WSJ wakes up to the psychobabble labeling of children for profit in the USA.

Opinion Journal Wall Street Journal Online


CITIZEN OF THE WORLD

  Shrinking to Excess
  I'll be damned if I let a psychiatrist near my son.

  BY TUNKU VARADARAJAN
  Tuesday, August 21, 2001 12:01 a.m. EDT

  I have a confession to make: I have a mental illness, and it is called
  Psychobabble Defiance Disorder. Since at this moment I am also afflicted
  with Ranter's Syndrome, I intend to have my say on a topic that troubles me.
  No, let me put that more strongly, a topic that makes me flood the room with
  rage.

  My boy, who turned two last month, will start to go to the local church
  school in the middle of September. His class, which will convene twice a
  week for two hours each time--short and sweet, which is how it should be for
  one so young--is called "Early Twos." I send him with mixed feelings, of
  course: How could I not? On the one hand, there is pride in his having grown
  up enough to go out in "the world," even if it is only to the assiduously
  controlled cocoon of an Episcopal school, three-and-a-half minutes by foot
  from our home.

  On the other hand, once out in the world, the little mite will be exposed to
  the vagaries of the benighted educational-medical complex, which regards it
  as its business to label all our children as being sufferers of some
  disorder or other. This won't happen at his church school, for sure--it's
  much too sensible and old-fashioned for that--but my boy will move on, by
  the time he's five, to another school, where the teachers, like most
  teachers of young children in this country, will be on ADD watch.

  Oops, sorry, forgive me. I should have said ADHD watch. The American
  psychiatric establishment now refers to Attention Deficit Disorder as
  Attention Deficit/Hyperactivity Disorder. Why the change? Beats me, but it's
  just as much nonsense-on-stilts as ADHD as it was pure poppycock as ADD. And
  I'd bawl out any teacher who said to me, "Mr. Varadarajan, I think your boy
  has an attention disorder," and then suggested Ritalin, or Adderall, or
  Metadate CD.

  Sunday's New York Times carried a front-page story on ADHD, and on how
  lawmakers in some states--Arizona, Connecticut, New Jersey, New York, Utah
  and Wisconsin--have introduced bills that would prohibit schoolteachers from
  playing shrink in their classrooms by telling parents that they must put
  their children on drugs to combat "attention deficit." Such instruction, the
  bills declare, must only come from doctors.

  This is good news, and to be vigorously lauded. Teachers must be stopped
  from playing God. Above all, they must be stopped from shirking their
  disciplinary duties and seeking to "fix" every boisterous child with a dose
  of drugs.

  What stops this legislative pattern from being excellent news, however, is
  that the doctors can't be trusted. After all, it was they who invented ADD
  and foisted it on a generation of American children. Twelve percent of all
  American boys between six and 14 have been diagnosed with "attention
  deficit" problems. (I get these figures from the International Narcotics
  Control Board, a United Nations agency.) These children all take
  medication--Schedule II drugs, which share the pharmacological effects of
  amphetamine, methamphetamine and cocaine--to sharpen their short-term
  attention span. Four million American children take such medication.
  Toddlers, and children under five, are being prescribed such medication.
  Ninety percent of all Ritalin popped in the world is popped in America.

  What is ADD/ADHD? According to the fourth (and latest) edition of the
  "Diagnostic and Statistical Manual of Mental Disorders"--DSM for short, the
  "bible" of the American Psychiatric Association--it is a disorder with nine
  diagnostic criteria. If your child shows six or more of the following
  behavior patterns, he's liable to be labeled:

  Often fails to give close attention to details or makes careless mistakes in
  schoolwork, work, or other activities
  Often has difficulty sustaining attention in tasks or play activities
  Often does not seem to listen when spoken to directly
  Often does not follow through on instructions and fails to finish school
  work, chores, or duties in the workplace (not due to oppositional behavior
  or failure to understand instructions)
  Often has difficulty organizing tasks and activities
  Often avoids, dislikes, or is reluctant to engage in tasks that require
  sustained mental effort (such as schoolwork or homework)
  Often loses things necessary for tasks or activities (e.g., toys, school
  assignments, pencils, books, or tools)
  Is often easily distracted by extraneous stimuli
  Is often forgetful in daily activities
  Easily distracted? Does not seem to listen when spoken to? Makes careless
  mistakes? Has difficulty sustaining attention in tasks? Is often forgetful?
  Often avoids homework? Homework, for Nora's sake! These are children they're
  talking about. Show me a child who doesn't avoid homework and I'd say he's
  not normal. Are these people for real? Are we to take this hysterical
  gibberish seriously?

