are crucially important in the treatment of bipolar disorders. Studies over the past twenty years have shown beyond the shadow of doubt that people who receive the appropriate drugs are better off in the long term than those who receive no medicine.”
What Lies Beneath
There is, however, much less evidence than many might think to support these claims for the prophylactic drug treatment of manic-depressive illness (bipolar I). And there is almost no evidence to support such claims in the case of whatever community disorders (bipolar II, bipolar NOS, cyclothymia) are now being pulled into the manic depressive net by the lure of bipolar disorder.
With the possible exception of lithium for bipolar I disorder, there are no randomized controlled trials to show that patients with bipolar disorders in general who receive psychotropic drugs are better in the long term than those who receive no medicine [19].
One short-term, randomized, placebo controlled trial (in which patients were only followed for up to 48 weeks) that some see as a basis for claiming that olanzapine may be prophylactic in bipolar disorder [2] has been regarded by others as indicating that this drug produces a withdrawal-induced decompensation when stopped [20].
The benefit for one more (olanzapine) must be weighed against two harms associated with use of antipsychotics:
(1) a consistent body of evidence indicates that regular treatment with antipsychotics in the longer run increases mortality [22–26]; and (2) there is evidence that in placebo controlled trials of antipsychotics submitted in application for schizophrenia licenses there is a statistically significant excess of completed suicides on active treatment [27]. A range of problems associated with antipsychotics, from increased mortality to tardive dyskinesia, never show up in the short-term trials aimed at demonstrating treatment effects in psychiatry.
In North Wales before the advent of modern pharmacotherapy, patients with bipolar I disorder had on average four admissions every ten years. In contrast, against a background of a constant incidence of bipolar I disorder, and dramatic improvements in service provision, bipolar I patients show a 4-fold increase in the prevalence of admissions despite being treated with the very latest psychotropic medications [11].
This is not ordinarily what happens when treatments “work,” but quite often is what happens when treatments have effects.
The best available evidence shows that unmedicated patients with bipolar disorder do not have a higher risk of suicide. Storosum and colleagues analyzed all placebo-controlled, double-blind, randomized trials of mood stabilizers for the prevention of manic/depressive episode that were part of a registration dossier submitted to the regulatory authority of the Netherlands, the Medicines Evaluation Board, between 1997 and 2003 [28]. They found four such prophylaxis trials. They compared suicide risk in patients on placebo compared with patients on active medication.
Two suicides (493/100,000 person- years of exposure) and eight suicide attempts (1,969/100,000 person-years of exposure) occurred in the group given an active drug (943 patients), but no suicides and two suicide attempts (1,467/100,000 person-years of exposure) occurred in the placebo group (418 patients). Based on these absolute numbers from these four trials, I have calculated (see Figure S1 showing calculation, and see Figure 2) that active agents are most likely to be associated with a 2.22 times greater risk of suicidal acts than placebo (95% CI 0.5, 10.00). Based on these absolute numbers I have calculated that active agents are most likely to be associated with a 2.22 times greater risk of suicidal acts than placebo (95% CI 0.5, 10.00).
There is already the potential for creating an “epidemic” of bipolar disorder, because people are being diagnosed with the condition based on operational criteria that depend upon subjective judgements (rather than an objective criterion of disability, such as hospitalization or being off work for a month). The potential is compounded in the pediatric domain by the fact that the diagnosis is based on caregiver reports with little scope in most clinical practice for critical scrutiny of the social forces that may lead to these reports. Experts that appear willing to go so far as to accept the possibility that the first signs of bipolar disorder may be patterns of overactivity in utero [32] can only further compound these problems.
If the resulting diagnoses were provisional, aimed at researching the natural history of childhood irritability, rather than reaching diagnoses that lead on to pharmacotherapy, there might be little problem. However, drugs such as Zyprexa and Risperdal are now being used for preschoolers in America with little questioning of this development.
What might once have been thought of as sober institutions, such as Massachusetts General Hospital, have run trials of Risperdal and Zyprexa on children with a mean age of four years old [34,35]. Massachusetts General Hospital in fact recruited trial participants by running its own television adverts featuring clinicians and parents alerting parents to the fact that difficult and aggressive behavior in children aged four and up might stem from bipolar disorder. This does more than recruit patients with a clear disorder; it suggests that everyday behavioral difficulties may be better seen in terms of a disorder.
Given that bipolar disorder in children is all but unrecognised outside the US, it seems likely that a significant proportion of these children will not meet conventional DSM criteria for bipolar I disorder. And given that it is all but impossible for a short-term trial of sedative agents in pediatric states characterized by overactivity not to show some rating scale changes that can be regarded as beneficial, the outcomes of this research are likely to appear to validate the diagnosis and increase the pressure for treatment.
The use of psychotropic medication for bipolar disorders was based on an analogy with epilepsy, rather than on demonstrations of proven clinical benefits over the long term or on the basis of a correction of a known pathophysiology. The absence of a solid theoretical or empirical basis for using psychotropic medication as “mood stabilizers” raises questions as to what lies in store for the Heather Norris’s and others of this world exposed to these complex psychotropic agents from such a young age.
