The Gross Over Medicalization of American Life

A Federal panel now recommends that all adults under 65 be screened for anxiety

By

David Gottfried

Today, the New York Times reported that the “U.S. Preventive Services Task Force” recommends that all adults under the age of 65 be screened for anxiety.  The members of this task force, according to the Times, were appointed by an arm of the Department of Health and Human Services.  The article did not identify a single member of this taskforce.   

This seems to be a rather pig-headed decision, a decision in line with the general drift of things in this era in which more and more facets of life are medicalized, all human quirks and idiosyncrasies become an excuse to aggrandize the role of “professionals” and people are taught to believe that they are feeble, fragile beings always in need of more expert help. 

1.   Medical and Psychiatric Tools Must be Applied with the Utmost discretion because that which can cure can also kill.

When are people going to get it through their damn, thick skulls --  More medicine and psychiatry do not necessarily make for healthier, saner people.  

As most of us know, the Hippocratic oath, which doctors are supposed to abide by but often seem merrily oblivious to, dictates that doctors must “First, do no harm.”

Psychiatric and medical care should be doled out with the utmost discretion because these interventions harbor a terrific propensity to inflict tremendous harm.  The scalpel that may excise a tumor may also lacerate the carotid artery and starve your brain of life.

More Americans than ever before are getting psychiatric care, but they seem sicker than ever:

a)  The suicide rate is rising,

b)  childhood bed-wetting is becoming more prevalent,

c)  the proportion of Americans in single person households (people who live alone) is higher than ever,

d)  the proportion of Americans in romantic or at least intimate relationships is going down,

e)  more and more children are diagnosed as having learning disabilities,

f)   more and more children are in single parent homes,

g)  and people are so phenomenally wacked out of their heads that airline passengers have been known to belt stewards who advise them to wear a mask, terminated employees go back to their former workplaces to spray the place with bullets, and Qanon adherents believe that Hillary Clinton is a leather wearing dominatrix who kidnaps children, stashes them in the basement of a Washington DC pizzeria, and makes them sex slaves. 

Of course, the treatment of physical illness has its share of horror stories too.   I will readily concede that modern medicine has done a magnificent job at combatting diseases which were once ferocious killers but are now as pacific as meek and mild kittens.  However, as medicine conquers ailments it seems to create new ailments.

In this nation, brain cancer, testicular cancer, colon cancer in young adults, autism, hypogonadism, and inborn genital defects in males (Some of these things are truly ghastly, such as a condition in which the slit in the penis through which urine and semen is emitted is positioned not at the head of the penis but at the base of the penis) are all becoming more prevalent.    

Of course, we actually have a good idea as to what some of the causes are:   For example,  an article in the New York Times, appearing about 15 years ago, said that a doctor at the prestigious Mayo clinic predicted that this country will have 25 thousand extra cancer deaths per year because of CT scans, which on average emit 500 times as much radiation as a chest x ray.   Many foods are contained in plastics which contain compounds which are carcinogenic and which mimic estrogen, and the latter attribute has been implicated in the aforesaid evidence of the increasing degradation of male sexuality.  

2.   Psychiatric Aberrations are Infinitely Murkier and More Mystifying that Physical Disease

Although dealing with physical disease forces the practitioner to confront many unknowns regarding the causes and cures of an illness, psychiatry is infinitely more nebulous and murkier:

When someone is suffering from acute appendicitis, we can identify the site of the problem:  A swollen, engorged appendix which might burst and kill the patient.  We can see the appendix.  We can feel the appendix, we can even smell the purulent infectious matter released by  a burst appendix.   

However, suppose we were to say that someone has a superego dominated personality.   No one has ever seen a superego.   Furthermore, behavior which to one person might seem inhibited, squeamish and fearful might to another person be  a sign of adherence to a healthy and stern moral compass, forbearance and high ethical standards.  

3.   Psychodiagnostics are a Bewildering Minefield of Contradictions where Utter Confusion Reigns.

For Christ’s sake, even psychodiagnostics are a hopelessly confused jumble of discordant, conflicting thoughts:  For example, a study showed that British psychiatrists were less likely to diagnose schizophrenia than American shrinks. 