  And what makes a child liable to be dubbed "hyperactive"? Here we go, again,
  from the DSM:

  Often fidgets with hands or feet or squirms in seat
  Often leaves seat in classroom or in other situations in which remaining
  seated is expected
  Often runs about or climbs excessively in situations in which it is
  inappropriate (in adolescents or adults, may be limited to subjective
  feelings of restlessness)
  Often has difficulty playing or engaging in leisure activities quietly
  Is often "on the go" or often acts as if "driven by a motor"

  Often talks excessively
  Fidgets? Squirms? Runs about? Leaves seat in classroom? Talks excessively?
  Has difficulty playing quietly? It is almost as if the psychiatric
  establishment wants to snuff the life, the joy, out of childhood, rendering
  our children robotic and docile.
  Teachers have latched onto this with alacrity. In part, they have an excuse:
  Denied access to more traditional forms of punishment, it is increasingly
  hard to maintain discipline in class. Ritalin, in many cases, has taken the
  place of discipline. How else can one explain that previous generations got
  by without recourse to such labeling and such medication?

  The label ADHD and the medication are, to quote Thomas Szasz--author of "The
  Myth of Mental Illness" and a professor of psychiatry--perfect examples of
  "the pharmacratic control of a social problem: how to educate children."
  Thomas Armstrong, author of "The Myth of the A.D.D. Child" cut right through
  the bull when he wrote: "ADD is a disorder that cannot be authoritatively
  identified in the same way as polio, heart disease or other legitimate
  illnesses."

  So how have we come to be saddled with this spurious syndrome? One reason
  might be that ADHD is but one example of a dangerous trend in our society,
  which is to pathologize everything. In the mid-19th century, in the days
  before the DSM and the APA, the U.S. government recognized only one category
  of mental illness: "idiocy/insanity." That, while hardly satisfactory, at
  least had the virtue of brevity. But now, in the grip of a dogma that holds
  that all troubles in people are the product of some internal dysfunction, we
  have had a veritable proliferation of madness. The ascendancy of this view
  can be linked, among other things, to a decline in the belief in individual
  responsibility.

  I cannot resist deploying a pithy quote here, from "Making Us Crazy," a book
  published three years ago and written by Herb Kutchins and Stuart Kirk, both
  psychiatry professors: "There is a growing tendency in our society to
  medicalize problems that are not medical, to find psychopathology where
  there is only pathos, and to pretend to understand phenomena by merely
  giving them a label." The latest edition of DSM lists more than 300 mental
  syndromes. Only two decades ago, an earlier edition listed a mere 106. Are
  we galloping toward madness? Or is the APA nuts? Judge for yourselves.

  Alongside ADHD, we have such new syndromes as these: "frotteurism" (defined
  in the manual as the irresistible urge to rub oneself against "a
  non-consenting person"), Asperger's syndrome (a pompous label for shyness),
  "dissociative fugue" (the urge to travel without clear plan, often under an
  assumed identity), "hypo-active sexual desire disorder" (found in people not
  at all keen on sex, and not to be confused with mere "sexual aversion
  disorder"), and "paranoid personality disorder" (the hallmark of someone who
  bears grudges).

  Children can suffer from "mathematics disorder" (you don't believe me, do
  you? It's Code 315.1 of the DSM), "disorder of the written expression," and
  "oppositional defiance disorder" (which my parents, bless them, would have
  called "disobedience" when they were raising me).

  The jewel in the APA's crown is "generalized anxiety disorder," from which
  12 million Americans, or 5% of adults, suffer. And what is this? Well, silly
  of you to ask! Why, it's excessive worry, of course, and restlessness, and
  anxiety, and tension, and the feeling of being keyed up. Bring on the
  Prozac. One for mommy, one for dad, and for you, son, a nice bit of Ritalin
  for dessert.

  Before I go, let me add another twist. According to Drs. Kutchins and Kirk,
  the psychiatric establishment is foisting these invented illnesses on us in
  a bid to lay claim to handsome reimbursements from insurance companies. For
  psychiatrists to receive payment from health insurance companies, they must
  find a way to label a patient with a recognized condition--which is why they
  recognize more, and more, and more conditions. Wait for the next DSM, and
  there will be at least another 50 conditions added to the existing list.
  According to Drs. Kutchins and Kirk, "the unlabeled masses are a vast
  untapped market, the virgin Alaska oilfields of mental disorder."

  As I was saying, my son goes to school next month, for the first time . . .

  Mr. Varadarajan is deputy editorial features editor of The Wall Street
  Journal. His column appears Tuesdays.