2000-03-10
The Diagnosis
It is so important to give it a label.
You feel tired. You are bored. You are frustrated. Maybe you’re also not very bright or ambitious. You don’t want to tell people you are tired and bored and frustrated and not very ambitious, because that would make you sound like it’s your own fault. So, instead, you have chronic fatigue syndrome.
Maybe your two-year-old is really active. He climbs up everything. He’s loud and noisy and eager and excitable. You find this annoying. But you can’t tell anyone that you find your own kid annoying or that you are too impatient to be a good parent, so, instead, you say that he has attention deficit disorder and pop some drugs into him.
The diagnosis, in our society, is essential. We need that label. We need an identifier. We have to generate public belief in and enthusiasm for conditions that might be nebulous, vague, or invisible.
Why?
Well, almost every time you hear the diagnostic label being propounded, it’s by someone who makes his or her living treating it. This is why the bible of psychotherapy, the DSM III or IV or V or whatever it’s at now, always gets bigger and bigger. It never shrinks. They almost never remove “syndromes” from it. (It caused a bit of nudging and winking when they did finally remove homosexuality from their list of morbidities not all that long ago.)
And that’s why pharmaceutical companies are determined to get your kid into their slimy clutches. They are promoting the idea that a four-year-old who wont go to bed nicely when asked has some kind of mental disorder and needs to be drugged. Once your kid is used to those colorful little pills twelve times a day, they know he’ll never, ever again feel that he can handle life without some kind of narcotic assistance.
The magic of the diagnosis is clear. Some people will deny that feeling tired or frustrated or depressed is an illness. Some people might think its just part of life. You put up with it. You endure it, and get on with the things you have to do.
But it’s easy to convince people otherwise. If you have the proper label for something, people will assume that adequate research and scientific analysis has determined that this condition really exists. We trust doctors. They’ll assume that a doctor made the diagnosis, and everyone knows how smart doctors are. They’ll assume that everyone thinks it is a real condition because it has become part of the language. It becomes shorthand, to a lot of people, for complexities that are too hard to explain quickly.
When I was a lot younger, if I heard someone say something like, “he has attention deficit disorder”, I would just assume that there was such a thing as “attention deficit disorder”, and therefore we better do something about it. Now I’m a lot more skeptical, but I can remember how easy it was to accept sophisticated-sounding terms like that as if they referred to clear, objective realities.
When you look at the “symptoms” of chronic fatigue syndrome, you realize how utterly subjective and arbitrary labels can be. Tiredness. Depression. Loss of appetite. Headaches. Difficult to get up in the morning. And so on. Sounds like just about anyone’s rotten little life. Label it, and we can blame someone else. Label it, and we can talk multi-million dollar lawsuits. Label it and we can make a drug that fixes it. Then we are not “doing drugs”. We are doing “therapy”. We are taking the “wonder drugs”, Lithium and Prozac, and whatever. It’s okay-- we have to take these drugs: we have a condition.
The drugs, of course, don’t really fix anything. They give you a sustained high. It is one of the great myths of our society that drugs like Lithium and Prozac actually treat real conditions. That is utter nonsense. They simply make you feel good. But we have to believe in the myth, or else we would have to admit that we’re really not much better than your average drug addict or alcoholic.
Well, we’re not.
I heard some parents on the radio recently (the CBC) talking about their “hyper-active” child. The parents of this child were at their wits end. They didn’t know what to do. They went to the doctor. He prescribed Ritalin. They tried it. It worked! Hallelujah. However, their child just didn’t seem to be herself anymore. She lost her sense of insatiable curiosity. She lost her spark, her zest for life. They took her off Ritalin and tried different parenting techniques instead. From the details the father gave on the air, it was clear that he and his wife simply got better at parenting. They learned to anticipate when problems might occur. They planned ahead for family outings. They became more flexible and adaptable. Amazingly, the problems seemed to go away.
Was their child ever really “hyper-active”? If you read the definition of hyper-activity from the DSM, it is an amazingly accurate description of just about any two-year-old.
Beware of labels.