Brits were less likely to diagnose schizophrenia because one of the symptoms of schizophrenia is flat or inappropriate affect.  This entails a schism between the content of one’ s speech and the tone of voice.  For example, if one were to say, “I fucking hate you and will boil you in a vat of oil,” but one were to say it in a voice bereft of emotion or anger, the schism between the hateful language and the voice lacking ire is deemed a symptom of schizophrenia.  

However, since Brits, in general, tend to mute their apparent emotions more than Americans, and are sometimes known for an even, flat, affectless tone of voice, British doctors are less likely to consider a patient’s emotional tone flat and empty and hence are less likely to diagnose schizophrenia.

4.   Anxiety is Not fear, but most American bimbos don’t know this, and some shrinks, too intent on following the party line of Big Pharma and making money, may forget this

You may imagine that psychodiagnostic problems visa vis psychosis are too far removed from the news story I am complaining about, to wit,  an article in the New York Times noting that a bunch of fancy federal doctors want to screen all adults under 65 for anxiety.  In that case, let’s talk about anxiety and other faddish ailments.

In this exhibitionistic era of confessionistic memoirs and confessionistic talk shows, every third person and his obese personal trainer has a tale of illness and shame that he proudly shouts about from the rooftops. Sample the divas and dilletantes shilling their sickness on shitty TV:     I shoplift panties, and I am a man.  I have anorexia nervosa.  I was butt fucked by my father and now I butt fuck my daughter and my son.  All in the Family has become all in the Mental Hospital’s day room.  

Anxiety and depression are very in vogue mood disorders.  A sad sack who claims he is depressed hopes for succor and support like a three-year-old who just scraped his knee.  If you are anxious, you can sell people on the BS that you’re anxious because you are sensitive, plugged into and aware of all the trauma in the world, or suffer from a bevy of au courant concerns demonstrated by your chic and oblique references to existentialism,  Virginia Woolf’s well educated nervous breakdowns, and Betty Ford’s Georgetown-approved alcoholism.     

Of course, most nincompoops don’t know the difference between fear and anxiety.   Doctors should know the difference  but in their zeal to medicalize and overtreat they may treat non pathological fear as anxiety.  What’s the difference?

If your house is on fire, your pulse might become very fast.   A fast pulse is a sign of anxiety.   It is also a sign of valid, non pathological fear.  However, if we were to treat one’s fear as if it were a sign of disease, and if we were to try to douse the fear with tranquilizers, we may impair our coordination, and when we become a klutzy son of a bitch it might be harder for us to escape the fire.   If we were to treat ordinary fear over a very important exam with valium, we may blunt one’s intellect and ensure a lower score on the exam.  If we were to treat performance anxiety with downers, we may make the penis a flaccid and floundering failure.

5.    The Special Advantages that Psychiatrists exploit in Malpractice Litigation

If we do find that someone is anxious, I suppose the yentas of mental health will want to treat it.  If a doctor does propose to treat someone for anxiety, he has a much better chance of getting off scott free for the commission of errors than a doctor who treats physical illnesses.   Very simply, a psychiatrist can rebut a case, grounded in psychiatric malpractice, if he can establish that he conformed to the beliefs and standards of ANY respectable minority school of psychiatric care.  Ergo, a shrink can evade liability for making a gay person crazy after he tries to make him straight, or after he tries to make him accept his sexuality, because both doctors who counsel that gayness should be changed, and doctors who counsel that gayness should not be changed, constitute respectable minorities of doctors.   Very simply, because psychiatry is so much more nebulous,  it is so much harder to find fault with a shrink’s behavior.   Doctors treating physical diseases have no such luxury.  For example, if one has a fever of 105, one is on the precipice of a hyperthermic crisis in which “heroic measures” are required.  No ifs, ands or butts about it. 

6.   Why are so many mental health professionals obtuse in  evaluating  the patient in front of them.

Sometimes the insights of mental health professionals are dazzling.  For example, Freud’s prose seems not merely intelligent but positively oracular.  In reading some of his finest texts, one gets the sense that his intellect is like a high-powered instrument illuminating heretofore unknowns like an electron microscope affixing its aggressive gaze onto the nucleic acids of viruses. 

However, most mental health practitioners seem too awkward to wield their tools with skill. 

