Brian Awehali interviews Dr. Bruce Levine
Author and clinical psychologist Bruce E. Levine wants to tell you that many forms of depression, discontent, and a whole raft of diagnosed mental illness are nothing more than natural responses to the oppression of institutional society. In his book, Commonsense Rebellion, Levine contends that the vast majority of mental disorders are, to put it simply, profit-driven fabrications with no established biochemical or genetic causes. This interview with Dr. Levine was conducted several years ago for publication in LiP: Informed Revolt, but the growth of corporate pharmaceutical “solutions” to deviant behaviors has only grown since then. Dr. Levine’s newest book, Get Up, Stand Up: Uniting Populists, Energizing the Defeated, and Battling the Corporate Elite, (Chelsea Green, 2011) is an exploration of the political psychology of demoralization and the strategies and tactics used by oppressed peoples to gain power in the United States.
Awehali: Bruce, you’re a critic of both psychiatry—the medical science of identifying and treating mental illness with drugs—and psychology—the study of human behavior, thought, and development. Are there substantial differences between the two?
Bruce Levine: When I first started out as a psychologist in the late ’70s and early ’80s, it was fairly commonplace to dissent from psychiatry—that’s why people became psychologists. They saw the pseudo-science of not only the treatments but of the Diagnostic and Statistical Manual (DSM) itself. Unfortunately, over the years, psychology itself has slowly aped psychiatry, and there isn’t that sharp a distinction between the two anymore. The American Psychological Association (APA)—the professional group for psychologists—now fights for prescription rights for psychologists. So I guess any psychologist who maintains a position that depression isn’t primarily an innate biochemical disease, and that the DSM is a nonscientific instrument of diagnosis, is a dissident!
I should say that back in the 1970s and 1980s, before psychiatrists had the backing of the drug companies, they had very little power. In fact, they were falling apart, as evidenced by so many movies that were making fun of them, like One Flew Over the Cuckoo’s Nest—which could never come out today. But back in those days, when [psychiatrists] weren’t in bed with the drug companies and didn’t have much political power, you saw movies like that come out. Now, psychiatrists have the media power; they’re able to describe the playing field of the controversy.
Let me ask you a blunt question, first: Do you think there’s ever any basis for diagnosing someone as mentally ill?
Well, certainly there are things that can happen in your brain to make you feel crazy. If you go on an acid trip and fill your brain with a bunch of foreign chemicals, and you act crazy—there’s something going on there. But when we’re talking about things like, for example, attention deficit disorder [ADD], or depression, most of these behaviors are problematic to society. And they’re too easily being classified in the same category as cancer and diabetes. It becomes a complicated semantic discussion of what an illness is.
Let’s just take one of the more obviously comical diagnoses, something fairly recent, like oppositional defiance disorder [ODD] —that one really makes a whole lot of things really clear.
I mean, oppositional defiance disorder is a “disease” in the DSM, and it’s not something that’s arcane; it’s something that’s being used frequently. It’s a diagnosis given to kids whose symptoms are often arguing with adults, refusing to comply with adults, and basically being a pain in the ass with adults. And once you declare it a disease, of course, you move into chemical treatments or behavioral manipulations. I think for the majority of folks out there, not just anti-authoritarian types, they have the same reaction you did: You’ve got to be kidding. Don’t [they] realize that kids rebel against authority? So there you have an obvious example.
And then you move over to something like attention deficit hyperactivity disorder [ADHD] or ADD, for which there are no biochemical markers, of any kind. None. If you have any doubts about that, just go to your doctor and say you think your kid has ADD, and ask her about the biochemical markers—she’ll say that there are none. It’s all behavioral symptoms that are used to diagnose it.
In the 1970s and early 1980s, a lot of people were looking for other explanations for why people were having problems, or creating problems for others. And in that era, prior to the drug company takeover, there were a lot more intelligent ideas. ADD/ADHD didn’t exist in the first DSM that came out in 1952, but I’m sure if it had been around, folks like Eric Fromm would have been talking about it as a form of passive rebellion. Oppositional defiance disorder is an obvious active rebellion, but most kids don’t have the courage, or they’re in situations where for them to actively rebel means they’ll get crushed—so they rebel passively. They go to a classroom and they stop paying attention; they just blow things off. Is it because they have no capacity to pay attention? No. And the research even shows that when you put these same kids in a situation where they’re either interested in the material or they’ve chosen the material, or it’s novel to them, all of a sudden these so-called ADHD kids can pay attentionn!
