According to a Report of the Surgeon General, dated December 16, 1999, the top public health official in the United States, Surgeon-General David Satcherone, claimed that one in five Americans suffers from a diagnosable mental disorder each year and half the entire population has such disorders at some time in their lives.  That’s a rather staggering figure.  It’s like saying every other person is nuts. And if it isn’t me, then it must be you.  It makes me wonder if I should have taken my mother’s advice and specialized in Psychoceramics (the study of crackpots).

Curiously, these statistics, as staggering as they, are nevertheless not all that surprising.  In fact, one might ask, “Only half?”  It’s not just a matter of knowing someone who’s been seeking psychiatric help, some form of therapy, or actually been committed, but the fact that there seems to be so many who appear to need one or more of the three.  Part of the problem is likely attributable to the widespread feeling that the average individual has little or no control over their life, and hence it must be due to something insane about them, the society around them, or just the insanity of the world in general.

The report -- in typical government fashion -- spends a lot of time on statistics, i.e.:

Mental illness, including suicide, is the number 2 cause of disability (which is defined as “years of life lost to premature death and years lived with a disability of specified severity and duration”), less than heart disease but worse than cancer and AIDS combined;

A fifth of all children show signs and symptoms of a diagnosable mental disorder in any given year, although only 5 percent suffer “extreme functional impairment”;  [Even if this is due in large part to overagressive diagnoses by doctors with a serious conflict of interest, the very idea that the diagnoses are being made is grave cause for concern!]

Among adults, ages 18 to 54, 15 percent suffer anxiety disorders, 7 percent have mood disorders and a little over 1 percent have schizophrenia;

Depression is common among people 65 and older -- also the age group with the highest suicide rates, although the report offers the dubious consolation that “suicidal thoughts are sometimes considered a normal facet of old age.”  [Obviously, something we can all look forward to.]

The report brings together a huge amount of data derived from the findings of hundreds of recent studies.  As such it provides a comprehensive snapshot of the state of mental health at the turn of the millennium.  The New York Times pointed out that the report “puts the imprimatur of the government on the findings”; the hope being that, in a fashion similar to the 1964 Surgeon-General’s report on smoking, the mental health report will become a catalyst for a major shift in public attitudes toward mental illness [December 13, 1999].

The assumption embodied in the report is that most of the suffering is avoidable, but also incorporated is a bewailing of the fact that two-thirds of the mentally disordered will not seek treatment, even though -- allegedly -- effective treatments already exist.  The idea that “effective treatments already exists” is, perhaps, one of the more damning statements in the report.  One example of a failed, mainstream psychiatric effort is Post Traumatic Stress Disorder (P.T.S.D.), which may have a radically different causative explanation.

The report claims a number of reasons for people’s unwillingness to submit themselves to the whims and prejudices of psychiatric treatment, including: simple ignorance that one has a problem or that it can be treated, a fear of being stigmatized by others, and the biggie -- few can afford the cost of treatment (i.e. no medical insurance or inadequate coverage).  What is not considered a reason is that people do not want to risk their lives with doctors whose twin aims for entering the psychiatric profession was to find out what was mentally wrong with themselves, and simultaneously, to enjoy a lucrative income.  In fact, the report is strangely silent on the idea that perhaps, just perhaps, the reason so many people do not want to undergo therapy is the idea that they’re not crazy to begin with -- but that placing themselves at the mercy of psychiatrists would indeed be insane!

In the increasingly hostile Corporate State in which we find ourselves, a fundamental money-making technique used by the legalized Drug Pushers (aka the pharmaceutical industry) is to create a disease for which the marketeers already have a drug to counteract the alleged symptoms, and then to aggressively diagnose the disease in everyone from new born babies to octagenarians whose health has been so blasted from Drug Reactions, Vaccines, and the effects of drugs like Ritalin, et al that they may really need some relief.

The Surgeon General’s Report on Mental Health can then be viewed -- at least to some degree -- in the same light.  There is much to suggest that people are undergoing extreme degrees of stress in their lives, and that the result is depression, anxiety, anger, and in some cases, a certain madness.  There is even an apparently causal link between Stress and Longevity.  Duh.  But the alleged cures or treatments, the years of high cost, alleged therapy, is blithely included in the report as the obvious solution -- but with the politically correct assertion that its proposals won’t cost a lot of money.

What does not appear in the supposedly comprehensive report is why so many people are supposedly having problems.  What are the causes of mental illness?  What can be done in our society to lessen the problems before they become symptoms?  In other words, what about preventative mental health practices?  Wouldn’t that be an obvious possibility?

