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Asperger's & other spurious ailments and inappropriate treatments du jour



Title: Asperger's
Let me tell you about the American Psychiatric Association. Until, I think, the late 1970s, they listed homosexuality as a disease requiring psychiatric treatment, with promises of cures to heterosexuality. A common treatment here and in the UK -- involuntarily when a "sufferer" ran afoul of criminal laws against homosexuality -- were hormone injections. The British mathematician Alan Turing had this treatment forced on him in the mid-1950s, grew breasts among other treatment-associated torments, and shortly afterwards committed suicide.
 
For decades, Soviet psychiatrists -- I've seen them interviewed, they were entirely sincere healers, this is the professional culture in which they were educated -- viewed opposition to the Soviet government and the Communist Party as severe psychiatric disease. They routinely treated those involuntarily committed patients with insulin and electric shock and with wet canvas shrinking straitjackets. They were horrified when their colleagues in Western nations threatened to throw them out of international psychiatric associations.
 
The distinction between the trendiness of psychology and psychiatry and the trendiness of musical styles is that when the world chooses to spend a decade at the Disco, no one is harmed beyond a little musical embarrassment.
 
Unhappily, psychiatry can't say the same thing. Lobotomy used to be a popular cure for psychiatric disorders, and electric shock is still a hotly debated (and readily available) procedure, particularly in the dubious area of "informed consent," where patients have not been candidly warned of the well documented possibility of permanent memory impairment. In general, psychiatry has been slow and reluctant to embrace the notion of fully informed consent.
 
I'm not at all hostile to psychiatry. For all its trendy historical harm, these are still by far the best people to flee to in an authentic crisis.
 
But Asperger's is one of psychiatry's periodic imaginary crises, remarkably and evasively resistant to quantitative, objective diagnosis. As far as I can see, the wholly untreated -- like Gould -- seem to do just about as well as, or fare even better than the professionally treated.
 
But the history of psychiatry is unhappily rich with ghastly junk science mistakes. Most of them had to be corrected by outsiders, lawyers, human-rights NGOs, and very angry victims. Only those innocent of these historical aspects of psychiatry in our times can feel as confident as you in citing their publications and pronouncements du jour as Gospel.
 
Canada is a wonderful place. It honored Glenn Gould from childhood to grave and beyond, and to the best of my knowledge never threatened Gould in his most eccentric moments with involuntary psychiatric commitment or treatment. That's the subtext of your strident defense of this Asperger's diagnosis -- you're disturbingly confident about the propriety of saddling goofy people who reside well within the range of intellectual, social and emotional activity with pathological diagnoses.
 
As we speak, the intimate and largely unexamined and unchallenged relationship between the pharmaceutical industry and American psychiatry is treating hundreds of thousands of public school children, almost all of them males, often under threat of expulsion, with powerful psychotropic drugs, Ritalin and Prozac the most famous. Wholly unsupported by clinical study, Ritalin has moved aggressively into mass distribution to pre-adolescents and even toddlers.
 
Prozac, under a trendy, Smiley-Face new name, is now being aggressively marketed to women for treatment of routine symptoms associated with menstruation. The women on this list are far more qualified than I to document the common severity of these symptoms, but the question is the medical propriety of routine prescription of Prozac for these symptoms, which is undergoing a lot of healthy and skeptical scrutiny.
 
I'm a Big Fan of the development and appropriate application of these newish drugs; in particular they have produced a revolutionary miracle in our times for the treatment of the most severe chronic psychiatric disorders, particularly the previously hopeless schizophrenia. These medications have turned the lives of many of our shelter guests from nightmares on the streets to functional lives with long-term windows of happiness and community integration.
 
But a decade from now -- forgive me for lapsing into prophesy -- there will be a very different and embarrassed public view of the last two decades' enthusiastic and often corrupt romance between psychiatry and the pharmaceutical industry, particularly as it skews the ultimate objective of medicine -- first, to do no harm, and second, never to subordinate considerations of profit to care of the patient.
 
As Mr Maloney was quick to point out at the beginning of his paper, people with Asperger Syndrome often are leaders in their field, albeit a bit strange socially. 
 
Who judges strange? Mr. Maloney? Who the hell is he? Does he have enough time on his hands to judge me? You? The musicians on this list? Isaac Newton? Who judges strange? What are the objective criteria for strange? I wouldn't want to run afoul of this Committee.
 
At least until the 1980s, perhaps to this moment, the American Psychiatric Association listed more than two tattooes as positive diagnostic indication of psychiatric disorder. If you've looked at a springtime college campus or rock concert audience lately, we seem to have a sudden mysterious epidemic of psychiatric illness. I hadn't previously suspected these sorts of things were contagious.
 
Again, you came in late with your Son of Asperger's thread, so again, apologies to all for repeating things I posted months ago. My only defense is that I sincerely believe this whole thing is junk science nonsense; GG's posthumous diagnosis is patently unsupported and ridiculous; and I don't think the issue ought to be allowed to rest based on the volume of ink one champion has the capacity to devote to it.
 
In a healthier age, Gould's lifelong relentless quest for artistic and intellectual perfection would be celebrated for its rarity, not referred to mental health professional for treatment. I admit to a hostility for the Celebration of Normal so characteristic of our times, and the inevitable colorless, predictable, impoverished and unhealthy uniform world it will condemn us all to. Of our particular interests and passions, it promises a more comforting standardization of the interpretations of Bach and Mozart; a Normal musical future may also finally get rid of that damn humming once and for all!  
 
Thanks for the helpful tip about List etiquette! Now I know whom to turn to for these things, as well as for psychiatric expertise!
 
Mr. Elevator