Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of The Mentally Ill, by Robert Whitaker. Perseus Publishing. 334 pages. $27.
Every problem in life can be solved with a pill. We learn this from TV ads where cartoon blobs are energized by Zoloft, snarling premenstrual women are beatified by Serafem and a lifetime of shyness is cured (poof!) by Paxil. Each day, more of us fall into a warm pharmaceutical embrace, seduced by blitzkrieg marketing to believe that psychiatry is always progressive and benign, its remedies always safe and effective.
But it isn't -- and they aren't -- and Mad in America explains why.
Although focused specifically on the treatment of schizophrenia, the book's lessons about the medical dangers of greed, ego and sham are universal and couldn't be more timely. In clear, nontechnical prose, author Robert Whitaker traces the efforts of the "mad doctors" from 1700 to the present to conquer insanity by terrifying and assaulting the insane. He details the "curative" induction of comas and fevers; the spinning, freezing, blistering and purging of patients, the surgical removal of supposedly infected parts, like ovaries and teeth, the jamming of icepicks through eye sockets to turn difficult patients into subdued "household pets."
Most people think such abusive treatments ended when the "miracle" drugs appeared. But since there's still no biological marker for schizophrenia, psychiatry continues to invent belated medical rationales for their treatments while misleading the public about their dangers. If managing schizophrenics requires damaging their brains with a "chemical lobotomy," and experimenting on them without their consent, well, it's a hopeless group, anyway.
This is not untraveled ground. Whitaker is hardly the first to discuss the arrogant pseudoscience in treating mental illness, but he has the outsider's advantage of not getting bogged down in theoretical quicksand. Being a journalist, he conducts a lively investigation, complete with scandals and names. He's especially good at documenting money trails, showing how we get dangerous medications that cost 10 dollars a day because drug companies pay academics to praise their products, labs to test them, journals to advertise them, and doctors to recommend them.
Most chillingly, he draws a straight line from the American eugenics movement to Auschwitz, claiming that psychiatrists were essentially bribed to promote the forced sterilization of "defectives" -- in 1935, a Rockefeller Institute doctor recommended the disposal of "useless and harmful beings" (e.g., "lunatics") "in small euthanistic institutions supplied with proper gases."
There are some flaws here: Whitaker minimizes the possibility of humanity among today's professionals, and that some drugs do help some people (for whatever reason). His narrative occasionally jumps around in time. And for all his impressive research, he completely ignores psychiatrist Thomas Szasz, who's been flying the same flag for half a century and 25 books of his own.
But it's still an important contribution, ending with a "simple plea for honesty" about the true state of knowledge: "stop telling those diagnosed with schizophrenia that they suffer from too much dopamine or serotonin activity and that the drugs put these brain chemicals back into 'balance.' That whole spiel is a form of medical fraud." This applies to all psychological disorders, not just schizophrenia.
People should read this excellent book -- and learn which questions to ask -- before filling that "miracle" prescription.
Judith Schlesinger, a professor at Pace University, is a psychotherapist who holds a doctorate in psychology. Her last book was a biography of Humphrey Bogart, and she is now working on Dangerous Joy: The Mad Musician and Other Creative Myths.