|
 LISTENING TO PROZAC
(1993)
by Peter Kurth
Listening
to Prozac, by Dr. Peter Kramer.
Does
anyone remember that old Twilight Zone episode where the citizens of
some future society are all required to look and sound alike -- that
is, on reaching adulthood, everyone was given a "choice" of body
type A or B, blond or brunette, amounting in either case to a
blandly attractive, surgically perfected, absolute sameness of
appearance? The plot
revolved around a couple of misfits, I recall, who thought they
might be happier being drab and maladjusted than flawless and not
themselves. But in the
end they changed their minds, or were made to change their minds,
and in those virtuous days of the 1960s, when Rod Serling was alive and the psychologists hadn't
done much more than IQ us into corners, loss of individuality was
regarded as a tragedy, pure and simple. We were against it, the way
we were against Communism, atheism and fluoride in the
water.
But
not any more -- or, anyway, not on the evidence of the books that
keep pouring out of the psychotherapy industry. The harder we're urged these
days to follow our bliss and run with the wolves the more determined
are the experts, in their oily little hearts,
that we stay on the straight and narrow. No real eccentricity
is permitted in the fix-it-all culture; no quirk of character or
twist of sentiment is even allowed to exist without reference to
"pain" and "abuse" and the duty of our citizens to "grow" at all
costs. Growth for the
sake of growth is the primary feature of a cancer cell, but never
mind. You are
not OK the way you are, and if you don't believe me, pick up
a copy of Listening to Prozac, Dr. Peter Kramer's riveting
account of the history and future of anti-depressant drugs in
America. If and when your brain
manages to absorb the dispiriting message of Dr. Kramer's book, you
might recommend it to your friends. If, on the other hand, your
hair stands up from now till Christmas, take heart: there's a pill out there
with your name on it.
Before
I make it entirely clear how disturbed I am about the imminent
triumph of chemistry and psychiatry over self-awareness, depth of
feeling, creativity, spirituality, subtlety, humility, discernment,
intuition, experience, significance and the dignity of the human race, I ought
to say a few kind words about Dr. Kramer and his book. I mean them sincerely. Listening to Prozac
is a fascinating, well crafted, sometimes ironic and possibly
momentous contribution to our understanding of personality and the
future of psychopharmacology (a fancy word for drugging the
population when it gets upset). Dr. Kramer is smart as hell,
and he writes awfully well for someone named Dr. Kramer. I have to admit, too, that I
prefer the sound of an M. D.'s voice to
the earnest kazooing of the
psychobabblers.
Listening to Prozac is filled with "aggressive
fathers" and "passive mothers," and there's a whole chapter devoted
to formes frustes, or "low self-esteem." But deep down, I think, Dr.
Kramer isn't sold on the lingo. He calls it "insulting," and
he's right: it
is.
It's
also next to meaningless.
Pick a problem (any problem) and call it what you want. Adult children of
alcoholics, outer-directed husbands' love-addicted wives, frenzied
sisters' younger brothers -- all of them, nowadays, suffer from what
Dr. Kramer describes as a "chronic condition: heightened awareness of the
needs of others, sensitivity to conflict, residual damage to
self-esteem." Come at
this from another angle and you've got "co-dependency." Fifteen years ago you had
Erroneous Zones and the When-I-Say-No-I-Feel-Guilty crowd. These rock-ordinary human
attributes have been with us since the dawn of time; they are "odd
indications for medication," Dr. Kramer thinks, but I don't. I honestly believe we've
been so badly damaged by a parade of shifting, pseudo-caring labels
that the only cure for what ails us would be an
anti-depressant, the psychologists showing no sign of pulling up
stakes anytime soon and moving on, say, to poetry. Prozac, as everyone knows,
popped out of the labs in the late 1980s, and, following some trendy
analysis in the newsmagazines (and on Oprah, Geraldo, 60
Minutes, and so on), it emerged as the fanciest thing on the
therapeutic circuit, the equalizing, all-embracing, all-fulfilling
drug of choice for the
occasionally-to-somewhat-bothered-by-lifers.
Please
don't think I'm being flippant when I say that. Listening to Prozac
isn't concerned with the treatment of insanity or even of mental
illness (where drugs to stabilize the mind and emotions obviously
play a needed and charitable role). Dr. Kramer is a practicing
psychiatrist who was moved to examine the "moral" and "ethical"
implications of Prozac when he observed its transforming effect, not
on schizophrenics or the severely disturbed, but on the most
insipidly unhappy people:
the discontented, the oversensitive, the sullen and the
dull. Traits of
character, the doctor says (but your grandmother knew this already)
are ingrained in our nervous systems and genetic codes. Our weaknesses and
vulnerabilities have a life of their own, in other words, regardless
of their "childhood" origin (psychic, historic, abusive, etc.). At first "psychological,"
they become biological, "autonomous," chemically rooted and
malleable; Prozac wipes them out in a "substantial minority" of
cases. It actually
"fixes" the personality, rendering the shy outgoing, the angry calm,
the lonely and tongue-tied convivial and (by the sound of it) hot to
trot. Deadbeats, on
Prozac, are "socially attractive" for the first time in their
lives. Shirkers at work
become positively Japanese in their eagerness to produce. Wallflowers blossom, losers
win. Nobody comes home
without a prize except those unlucky few who, for reasons no one has
yet figured out, are driven to the brink of suicide by Prozac's
mucking around with their serotonin levels. (There is actually such a
thing as a "Prozac Survivor's Support Group.")
Try
as he might, Dr. Kramer can't escape the feeling that something
doesn't "sit right" with self-improvement on a chemical basis. Could it be, he wonders,
that "diminishing pain can dull the soul?" The studies he provides of
"successful" cases all concern people whom society rewards in their
Prozaced condition: teenagers who've stopped
moping, wives who've stopped yelling, men
who've stopped screwing around. Dr. Kramer wants to know if
the world is ready for "cosmetic psychopharmacology" and "the medicalization of
personality."
"What
are the implications," he asks, "of a drug that makes a person
better loved, richer, and less constrained -- because her
personality conforms better to a societal ideal?" What sort of road are we on
when medicine is used, not to cure, but to control, and
simultaneously to revise the concept of illness, taking standard
traits of human behavior and stripping them down into
"symptoms?" Will we go
quiet into that anti-depressant night, allowing "material
technology, medications, to define what is
health and what is illness?"
Dr.
Kramer is too sharp-witted not to realize that we are standing in
the shadow of the Brave New World, but in the end, I'm afraid, he's
squarely on the side of the medicators. Psychotherapy, too, he tells
us, was once lambasted "for inducing adaptation to the dominant
culture," and "asking about the virtue of Prozac [is] like asking
whether it was a good thing for Freud to have discovered the
unconscious." There are
those, of course, who think it was not. Dr. Kramer closes his book
with a tribute to Woody Allen and his New Age fantasy,
Alice,
where an edgy Mia Farrow pops downtown to a Chinese doctor and
snorts a mixture of mysterious herbs that allows her to dump her
insulting husband and put the make on strangers at the zoo. These aren't quite
the people I'd pick to recommend a vision of the future, on or off
drugs, but they keep the shrinks in business, after
all.
A
word of advice: if you
read the book, you'll want the dope. Don't say I didn't tell
you.
|