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5. Disease Mongering in Drug Promotion: Do Governments Have a Regulatory Role? By Barbara Mintzes
One aspect of disease mongering: activities financed by drug companies to promote sales by expanding the pool of patients potentially treated by their products, when no benefit in terms of reduced morbidity is likely. In theory, these activities are covered by national laws governing drug promotion that forbid misleading or deceptive advertising. However, enforcement is piecemeal and largely ineffective. Drug regulation remains limited in many parts of the world. In 2004, fewer than one-sixth of countries had a well-developed system of drug regulation, and one-third had little to no regulatory capacity [2]. Although 89 countries (46%) reported active regulation of drug promotion, resources devoted to this work may be limited [3].
Full direct-to-consumer advertising (DTCA) of prescription drugs is legal in only the United States and New Zealand. However, in many other countries, unbranded disease-oriented advertising (in which no drug names are mentioned, but patients are often advised to “see your doctor”) is increasingly common. A market analyst reports that drug companies spent US$85 million on unbranded DTCA in Europe in 2004 [5]. Spending is expected to reach US$345.5 million by 2008. In 2005, the Australia–US free trade agreement allowed unbranded advertising in Australian media to be linked to branded information on Web sites [6]. Canada introduced more lenient policies on unbranded advertising in 1996, a shift that has occurred without legislative change [7].
A claimed benefit of disease awareness campaigns is that the public becomes more aware of untreated health problems and seeks effective care at an earlier stage, leading to better health [8].
The United Kingdom Medicines Health-Care Products Regulatory Agency has issued guidelines stating that the primary purpose of disease-awareness advertising must be health education on a disease and its management, not product promotion Paradoxically, although these newer drugs were promoted for greater gastrointestinal safety, Mamdani and colleagues found that approximately 650 more hospitalizations for gastrointestinal bleeds occurred per year after the drugs’ introduction. In their conclusion, the authors stated the following: “Although we cannot prove causation, we believe that the striking temporal correlation, biological plausibility, and lack of any other trends that would explain the association strongly suggest that the two events are directly related” [21].
Questionable New Indications
Regulatory agencies have differed in their response to manufacturers’ bids to market selective serotonin reuptake inhibitor (SSRI) antidepressants for “premenstrual dysphoric dysfunction” (PMDD). Business analysts linked the launch of the first drug in the US for this indication, fluoxetine (Sarafem), to Eli Lilly’s pending loss of patent protection for Prozac (also fluoxetine) [24]. The European Medicines Evaluation
Agency refused to approve drugs for PMDD… Soon after Sarafem’s launch, the FDA judged a TV advert to violate US law because it failed to distinguish clearly between PMDD and premenstrual syndrome [27].
A US community survey Lacasse and Leo reviewed the evidence supporting the hypothesis that depression is caused by a serotonin defi ciency, concluding that a lack of evidence exists to support this hypothesis [31]. They questioned the FDA’s lack of attention to the claims in SSRI adverts for antidepressants that depression and anxiety disorders are caused by a chemical imbalance in the brain. The Irish regulatory agency has prohibited GlaxoSmithKline from making similar claims to support the use of paroxetine (Paxil) [32]. Kravitz and colleagues found more broadly that patient requests for advertised medicines could lead to off-label antidepressant prescribing for “adjustment disorder,” a disorder involving temporary distress due to a troubling life situation that rarely requires drug treatment [33].
Disease mongering by definition creates erroneous impressions of the condition a product aims to treat and the merit and safety of treatment, and frequently provokes undue anxiety or exaggerates prevalence rates. Many of the activities in Box 1 are off-label promotions. A key question is whether there is sufficient political will among government regulatory agencies to better enforce existing regulations governing drug promotion or to introduce new solutions. Most regulatory agencies fail to treat regulation of drug promotion as a public health concern. Unless this changes, the public can expect more unfettered disease mongering warning them that without the latest treatment, life will be grim indeed……….
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6. Combating Disease Mongering: Daunting but Nonetheless Essential Iona Heath
The rhetoric surrounding disease mongering suggests that it will promote health, but the effect is in fact the opposite. Much disease mongering relies on the pathologising of normal biological or social variation and on the portrayal of the presence of risk factors for disease as a disease state in itself. When pharmaceuticals are used to treat risk factors, the vicious circle is completed because “anyone who takes medicines is by defi nition a patient” [5].
Human societies are riven by the effects of greed and fear. The rise of preventive health technologies has opened up a new arena of human greed, which responds to an enduring fear. The greed is for ever-greater longevity; the fear is that of dying. The irony and the tragedy is that the greed inflates the fear and poisons the present in the name of a better, or at least a longer, future. Ultimately, the only way of combating disease mongering is to value the manner of our living above the timing of our dying.
