Book Review: Comfortably Numb
Posted on Friday, June 6th, 2008
Over the past few years, dozens of books critiquing Big Pharma and industrial medicine have come and gone – many of them excellent, a number of which we reviewed in our office newsletter Biosis:
Thus, when new titles come along, anymore, we’re prepared for more of the same. After all, between such books and the wealth of excellent journalism, analysis and scholarly work now available, you start to wonder what more can be said.
For this reason, we put off looking at one of the more recent titles, Comfortably Numb: How Psychiatry is Medicating a Nation by Charles Barber. Then we kept running into references to the book online, interviews with the author, excerpts from the work – all of which suggested that maybe we really ought to take a look at it.
Suffice it to say, we’re glad we did.
For Barber does cover a lot of new ground. Avoiding a rehash of Big Pharma’s political and market machinations, Barber focuses more sharply on the social, cultural and historical factors that have normalized mental illness and how drugs have been transformed from “mediators of illness” to “agents of self,” substances that allegedly make us who we want to be, that are truly lifestyle drugs. He also offers a smart recounting of how the “brain disease” hypothesis of mental illness became the dominant paradigm, despite a lack of sound scientific evidence that just four of hundreds of neurotransmitters could be responsible for depression, schizophrenia and other disorders. As is most often the case anymore, the drugs were discovered first, almost accidentally. They seemed to have a positive impact on mental states, so they were embraced and then mechanisms were theorized after the fact.
Unfortunately, lifestyle marketing convinced lots of people who were not clinically mentally ill that their lives could be improved through drugs. Indeed, many of the most vexing “side effects” of SSRIs and atypical antipsychotics – the two most popular classes of psych meds – are suffered by those who don’t need meds in the first place, who are suffering problems of living, not problems of the brain, who could be helped much more cheaply and effectively by therapies such as CBT and variants on traditional talk therapy – therapies that Barber discusses thoroughly in the second half of the book.
Instead, Barber’s overwhelming concern is with what he acutely refers to a “a uniquely American process of emotional sanitation” – pathologizing all sorrow, anger, grief, fear, shyness or any other “negative” emotion so that we become emotionally dulled, disconnected and isolated from each other.