Instead, the report actually has the gall to state that, “The precise causes of most mental disorders are not known.”  This statement may be more frightening than the statistics.  How does one effectively treat mental disorders, to say nothing of preventing them, if one doesn’t have a clue as to what gives rise to them in the first place?  And what accounts for this ignorance at the end of a century that has seen remarkable progress in medicine on virtually every other front and when the illness we are dealing with is not some mysterious new outbreak, but an affliction that has been around for a very long time?  E.g. stress.

As Frank Brenner, in a commentary dated March 24, 2000, said:  “What the report has to say in addressing these issues doesn’t provide much comfort.  First, it contends that while precise causes may be unknown, “the broad forces that shape [mental disorders] are known: these are biological, psychological, and social/cultural factors.”  But this is so broad that it really tells us very little.  What aspect of an individual’s life isn’t covered by “biological, psychological, and social/cultural factors”? One might as well say that, “broadly speaking”, you have to be alive in order to be mentally ill.  What we need to know is which factor is the decisive one; otherwise, we’re still wandering in the dark.  And that’s just where we seem to be when it comes to the crucial question of prevention: the Surgeon-General admits that “progress in developing preventive interventions has been slow”, because, of course, how can you be effective in preventing a disease if you don’t know why it’s happening?

“And you have to wonder about treatment as well, even though the report keeps insisting that most disorders can be treated successfully.  Given that the causes are unknown, mental disorders are defined “by signs, symptoms, and functional impairments,” and it is these that get treated.  In medicine, if all you can do is treat the symptom rather than the disease, this is an admission of failure, not a sign of success.  What is more, if you are treating only symptoms, how can you be sure that the treatment isn’t actually making the patient worse? In this regard, the pervasive use of extremely powerful drugs within psychiatric treatment is deeply troubling: the concern seems far less with curing patients than with tranquilizing them to the point that they stop being a “problem.”  The report admits that financial considerations play a role here, and it isn’t hard to see that drugs are much more “cost-effective” than psychotherapy, which takes a long time and therefore costs a lot of money.  A cheap way to police an unruly population - to an appalling extent, that is what this kind of “treatment” seems to be about.  (Which isn’t to say that all drugs are always bad: as a last resort, they clearly have a legitimate role, but what is appalling is the extent to which they have become a first resort.)”  [emphasis added]

The Mother of Conspiracies would assume that the rush to increased mental and physical diagnoses among fee-paying consumers is a means by which a potentially unruly mob or population at large can be controlled, if not by drugs, then by convincing everyone they are indeed sick and must be taken care of.  As one thinks, or believes, one becomes.  And with the phalanx of mass marketing of drugs for every imaginable disappointment in life or hang nail, there is ample opportunity for anyone to assume that they are undoubtedly sick.

But one should never attribute to conspiracy what can be explained by incompetence and/or greed -- especially the latter.  To make the point almost conclusively, the Report on Mental Health actually considers as a viable means of treatment, electroconvulsive therapy (ECT), better known as shock treatment.  Despite an horrific history, expects are now claiming that ECT is safe and effective -- despite a group called the Committee for Truth in Psychiatry (lots of luck, guys!), who has expressed its outrage over the Surgeon-General’s recommendation, saying that the report largely ignored evidence of the treatment’s harmful effects, including permanent memory loss and brain damage. The group also pointed out that 15 of the citations used by the report on ECT were from “men with known financial ties to ECT machine companies” and that the Surgeon-General’s claim that modern ECT uses one-third less electricity than earlier versions is wrong. [Committee for Truth in Psychiatry, press release, December 14, 1999]

A very strange aspect of the Report is to blame Rene Descartes for conceptualizing the mind as completely separable from the body.  This mind/body “partitioning” allegedly “ushered in a separation between so-called mental and physical health”, a process which has bedeviled the mental health field throughout most of the Twentieth Century.  Even the stigma attached to mental illness stems in part “from the misguided split between mind and body first proposed by Descartes.”  Then in true ludicrous fashion, the Report notes the split is finally being overcome due to the “breathtaking progress” made by “modern integrative neuroscience.”  [“Breathtaking” because one tends to gag at the claim?]

The connection of mind and body is so fundamentally ingrained in most philosophies -- the ability of Creating Reality, to cure oneself by changing one’s mind, and to avoid the twin plagues of Woundology and/or Scapegoatology -- that it is astounding that the Surgeon General’s Report is only now suspecting the connection, or that the revelation of its reality is due to “modern integrative neuroscience.”  The generous view, of course, is that at least mainstream psychiatry and medicine are beginning to see the light -- even if they are attempting to claim the honor of its discovery for themselves.

Blaming Descartes is obviously a dodge!  The real problem plaguing the mental health field isn’t the partitioning of mind/body, but rather a crudely mechanical outlook which reduces the mind to biology.  Far from addressing the misguided nature of reductionism, the report enthusiastically endorses what amounts to refurbished version of it.  This is the “modern integrative neuroscience” touted by the report as a great leap forward.