For complete text of all 11 articles see:http://collections.plos.org/diseasemongering-2006.php
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Mothering Magazine
Issue 101, July/August 2000
Does ADHD Even Exist?
The Ritalin Sham
By John Breeding
Alice, the mother of a seven-year-old son, Nathan, recently visited my office for a counseling session. Nathan had reportedly been different and difficult from the beginning: exhibiting early seizure-like activity, a most challenging temperament, great sensitivity to various types of stimulation, intense frustration, aggressive tantrums, and other apparent developmental difficulties. Alice had taken him to doctors from a young age, obtaining a variety of mostly nonspecific diagnoses of developmental problems. Alice felt unappreciated as a parent, hurt and angry that the Montessori school her son had attended at ages four and five had ultimately rejected him. She felt judged by other parents, whom she felt blamed her for her son's challenging behavior. And she felt unsupported by both camps of opinion regarding "medication": the pro-Ritalin forces challenged her reluctance to use the drug for her son, and the antidrug group vehemently urged her to resist drug use.
Alice's personal stance on the Ritalin issue was clear. While she basically agreed that these "medications" are not good for children, she also felt that, in her family's case, it had been helpful. Nathan had been diagnosed at age five with attention deficit hyperactivity disorder (ADHD), and had taken Ritalin for a year. Alice thought the drug greatly helped her son, slowing him down enough so that he could listen and process information. She and her boyfriend both felt drugs made the boy much easier to be with; further, their own reduced stress eased them so much that they were now able to consider other alternatives for Nathan, such as nutritional supplementation.
Proponents of psychiatric drugs attest that they "work," meaning they alter mood, thought, and action. They also "work," of course, in that they assuage the medical community's expectation that drugs be used to "treat" these children. I believe that fully informed adults should have every right to voluntarily use any drugs they wish, as long as they don't endanger others in doing so. Children, however, are not able to give fully informed consent to drug use--especially those under six years of age, a group in whom we are witnessing a dramatic increase in psychiatric drug prescription.1 It is, therefore, our responsibility as adults to ensure every possible opportunity for optimal development for our children, to protect and defend our children from powerful toxic drugs, particularly those prescribed for psychiatric purposes. Like Alice, a large percentage of adults who take psychiatric drugs or give them to their children would prefer to avoid them--and yet they capitulate and use them because the drugs provide relief: from tension, fear, and desperation, as well as from the external strains of judgment and coercion. Lawrence Diller, author of the best-selling book Running on Ritalin, argues that: "The 700 percent rise in Ritalin use is our canary in the mineshaft for the middle class, warning us that we aren't meeting the needs of all our children, not just those with ADD. It's time we rethought our priorities and expectations unless we want a nation of kids running on Ritalin."2 Dr. Diller decries the trend (as I do in my book The Wildest Colts Make the Best Horses), contending that this increased reliance on drugs reflects a society in distress. Rather than try to force our children to shrink into situations that do not meet their needs, he states, we need to take responsibility for our society.
Diller himself is, however, torn by the same conflict many parents have concerning Ritalin. On the one hand, he says: "As a citizen I must speak out about the social conditions that create the living imbalance. Otherwise I am complicitous with forces and values that I believe are bad for children." On the other hand, though, he concludes: "As a physician, after assessing the child, his family and school situation, I keep prescribing Ritalin. My job is to ease suffering and Ritalin will help round- and octagonal-peg kids fit into rather rigid square educational holes." 3
This seemingly contradictory stance is the same one Alice and millions of other parents face. It's not as if all parents readily accept the prescription of Ritalin. Alice, in fact, incurred the wrath of her son's neurologist because she refused to give her son Adderall, a combination of three different amphetamine-like stimulants often used as an alternative to Ritalin. Increasingly over the past ten years or so, millions of parents are nagged by their children's physicians: "If your child had diabetes," the doctors taunt, for example, "you'd give him insulin wouldn't you?"
"What could I say to that?" Alice asked me. Her question was not so much a call for information as it was a need to express her hopelessness. It was encouraging to me that she was angry, for anger is a great antidote to hopelessness. She was mad about the treatment she had received from prior medical and mental health professionals, as well as the lack of support from two opposing drug camps. Before I would hazard a possible response for that neurologist, Alice and I talked about the feelings of relief, guilt, and anger the Ritalin issue had caused for her family. Finally, I gave her what would have been my response: the diagnosis of ADHD is, itself, fraudulent.
