A mid-reading response to Robert Whitaker’s Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America is posted here. This is Part 2 of a two-part post-reading response to a book that has been stirring up quite a storm of conversation within mental health circles. This pair of responses is the result of a conversation between ∃ and Meredith, wherein we each summarized our take-away impressions from the book. The consensus (if you can form a consensus between two people) is that it is an often difficult, often startling, and often frustrating read. The research and reporting raise several interesting and compelling ideas while also raising several important questions that are left either unaddressed or unanswered. As a contribution to general knowledge reading on psychiatry in America, it is informative but should not be read in isolation. Part 1 of this response is here.
PART 2 — IMPLICATIONS: Whitaker’s Unintended Meanings
The intended take-away of Whitaker’s book is that the intertwined needs to legitimize a profession and generate a profit have manufactured a psychiatric epidemic in America. No doubt that both have contributed to the numbers. No doubt that both have exhibited and engaged in less than ethical practices. No doubt an inordinate and truthfully dangerous amount of power over the collective well being of Americans is being wielded by institutions and companies with ego and money on their minds. No doubt the assertion that anyone with a human mind might actually understand (and solve!) the intricacies of every human mind seems more than a little logically stupid. No doubt.
Still, those things lacking in this book leave a lot of its contents up for interpretation. The intended take-away is very easily imagined as not at all resembling the actual take-away. Here are some of our (I think reasonably) imagined responses to this book as it is written and as its argument is presented:
How any reasonably smart and critical thinker (i.e. a literate person who’s read other things and has experience in not being pandered or condescended to) might read this book: Please stop beating the extremely dead horse you’ve already kicked while down and shot forty times. I get it. Now put down the sledgehammer and please answer my other questions.
How a skeptic (or Scientologist since Whitaker discusses their role in this story more than the role of drug use) might read this book: Mental illness is fiction, a manufactured chronic condition. Those who suffer are victims of a system that is out to exploit rather than help, a monolithic system wherein every psychiatric practitioner is nothing but a greedy con artist and every pharmaceutical researcher is nothing but a witch doctor.
How a therapist might read this book: I am here. Talk therapies do not only exist in Europe. I am here. There is extensive research on the many types of work my field practices. I am here. You may be doing more damage than good by convincing the general public that my practices are absent in the US. You may be doing more damage than good by questioning the extent to which my patient’s experiences are “real.” You may be making my job more difficult than it already is.
How a seriously debilitated mentally ill patient on SSDI might read this book: My life is what it is because I’ve been victimized, exploited — a siphon for insurance money. What I know as my everyday life, that which is my existence, is the result of a monetized reduction in my humanity. [If this is not the most dangerously anomic potential reading of this book, I don’t know what it is.] My condition, whatever that may be, will probably not improve. What I know now will probably be, at best, what I know for what remains of my medically shortened life. [God this hurts to write, but it is the broad-brush picture he paints.]
How Rand Paul might read this book: Pharmaceutical companies are manufacturing debilitating conditions that are sucking this country dry through entitlements. The best answer is to cut the programs that support patients. They will no longer be able to afford the fake care ultimately hurting them. They will have to reenter the community and work force, which will be good for them. It’s a win-win. [Scary.]
How a high-functioning mental illness patient on meds (i.e. many of us) might read this book: What are “functional outcomes” and what does “functionally recovered” mean (171)? What does it mean to be “functionally impaired” (321)? My treatment more or less works for me. Why didn’t you interview me? Or anyone with my experiences? Yes, I suffer side effects. Yes, I am aware of the risks of long-term medication. Yes, I hate the financial mechanisms that dictate the treatment paradigm on which my care is predicated. Yes, I still work hard every day to maintain myself and my life. Yes, I choose medication because I’ve lived without it, because I’ve tried other treatments, because this plan helps me live the life I want to live or, at least, gets me closer to it. Why didn’t you interview me? Or anyone with my experiences? I am not alone. We are here.