And yet the Report still maintains that, “Mental functions, which are disturbed in mental disorders, are mediated by the brain. In the process of transforming human experience into physical events, the brain undergoes changes in cellular structure and function.” Get at those changes and you have the key to understanding and treating mental illness. This is just more reductionism; the brain is still just a glorified computer, mechanically turning out its product.  In effect, the precept that “insanity is brain disease” derives from nineteenth century psychology and traditional psychiatry -- a belief so fundamental that it has been enshrined in the requirement that psychiatrists have medical degrees.

The problem is for most mental illnesses, it’s impossible to find a physiological cause.  The Report admits, “there is no definitive lesion, laboratory test, or abnormality in brain tissue that can identify [mental] illness.”  I.e. most people with what is alleged to be mental illnesses have normal brains, while the abnormal brains are due to neurological disorders, not mental illnesses.  The difficulty in treating mental illness as a brain disease has a history of failure for the last century, including the development of technological marvels allowing researchers to probe the brain as never before and understand its workings right down to the cellular level.   And yet there’s been virtually no difference in treating mental illness.

Obviously, the mind and brain aren’t the same thing.  You may need both (while in human form), but a mind is not necessarily reducible to a brain.  While the brain may provide the physiological potential for the mind, the realization of that potential can only take place through the individual’s interaction with other human beings, i.e., through society.  (This is why children who are locked away for long periods and denied such interactions inevitably suffer serious mental impairments.)  To reduce the mind to the brain is to blot out the fundamental role of society in mental development.  And if the mental health field keeps sticking to this misguided reductionism, despite its long-standing failure to produce results, this must mean that there is a powerful resistance to examining this social factor.

The Report alludes to this issue by stating, “The study of the brain requires reducing problems initially to bite-sized bits that will allow investigators to learn something, but ultimately, the agenda of neuroscience is not reductionist; the goal is to understand behavior, not to put blinders on and try to explain it away.”  But then the Report backs off by saying, “Ultimately, however, the goal is not only human self-understanding. In knowing eventually precisely what goes wrong in what circuits and what synapses and with what chemical signals, the hope is to develop treatments with greater effectiveness and with fewer side effects.”  This is just a return to the circuits, synapses and chemical signals -- which scientifically are understandable -- while ignoring human behavior.

Clearly, there are none so blind as those who will not see, including the Surgeon General and the other contributors of the Report on Mental Health.  For if it’s not the psysiological part of the brain that’s responsible for mental illness, then the next obvious alternative is that society must be responsible.  I.e. Mental illnesses are social diseases.  The problem is that such a statement is inexplicable from a reductionist perspective.

For example:

* The Report notes that there is “no bright line separating [mental] health from illness;” rather the two are part of a “continuum.”  But if mental illness were really brain disease, then there would be a discontinuity, a molecule or virus out of place or deformed in some way.  A “continuum” implies the cause of social behaviors.  Curiously, the Report defines mental health as “a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity.”  Mental illness is defined as being “characterized by alterations in thinking, mood or behavior associated with distress and/or impaired functioning.”  It is “functioning” that is the key term here, and this is a social criterion: you are well if you can function within this society and you are ill if you cannot!

* The report admits that “what it means to be mentally healthy is subject to many different interpretations that are rooted in value judgments that may vary across cultures.”  But this eliminates brain disease, as a virus knows nothing about cultural borders!  If mental health and illness are rooted in cultural values, this only confirms their social character. The same goes for the impact that socioeconomic status, gender and race have on mental disorders.

* The report notes that “relatively few mental illnesses have an unremitting character... rather, for reasons that are not yet understood, the symptoms associated with mental illness tend to wax and wane.”  From the viewpoint of a social disease, this waxing and waning is entirely straight forward.  Obviously, it bears some correlation (though a highly complicated one) to the waxing and waning of the social pressures which caused the initial breakdown in the individual’s ability to function within the society’s constraints.

So why is the Surgeon General of the United States so reluctant to defining mental illness as a social disease?  Perhaps he is loath to declare that the epidemic of mental illness in America is due to... American society?  Oops.  Clearly, the social and political implications of such a report would be -- at best, politically incorrect, and at worse -- explosive.  Such an ideology would be untenable, as if to admit to what is currently being hidden as an ideological blind spot.  How could the best, wealthiest, most advanced society in the world, the alleged apex of human civilization, be responsible for the terrible ravages of mental illness?  To admit mental illness as a social problem, would be devastating to the old Paradigms shared by the authors and contributors of the Report.

The only hope to avoid this implication is to assume that the inability of an individual to function in society must be due to the individual and not to society.  It must be his brain, or his genetic inheritance, or some external virus (and inasmuch as the virus has no political connections, it can easily be blamed in classic Scapegoatology).