ADHD: Nothing but a Sham
A condition such as diabetes carries detectable physical evidence of disease--abnormal blood sugar levels, evidence of pancreatic malfunction--justifying medical treatment. Families confronted with the "wouldn't you give insulin" argument could begin by asking the neurologist to provide medical evidence that a disease requiring treatment exists. Between 1993 and 1997, neurologist Fred Baughman corresponded repeatedly with the Food and Drug Administration (FDA), the Drug Enforcement Agency (DEA), Ciba-Geigy (now Novartis, manufacturers of Ritalin), and top ADHD researchers around the country--including the National Institute of Mental Health--asking them to show him any article(s) in the peer-reviewed scientific literature constituting proof of a physical or chemical abnormality in ADHD and thereby qualifying it as a disease or a medical syndrome. Through sheer determination and persistence, Dr. Baughman eventually got these entities to admit that no objective validation of the diagnosis of ADHD exists.4
Prescribing Ritalin for something that is not a "disease" does not, in my estimation, constitute a legitimate practice of medicine. If ADHD is not a disease, treating it medically constitutes a fraud. Yet many physicians are true believers in medically treating "mental illness," despite the consistent lack of scientific evidence of "mental illness" as a "disease."5 Herein lies the conflict for parents like Alice.
The Significance of Oppression Theory
Victims of oppression are not only blamed for their condition, and usually thought to be deserving of their inferior position, they are eventually conditioned to accept it as their reality. As the great American writer James Baldwin stated: "It's not the world that was my oppressor, because what the world does to you, if the world does it to you long enough and effectively enough, you begin to do it to yourself."6 In what may be the ultimate power play, a victim is, over time, conditioned to internalize, accept, and ultimately, forget about the very fact that they are oppressed.
There are two specific forms of oppression that are pertinent to the discussion of psychiatric drug use for children. The first is adultism--the systematic mistreatment of young people by adults simply because they are young. Like other forms of oppression, adultism is self-perpetuating: when we are treated poorly as children, we internalize the idea and feelings that life is unfair; that rank and power should be used for personal advantage; and that we are somehow unworthy of respect, incapable of clear thinking, and unable to become our own authority.
The second form of oppression is what I call psychiatric oppression: the systematic mistreatment of people labeled as "mentally ill"--including children diagnosed with fictitious illnesses such as ADHD. Institutionalized in our society, psychiatry is also guided by a worldview that embraces biopsychiatry.7 Juxtaposed with adultism, psychiatric diagnosis and treatment enforce the message that an "ADHD child" is inadequate, defective, unworthy of complete respect, and in need of drugs to control and cope with the effects of his or her "illness."
Lies My Doctor Told Me
What exactly does it mean to "help round- and octagonal-peg kids fit into rather rigid square educational holes?" I believe there are at least six fallacies that underlie the rampant prescription of drugs like Ritalin to our children.
1. "Social adjustment is good." While the ability to adjust socially may be important, it is not always a "good" thing. In its most extreme form, social adjustment leads to conformity and compliance, which has resulted in dire social phenomena, including slavery and genocide. This seems a particularly aberrant notion in a society like ours, which is so deeply grounded in the quest for individualism, free speech and association, and the "pursuit of happiness."
2. "Children must learn to conform." When a child fails to adjust to school, we should at the very least think about our abilities to consider the child's needs. It is certainly important for children to learn how to get along in various situations, and how to avoid drawing sanction upon themselves. Nevertheless, young children must be enabled to express their unique gifts within their communities. It is a mistake to force our children to fit molds imposed upon them according to the needs and conventions of the adult order.
3. "Failed social adjustment causes suffering." In our competitive culture, we tend to view mistakes as negatives to be avoided. It is hard to accept the notion that mistakes can be good, and actually, in fact, are the way we learn. We are obsessed with the notions of success and failure. We judge a child's actions as success or failure according to our expectations and demands, not through the eyes of a developing child. Eventually, the child internalizes both the standard and the evaluation: "I failed to live up to the expectations, therefore I am a failure." I would argue that it is not failure that causes suffering, but rather it is oppression--in the form of adultism--which imposes arbitrary standards, and an adult shame-based worldview. This is what causes children to feel and think of themselves as failures, and therein lies their suffering.
4. "A physician's job is to ease suffering." Certainly it is--through the practice of medicine that incorporates compassion--not labeling, coercion, or guilt.
5. "Ritalin helps children conform." Not always. Sometimes it makes them "psychotic," sometimes it makes them aggressive. Other times Ritalin makes children anxious or nauseous. It can make some children feel suicidal. And for some children, Ritalin has been a deadly prescription. 8 When it "works" well, the child is observed to produce better in the classroom. This, the research shows us, is the only positive short-term outcome. There are no positive long-term effects in any aspect of child functioning--social, behavioral, or academic--associated with the use of Ritalin.9
6. "Therefore, giving your child Ritalin lets me ease her suffering." In an 1854 speech on the Kansas-Nebraska Act, Abraham Lincoln said, "I would consent to any great evil, to avoid an even greater one."10 Many parents feel the compulsion to punish or discipline their child in hopes that even greater misfortune might not befall them. Given the reality of today's oppressive society, and its lack of resolve to truly meet the needs of our children, the argument goes, Ritalin may seem a better choice than continued pressure, disapproval, and sanction.