Some of the most illustrious doctors in the field of mental health seem to have been terrible clinicians, or enormous frauds or possessed a certain inability to understand themselves which suggests that they will never truly understand their patients.     

Consider some  of the disturbances which litter the finest minds of psychiatry:

i)             Anna Freud:  Her Father maintained that sexuality was at the center of neurotic disturbance and seemed to assert that a good sex life was a pre-requisite to emotional homeostasis. Anna never married and died a virgin.

ii)          Erick Ericksen:  His big thing was “identity.”  For Erikson, having a good sense of identity was all-important.  If  he thought it was so important, why did he discard his real name, his Jewish name, for such a manifestly Aryan name.

iii)        Bruno Bettelheim:  This supposedly wise, kind Fatherly figure who escaped the Nazis and set-up the “nurturing” Orthogenic school in Chicago A) committed suicide (not what you types call well-adjusted behavior, and B) falsified his life in Europe and his evacuation to the United States (He fabricated non-existent credentials attained in Vienna and, in a shrewd attempt to ingratiate himself with the Jewish liberals in the analytic community, pretended that Eleanor Roosevelt got him out of Germany.)  Also, his Orthogenic school was exceptionally weird:  He insisted that boys, as old as twelve and thirteen, wash themselves by sharing bathtubs.

iv)        Melanie Klein:  She was the leader of the Berlin psychoanalytic institute, and she decided to psychoanalyze her son, beginning at around age 5 or 6.  When he told Mama Melanie that he was afraid to walk down a particular street, she told him that he did not like the street because it had very tall trees which, Mama said, reminded him of his relatively tiny penis.  Klein was oblivious to a few seminal facts about that street her son feared:  The Street was in Berlin.   The Kleins were Jewish.  The street was often roiled by Nazi demonstrations.   Hans Klien changed therapists, switching to a male doctor instead of his mother when he became 13 or 14 and his gayness was undeniable.  He killed himself at around age 30.  

v)           Charles Socarides:  He was a leading analytic proponent for the proposition that homosexuality is an aberration which is caused by harmful environmental factors, in particular a deleterious familial environment. (His work is simply a derivation and elaboration of  Bieber’s work, whose work was a mere elaboration and derivation of Rado’s work, who sanitized and simplified Freud’s work –- this sort of reminds me of an old joke among intellectuals in New York’s Upper West Side:  A man introduces himself by saying, “I am the man who wrote the book review, about the book review, about another book review which reviewed David Reisman’s  “The Lonely Crowd”)  In any event, in the 90’s we found out that his son was gay and was President Clinton’s liaison to the gay community. 

Many doctors are convinced that homosexuality is inborn, and many doctors are just as convinced that homosexuality is caused by bitchy women, and psychology, like all disciplines in America, is so severely under the thumb of current political battles that most doctors are unable to think freely, independently or imaginatively and they are, it appears, unable to realize that sometimes people become gay because of doctors and parents who want to prevent them from becoming gay.       Consider the Socarides family:  The Father, who was the Dean of American analysts against the lavender menace, was probably worried about homosexuality, feared that his son might become homosexual,  and his Father’s anxieties were transferred to the son who reasoned that the pervasive anxiety about homosexuality must have ensued because he was in some way wanting or deficient in terms of his virility.  

Cases like this abound, but I haven’t heard any gay people, or any psychoanalysts of the old-fashioned anti-gay stripe, mention this. For example, when my Uncle’s first son was born, my Mother said that he was named Douglass because that name would prompt the nickname Doug, and a stout monosyllabic name like Doug would facilitate the development of a healthy heterosexual orientation.   Upon hearing this, in 1971, my cousin Barry said, “This kid is definitely going  homosexual.”  And sure enough, when he left his dormitory in Columbia, he moved into an apartment on Christopher Street, the gayest street in the gayest neighborhood of New York City.

In any event, my Uncle, like Dr. Socarides, were dutiful supplicants of the Court of Sigmund Freud, and in the course of pursuing objective A, they achieved the negative of A.  And much the same thing takes place with psychotropic meds: When you give a patient a drug to calm down, he will become dependent on that drug, and if the drug is withdrawn, he will be antsier than he was before he had encountered the drug.