An alternative view is that individuals who do not function well with society may have chosen not to function within society, because society in their view is not worthy of their time and energy!  They may not be crazy.  They may in fact be the only sane ones.

There are, admittedly, people who do some very strange things in reacting negatively to the whims of society, but this may simply be a case where they haven’t figured out yet a creative or innovative way to shed the constraints of society.  They may not be intelligent enough, or have the wisdom to drop out without dropping into a mental institution.  But there is no implication that they’re insane.

Perhaps, insanity is best defined as doing the same thing over and over again, and yet expecting a different result. The Surgeon General’s Report on Mental Health is still holding on to the unconscionable “individualized brain disease theory” and expecting a different result from its massive effort to correct the defects. By this definition, it’s insane!

Admitting that mental illness is a social problem, doesn’t solve the problem, but rather redirects the efforts into how to change society.  How precisely to fundamentally change things is not always clear -- although there are a lot of obvious clues, like what really makes people angry or frustrated?  (Unresponsive bureaucracies?  Victimless crimes, e.g. speeding tickets?  Unnecessary legal restraints -- ranging from laws prohibiting individuals from choosing their own poison/cure to any and all deviations from Common Law or more simply, following The Golden Rule?)

However, any restructuring of society will also necessitate a degree of research into what causes are the root problems, and how one changes society in order to alleviate these causes.  There is also the fundamental difficulty in that change or paradigm shifts are not welcome commodities -- as in Eric Hoffer’s The Ordeal of Change.  The problem is one of those in power potentially losing power, or those in control perhaps losing a degree of control over others.  It’s a political problem.  [The latter also akin to insanity.]

There is also the difficulty in asking individuals to be responsible for themselves -- as in Health and Responsibility -- and to assume their own power.  Creating Reality is easier said than done.  This is because self-creation requires self-responsibility, self-effort, and self-discrimination.  At the same time, this mentally healthy approach could be greatly facilitated by governments, bureaucracies, and the bulk of the mental health profession... Getting out of the frigging way!

Ultimately, according to Frank Brenner, “alleviating suffering isn’t the same thing as a cure, and to lose sight of that is to obscure the underlying social conditions responsible for that suffering.  The basic truth is that there are no individual cures for a social disease.”

This is a strong statement.  It suggests that perhaps we can not label as insane a so-called terrorist who commits suicide by blowing themselves up with explosives, along with allegedly innocent bystanders.  If the individual committing the act sees absolutely no other option, no other means to rectify their lives, then the act may be more sane than most of what the rest of us do.  If the society in which the so-called terrorist lives is such that the individual cannot realize their own sense of significance, their own hopes (no matter how simple or great such hopes are), or see anyway in which things might improve; then one can challenge that society by suggesting perhaps it is that society which is insane.

Ultimately, mental illness must be treated by examining in great detail the cause(s) of the problem, and must absolutely consider how the societal and political structure under which we live is the contributing (if not sole) factor.

And thereafter, we must change the society to remove the causes!  It’s a major paradigm shift, but one that is essential.  It’s time to take our heads out of the sand.

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Significant portions of the above were taken from a March 24, 2000 commentary by Frank Brenner of the World Socialist Web Site, who in accordance with Title 17 U.S.C. Section 107, distributes material without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes, and thereafter allowing others to distribute the material widely (provided the source is acknowledged).

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A secondary, but equally serious, complication is the current efforts of Drug Pushers to push mental-rearranging drugs to the rest of the world.  It’s as if the local population of the Western nations is getting too smart, and the pharmaceuticals need new and captive markets in which to distribute their poisons.  This is discussed in some detail by Rob Wipond in Adbusters: Journal of the Mental Environment, November/December, 2001, 1243 West 7th Ave., Vancouver, BC V6H 1B7, Canada, 604-736-9401.

Meanwhile, were you aware that voice changes 'predict' suicide risk.  According to the BBC News, "A subtle change in a person's voice could be the first sign that they are at risk of committing suicide, according to a study."  Typically, one's voice becomes higher, and they use a narrower range of frequencies when pronouncing their vowels. 

Speaking of suicide, What's New Netscape (August 13, 2003) reports that when one's e-mail goes down, 20% of people get angry and irate instantly, another 13 percent within 5 minutes, another 33 percent within 30 minutes, and other 16 percent within an hour.  This amounts to 82% who are getting mad over e-mail.  Can you imagine what would happen if one's computer crashed!

Is there something here that might suggest computers are not a good idea?

Health and Responsibility         Evil Wind

Or forward to:

Life Vehicles         Fear of Flying

Stress and Longevity         Post Traumatic Stress Disorder

The Play: P.T.S.D.         Therapists         Laughter