This "ease the suffering" argument reveals one of the most consistent justifications for the use of psychiatric drugs for children: on one level or another, Ritalin absolves each person of his or her responsibility. The child is not responsible, he's "sick." Parents, doctors, the community, the medical and educational institutions--the society at large--are relieved of their duty to meet the real needs of that child. We prescribe drugs; the child conforms; the educational and medical institutions don't have to change; and our standards of "normalcy" are passed on to the next generation of drug-assisted children learning to fit into the mandated square hole. We have endless justifications that allow us to conform to oppression with a seemingly clear conscience, while an estimated 5,000,000 children are on methylphenidate, and another 3,000,000 on other toxic drugs -- given to them by adults who care for them. Some may call this "medicine," but a growing group of parents and others are beginning to see it as institutionalized child abuse.
Sidebar: Suffer the Children?
Although ADHD does not exist as a real disease, it is a very real label imposed on children, with very real consequences for the child. On a physical level, the recommended drugs are toxic, and they have a long list of deleterious effects.1 Regarding Ritalin, the fact is that "methylphenidate looks like an amphetamine (chemically), acts like an amphetamine (effects), and is abused like an amphetamine (recreational use, Emergency Room visits, pharmacy break-ins)."2 (parentheses mine)
On a psychological level, Ritalin produces two especially harmful effects. It deprives a child of the right to develop a character and a way of living with self and world, in a drug-free state. Ritalin also creates a burden of shame, a conviction that a child who is on this drug is somehow defective, unworthy, and neither lovable nor even acceptable in his or her "natural" state.
These stimulant drugs for children truly are about enforcement of our culture's preeminent value: productivity.3 Amphetamines, as we have learned over the course of the past century, increase output. But of course, with amphetamines, the trajectory is usually crash and burn. In the US, millions of adults, and an alarmingly increasing number of children, take psychiatric stimulants like Prozac to "keep going and going." Similarly, we give children as young as two years of age stimulant drugs to help their "impaired" productivity. But wherein lies the suffering, in the "failure" to produce or achieve, or in the so-called remedy we prescribe?
Sidebar: Ritalin Use--Simply Out of Control
Psychiatric drug use by children in US schools is turning into an enormous problem. In 1970, an estimated 150,000 US children were taking Ritalin. By 1980, the estimates were between 270,000 and 541,000--double the numbers of a decade before. By 1990, the numbers doubled again; close to 900,000 children were on Ritalin. The Drug Enforcement Agency (DEA) estimates there was a 700 percent increase in the production of Ritalin between 1990 and 1997, 90 percent of which was consumed in the US.
Based on the available data, a realistic estimate of the number of school-age children on Ritalin today in the US is 5 million. Considering that Ritalin--like other amphetamines, a Schedule II controlled substance that carries a significant risk of abuse--represents 70 percent of the total prescriptions for amphetamine-like drugs, it is reasonable to estimate that over 7 million US schoolchildren are on some sort of stimulant drug. We can add close to 2 million children now on so-called antidepressants, so it appears that over 8 million children in this country are on psychiatric drugs today. According to census data from 1999, the US population for ages six to 18 is just under 51.5 million, meaning approximately 15 percent of our schoolchildren are on psychiatric drugs. In many schools and districts, the estimations are quite higher, as much as 20 or 40 percent. A study reported this year in the Journal of the American Medical Association revealed that Ritalin prescriptions for two to four year olds increased 200 to 300 percent between 1991 and 1995.1
In an era when we are constantly told to protect our children from drug abuse, it seems there are some very disturbing exceptions to the rule.
This article is adapted from a report by John Breeding, which can be found at www.wildestcolts.com.
Notes
"Does ADHD Even Exist?"
1. J. M. Zito, D. J. Safer, S. dosReis, J. F. Gardner, M. Boles, and F. Lynch, "Trends in the Prescribing of Psychotropic Medications to Preschoolers," JAMA 283 (2000): 1025-1030.
2. "A Nation of Kids on Ritalin," an essay posted on Lawrence Diller's website: www.docdiller.com.
3. Ibid.
4. See the website of neurologist Fred Baughman, MD, for information on the ADHD fraud: home.att.net/~fred-alden.
5. See Peter Breggin's book Toxic Psychiatry (St. Martin's Press, 1991), or the journal Ethical Human Sciences and Services, for evidence on the pseudoscience of biopsychiatry.
6. Conversation between James Baldwin and Nicki Giovanni, November 4, 1971, "A Dialogue," cited in L. R. Frank, ed., Random House Webster's Quotationary (New York: Random House, 1998).
7. See John Breeding's book The Wildest Colts Make the Best Horses (Austin, Tex.: Bright Books, 1996) or his website, www.wildestcolts.com, for a fuller exposition of the belief system of biopsychiatry.
8. Dr. Fred Baughman is currently involved in three Ritalin death cases. His essay "Who Killed Stephanie Hall?", available on his website (see Note 4), tells of one of these three and includes a brief review of relevant cardiac literature. An article by Caroline Kern in the Oakland Press, April 14, 2000, entitled "Prescription Drug, Not Skateboard Accident, Killed Clawson Teen," reports on the most recent death in March of 14-year-old Matthew Smith of Clawson, Michigan.
