Pubdate: Mon, 03 Jul 2000 Source: North Shore News (CN BC) Copyright: 2000 by the North Shore News Contact: http://www.nsnews.com/ Author: Ilana Mercer MASKING PAIN WITH PILLS IS NOT THE ANSWER THE love and concern for our children is one of the most powerful things in the lives of parents. We want them to succeed in what is an increasingly competitive and unpredictable world. Attention Deficit Hyperactivity Disorder (ADHD) touches on our fears and aspirations for our children, but it also puts to the test the manner in which we accept their imperfections, and the effect of those imperfections on us. The substance of my argument in the past against this catchall diagnosis is in no way radical, and echoes a robust and ongoing debate under way in the scientific community. The formula generating the ADHD and other trendy diagnoses involves twin evils: First, we reduce complex psychosocial behaviour to the basic components of genetics and biochemistry. Then we pathologize it, and outsource the problem to the "expert." This is both poor scientific practice as well as morally and intellectually impoverished. But it has not stopped "experts" from putting approximately six million children on Ritalin in North America, up from one million in 1990. Most of the children being medicated are boys, with minority boys 11 times more likely to be on this stimulant. Ninety per cent of Ritalin, which is supposed to help children focus, is marketed in the U.S. One can't help but wonder why American and Canadian children don't score very well on international scholastic tests. Maybe there isn't enough Ritalin going around? On the other hand, maybe the schools are failing children. Either way, it doesn't really matter: as long as Ritalin is making kids happier, who cares? Certainly not the pharmaceutical companies who are making merry with between $30 to $60 a month per medicated child. In 1997, Robert Sternberg, a prominent Yale professor of psychology told The New Republic magazine there was no evidence to support the view that children who are labelled learning-disabled have an immutable neurological disability in learning. "From a medical point of view," said Sternberg, "there is no scientific proof that these children actually have a discernable ailment." A year later the flagship American National Institutes of Health (NIH) confirmed his pronouncement. In a Consensus Statement on the Diagnosis and Treatment of ADHD, prepared by a non-advocate, non-federal panel of experts, the NIH cautioned that there exists "no independent valid test" for ADHD, adding that "further research is necessary to establish ADHD as a brain disorder." This paper offers a distillation of all the relevant research to date in the field. Readers should be aware that there are, moreover, persistent concerns in the research and clinical communities regarding the psychiatric Diagnostic and Statistical Manual of Mental Disorders (DSM) from which the ADHD and many other fashionable diagnoses are culled. The latest critical examination of the manual is entitled "Making Us Crazy DSM: The Psychiatric Bible and the Creation of Mental Disorder." Written by two American academics, it received a nod from no less than the august British Times Literary Supplement (TLS), whose reviewer ventured that the DSM is an American invention, unique to that culture. The DSM, wrote the reviewer -- an American social psychologist by the name of Carol Tavris -- represents a "brilliant orchestration of pseudo-science, marketing and promotion," which has "succeeded in transforming the normal difficulties of life into mental disorders." The book points not only to the shabbiness of scientific evidence inherent in the DSM categories, but to the hundreds of diagnoses created which are vulnerable to misuse. Conditions like "Oppositional Defiant Disorder," or "Conduct Disorder" harbour Orwellian possibilities. Such diagnoses were likely the bailiwick of the mental health professionals in the former Soviet Union, when they needed to dispose of dissidents. For real double bind value, look no further than a DSM condition called "Non-Compliance with Treatment." Disagree with the medical demiurge, and he slaps you with a diagnosis. Safer not to risk that second opinion. Not only are "most of the DSM labels circular," asserts the Times reviewer, but they "confuse labels with explanations." Ultimately they aim to give the public a psychiatric explanation for the pain in their lives, and the hope that a pill can eradicate it. ADHD is an emotional topic. But by masking the pain of living with a pill, mental health professionals are abnegating their responsibility and traditional mandate to explore and improve the many psychosocial factors that influence a life. In the process, vital interventions are overlooked, and we whittle down control over and responsibility for our lives to the inaction and resignation inherent in a biological determinism. Finally, by allowing emotional life to be homogenized through pharmacology, we are passing up on what it means to be human. - ---