9. See Peter Breggin, Talking Back to Ritalin (Monroe, Maine: Common Courage Press, 1998) or Lawrence Diller, Running on Ritalin (New York: Bantam Doubleday Dell, 1998) for summaries of this research evidence.
10. Abraham Lincoln, speech on the Kansas-Nebraska Act, Peoria, Illinois, October 16, 1854. Cited in L. R. Frank, ed., Random House Webster's Quotationary (New York: Random House, 1998).
"Suffer the Children?"
1. Peter Breggin, Talking Back to Ritalin (Monroe, Maine: Common Courage Press, 1998).
2. Mary Eberstadt, "Why Ritalin Rules," Policy Review 94 (1999): 24-44.
3. See John Breeding's new e-book, The Necessity of Madness and Unproductivity: Psychiatric Oppression or Human Transformation? (Online Originals, 2000), for an explanation of how psychiatry acts to enforce our social mandate of relentless productivity. (Available at www.onlineoriginals.com.)
"Ritalin Use: Simply Out of Control"
1. Zito et al., "Trends in the Prescribing of Psychotropic Medications to Preschoolers," JAMA 283 (2000): 1025-1030.
FOR MORE INFORMATION
Books
Anderson, Nina, and Howard Peiper. A.D.D.: The Natural Approach. Safe Goods, 1996. 860-824-5301.
Bell, Rachel, and Dr. Howard Peiper. The A.D.D. and A.D.H.D. Diet! Safe Goods, 1998. 860-824-5301.
Breeding, John. The Wildest Colts Make the Best Horses. Bright Books, Inc., 1996.
O'Dell, Nancy E., and Patricia A. Cook. Stopping Hyperactivity: A New Solution. Avery Publishing Group, Inc., 1997.
Zimmerman, Marcia. The A.D.D. Nutrition Solution: A Drug-Free 30-Day Plan. Henry Holt and Company, 1999.
Newsletters and Video
Extraordinary Parents is written by and for parents doing home-based programs with their special needs children. Editor Pauline Banducci has directed a successful home-based program for ten years. For a complimentary copy, call 413-528-1589 or e-mail clark@bcn.net.
New Developments published by Developmental Delay Resources, 4401 East West Highway, Suite 207, Bethesda, Maryland 20814. 301-652-2263; www.devdelay.org. Your Child and ADD/ADHD: A Parent's Guide. Institute of Human Development, 1998. (Video)
Organizations
Citizens Commission on Human Rights (CCHR), International Office, 6362 Hollywood Boulevard, Suite B, Los Angeles CA 90028. 800-869-2247. Founded in 1969, CCHR is a private, nonprofit organization whose sole purpose is to investigate and expose psychiatric violations of human rights.
The International Center for the Study of Psychiatry and Psychology (ICCSP), 4628 Chestnut Street, Bethesda, MD 20814. www.icspp.org or www.breggin.com. Founded by Peter Breggin, MD, in 1971, ICCSP is a nonprofit network of individuals concerned about the impact of mental health practices on individual well-being, human values, and community. Spearheading reform in psychiatry, it has been called "the conscience of American psychiatry."
Support Coalition International (SCI)/Dendron, 454 Willamette, Suite 216, PO Box 11284, Eugene, OR 97440-3484. 541-345-9106. dendron@efn.org. www.mindfreedom.org. SCI is a federation of individual members and over 60 grassroots groups in eight countries promoting human rights and alternatives in the mental health system. Dendron News, edited by David Oaks, is an outstanding information service for the movement.
Texans for Safe Education (TFSE), 2503 Douglas Street, Austin, TX 78741. 512-326-8326, 800-572-2905. john@wildestcolts.com. www.wildestcolts.com. Founded by John Breeding, PhD, TFSE is a citizens' group whose purpose is to defend the safety of children in our schools. We work to influence educational leaders to take a position on the harmful effects of the ever-increasing role of psychiatry in the schools, and to redirect our focus to proven methods for enhancing learning, especially reading fluency and comprehension. We also invite individuals to discuss their stories of coercion or harmful effects of psychiatric drug use with children.
The Gluten-Free Pantry, Inc., PO Box 840, Glastonbury, CT 06033. 800-291-8386. www.glutenfree.com. International Health Foundation, PO Box 3494, Jackson, TN 38303. 901-660-7091. Founded by Dr. William Crook, author of The Yeast Connection and The Yeast Connection Handbook.
Products
Enzymatic Therapy. 800-558-7372. www.enzy.com. Makers of KidCalmTM St. John's Wort Complex
European Reference Botanical Laboratories, Inc. 877-275-3725. www.coromega.com. Makers of CoromegaTM, Omega-3 dietary supplement. Offers free sample and brochure
Gaia Herbs, Inc. 800-831-7780. www.gaiaherbs.com.Makers of Melissa SupremeTM, herbal supplement
J. R. Carlson Laboratories, Inc. 800-323-4141. Makers of Carlson Super DHATM, dietary supplements
Martek Biosciences. 800-662-6339. www.martekbio.com. Makers of Neuromins¨ DHA, dietary supplements
Nelson Bach USA, Ltd. 800-319-9151. www.nelsonbach.com. Offers free brochure "Bach Flower EssencesTM for the Family"
Nutrition Now. 800-929-0418. www.nutritionnow.com. Makers of Rhino ActalinTM, dietary supplement bars and tablets
Planetary Formulas. Soquel, CA 95073. 800-606-6226. Makers of Calm ChildTM, herbal supplement Source Naturals, Inc. Scotts Valley, CA 95066. 800-815-2333. Makers of Focus ChildTM and Focus DHATM, dietary supplements
Websites
Spirit in Action. www.spiritinaction.org
Fred Baughman, MD. ADHD Fraud website: home.att.net/~fred-alden
For more information about ADHD, see the following articles in past issues of Mothering: "Ritalin-Free Kids," no. 83; "In Amanda's Room," no. 77; "Hyperactivity?" no. 74; and "Stimulants and Children," no. 60. John Breeding, PhD, is a licensed psychologist with a private practice in Austin, Texas. He has two children, Eric, 14, and Vanessa, 10. His book The Wildest Colts Make the Best Horses is a forceful and informative challenge to the use of stimulant drugs with children, and a great resource for parents. His new work, The Necessity of Madness and Unproductivity: Psychiatric Oppression or Human Transformation?, is available as an e-book through Online Originals, www.onlineoriginals.com. Dr. Breeding is founding director of Texans for Safe Education. His website, www.wildestcolts.com, is a valuable resource on psychiatry-related issues.
Sidebar: Here's a REAL Drug-free School
By Chris Mercogliano
For 30 years, the Albany Free School has refused to allow its students to take what John Breeding and others so aptly term "biopsychiatric" drugs. A small, independent, inner-city school with 50 students, age two through 14, we see more than our share of youngsters who do not seem to be able to fit into conventional classroom settings. Increasing numbers of "Ritalin refugees," as I call them, are appearing at our doorstep every year.
Last year four new boys arrived, all of whom had fled to us to escape the juggernaut of mental or behavioral labeling and biopsychiatric drugging: Six-year-old Jamal was referred to us by a social worker at a community health clinic. The principal of the parochial school Jamal attended advised his mother to take her son in for "testing," contending that the boy was too disruptive, inattentive, and aggressive to remain in the school unless he was "treated" for a probable diagnosis of attention deficit hyperactivity disorder (ADHD). However, Jamal's older brother had been taking Ritalin for three years, and their mother was unhappy with the drug's effects on him. She was anxious to find a better alternative for her younger son.
Clint's mother sought us out after she'd attended the annual Parents' Day and found her eight-year-old son slumped over at his desk. This, apparently, was the "marked improvement" in Clint's behavior that the school had reported to her after she had begun adding a third drug to his before-school ADHD cocktail. Nine-year-old Anthony had somehow managed to make it to the fourth grade without being labeled and drugged, but the school was putting increasing pressure on his mother to have him undergo a psychological evaluation because he was restless in class and was more than a year behind in reading. When Brian was in third grade, the school psychologist at his suburban elementary school recommended that Brian begin taking Ritalin "to help him focus." By the time he came to us for seventh grade, Brian had become so uncomfortable with how the drug made him feel -- jumpy, irritable, anorexic, angry -- that most days he only pretended to take the pills.
A Drug-Free Way
Why is it that these students, each with a history of academic and behavioral problems, don't need biopsychiatric drugs in our school? First of all, we believe that the existence of biologically-based "disorders" such as ADHD is a myth. Our experience has confirmed over and over again that, when you get to know the stories of kids such as Jamal, Clint, Anthony, and Brian -- or of any of the millions of others like them all across America -- you soon discover that what they are actually suffering from is an inner distress that has clear, nonbiological causes: physical and emotional neglect or abuse, absent parents, marital discord, excessive TV viewing, academic pressure, poor diet, and sometimes a combination of the above. These children don't "have" a "disorder," rather, they are living in a disordered universe. Or in some cases, they aren't suffering from anything at all. They are simply more energetic or on a different developmental timetable than the currently perceived "norm."
Secondly, our approach to education is grounded in the reality that every child is unique. We operate without a set curriculum so that students can progress at their own pace, and according to their own learning style. Some kids are ready and eager to read at age four, others not until nine or ten. Some like to learn from texts and workbooks; others are more kinesthetic and need to have their "hands on" what they are doing. We also remove the fear and compulsion from teaching and learning. In our school, children learn for their own reasons, and there are no grades or standardized tests -- and therefore no failure.
Perhaps Alexander S. Neill said it best. "The school must fit the child and not the other way around," he once wrote in Summerhill: A Radical Approach to Child Rearing.1 When you permit high-energy kids to run, jump, and make noise; when you encourage distressed ones to express their negative feelings safely; when you place ones who have grown resistant to learning in charge of the process; when you empower ones who distrust authority to participate in school governance and conflict resolution, it's unnecessary to put even the most difficult student in a chemical straightjacket.
All four boys thrived in our unconventional, individualized environment. Clint and Brian expressed immediate relief at being off the drugs. Both reported feeling calmer and more at ease. Suddenly free to move about in school and engage in frequent physical activity -- wrestling, playing basketball, swimming, climbing on the multilevel backyard jungle gym -- they quickly shed the signs of their so-called "hyperactivity."
Jamal, on the other hand, wasted no time demonstrating how he had managed to wear out his welcome in his previous school. Angry and defiant, he spent much of the time antagonizing classmates, and exhibiting little respect for his teachers whenever they attempted to stop him. As soon as he escalated to bullying his peers, his victims began calling "council meetings" in order to get help in halting his antisocial behavior. Elementary and junior high-age children who are experiencing serious problems in our school can call a meeting at any time, and by prior agreement, everyone must attend. Meetings are run by Roberts' Rules of Order, a set of standard operating rules for democratic meetings, which allows the children to work through conflicts and devise ways to set limits on each other's conduct. In this case, one of the kids Jamal was pushing around made a motion that Jamal would not get to go swimming the next time if he did it again. The motion passed, and Jamal would miss several pool visits before he stopped intimidating his peers once and for all.
And then there was Anthony, whose household was continually in crisis. He became the school thief -- and a clever one at that. He was nearly caught stealing on several occasions, but was able to talk his way out of trouble each time. Finally, one day his story unraveled in a council meeting after he was found in possession of a classmate's missing two dollars. Despite the overwhelming circumstantial evidence, however, he refused to admit to taking the money. Someone raised their hand and suggested we hold a trial, and everyone, including Anthony, agreed. It was a dramatic moment. A judge was elected, attorneys were appointed, and witnesses were interviewed. Serendipitously, the seventh and eighth graders had been out that morning and knew nothing about "the crime." They served as an excellent impartial jury. After a half-hour of deliberation, they ruled Anthony guilty as charged and sentenced him to ten hours of community service in the school kitchen, where he helped to prepare lunch the following week. Several months later, he publicly acknowledged the theft and never stole again.
By mid-year, the boys were accepted members of our school community. While their education wasn't proceeding in neat, straight lines, each was learning successfully on many levels. Clearly, none of them was suffering from a pathological disorder that required treatment with powerful psychotropic drugs. What they did require was an environment where they could be themselves, and where their individual needs would be honored and addressed with love.
Notes
1. Alexander S. Neill, Summerhill: A Radical Approach to Child Rearing (New York: Hart Publishing, 1960). Currently out of print. Also see Alexander S. Neill, Summerhill School: A New View of Childhood (New York: St. Martin's Press, 1995).
Chris Mercogliano has been a teacher at the Albany Free School for 26 years, and its codirector for 14. Author of Making It Up as We Go Along (Heinemann, 1998), he recently completed a second book, Rid-a-him: Or Why Are So Many Kids Labeled and Drugged in School? His essays and commentary on children and education have appeared in SKOLE, The Journal of Alternative Education, Friends Review, the Albany Times Union, The Journal of Family Life, Paths of Learning, The Journal of Humanistic Psychology, Yes! magazine, and Deschooling Our Lives, edited by Matt Hern.
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Permalink Reply by Kelley Woods on -
Michael,
This post is awesome! "Disease mongering" is rampant and ONE more (I'm beginning to feel a lot like Saul Rosenfield as I write this) reason I don't watch television.
Last week, my hypochondriac sister called to inform me that her 18 mo old grandson has ADHD!! When I asked her why she thought this, she went on a harangue about how he bounced around the house during a visit, climbing curtains and "never" sitting still.
I cautioned her that 1) 18 mo is WAY too young to diagnose an attention deficit, which is probably not even a "disorder" 2) Short attention span is typical for toddlers 3) Physical energy, especially in large motor skills, is great for kids; take him outside if he's too rough for your home 4) To NEVER repeat her opinion in that manner again!!
She was surprised at my reaction, but mainly hurt because I didn't give her the type of attention she was looking for (sympathy and empathy). I went on to remind her of what a wonderful mom she was when her kids were little and reflected on how fast that time went, blah blah blah.
But, this story shows where the current mindset is and it makes me frustrated and sad. And so, so grateful I pulled my little 7 yr old "attention-challenged" boy out of public school nearly 10 yrs ago. (He's back in high school now and bored out of his skull, but that's another tale...)
So, your example here hit a spot with me, but it's one that colors our culture at large and is having ramifications that are just beginning to surface. I'm sure you, like I, have dealt with de-hypnotizing clients who have lived for decades with "attention disorder" burdens and isn't it amazing when they realize the power of their own abilities for the first time?!!
Thanks for the excellent post and articles...
Best wishes,
Kelley
mother of 3 healthy free-thinkers -
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