And that’s what I try to explain to folks: If you have diabetes or cancer, and all of a sudden you’re having a good time, the disease doesn’t go away. How can something be a disease when you put somebody in a different situation, and the “disease” goes away? That should tell you something.
But it’s in the interest, obviously, of drug companies—and psychiatry, because all they do is prescribe drugs pretty much nowadays—to view everything as a disease that needs drugs. It’s also in the interest of a society that doesn’t want to spend much money or resources on populations that aren’t fitting into the standardized order of things. One interesting aspect of this is that, more and more, it’s not just kids of color, but even suburban white Anglo-Saxon Protestant kids who can’t fit into the standardized order.
I was going to ask you if you think the net for mental illness has gotten wider.
Absolutely. There’s a certain karma in this for the dominant culture. For years they’ve tried to make all kinds of people in non-dominant cultures fit into a rigged, standardized system, and all kinds of rebellion went on. Rebellion through truancy, or substance abuse—and they pathologized this, criminalized that. But once that net was cast, it eventually starting catching lots of their kids. They narrowed and narrowed the standards, and made it more and more impossible for certain kinds of kids to fit into society.
It’s interesting. It’s like, you built the machine, and then the machine has to feed itself. It seems like it’s sort of a runaway institutional process—
Yeah, that’s a good metaphor. A lot of folks like Lewis Mumford and Kirkpatrick Sale have talked a lot about our machine-worshipping culture, and once you understand that our society does worship the machine and technology more than it does life and diversity, then you understand that the goal of that society is to become more machine-like, more standardized. Which means you’re trying to create a society in which everyone fits into the same box. And once you do that, you’re going to find more people not fitting in, and then you have—and this is a real problem of psychiatry, as far as I’m concerned—then you have these psychiatrists who come along and, instead of saying there’s a problem with this kind of machine-worshipping society, they say that there’s a problem with all these people not fitting in. They’ve got this disease, or this disorder.
In your book, Commonsense Rebellion, you have a whole chapter devoted to mass society and mass living. I wonder if you could talk a little about that.
Well, it’s important for folks to have a historical perspective on the way human beings have lived for the vast majority of our history, and to think of how differently we’ve been living since the Industrial Revolution. For 99% of human history, people were living in non-mass societies—we were living in small groups. We were living in situations where, for the most part, we knew everybody around us. We had bands within tribes, less than 500 or 1,000 folks, and people had a greater sense of autonomy, because what they said and what they cared about actually had some political impact.
Whereas, today—here in the US, for example—what the hell does your average person do? Every four years they get to vote between two people they have no respect for? At some level, you may want to wave the flag and convince yourself you’re living in a democracy because you get to vote, but on a more core psychological level, you’re one of 300 million who are voting for [one of] two people who are decided for you by corporate society! So on some level, you know you have no impact; you know you have no power. It’s just common sense that in a more humanly scaled society [Kirkpatrick Sale’s term, from his book On a Human Scale] you‘re going to have a sense of greater potency, of greater power. And a sense of empowerment is a huge antidote to almost any emotional problem. That’s common sense!
Another huge antidote to emotional difficulty is community. People who have a genuine community have fewer emotional difficulties. And “genuine community” is an important term. Oakland, for example, is not a community—it’s a location. Real community means face-to-face emotional and economic interdependence. In a real community, people decide for themselves what their problems are, and they themselves implement solutions, as opposed to handing them over to distant authorities.
A mass society like ours is good for producing more material goods. A standardized, commercialized, industrialized society certainly has more teevees, more washing machines—and this is very attractive to a lot of people. And there are certain advantages to standardized society in terms of, you know, physical health. But mass society destroys things like autonomy and community.
In realistic terms, what do you think people might do to try and build real community?
Well, a lot of people are isolated, and they have all kinds of emotional difficulties, whether it’s depression or substance abuse. They obsess on their disconnectedness, or they don’t even get that far, they’re just getting drunk all the time. In the face of this mass society, people feel powerless. What’s the point of trying to get this guy you think is innocent out of jail; what’s the point of doing anything? You’re dealing with such a power that it feels impossible to accomplish anything. And under that rationale, [people] just say, the heck with it—I’m just going to get drunk and have a good time. One of the things I try to tell folks is that even if you don’t succeed, when you have a cause you believe in, and you act on it, and you try to connect with other folks, at least that cause itself becomes a fuel for people to meet one another and have friendships. That happened in the 1960s and 70s to some extent, and it certainly happened in the 1880s and 1890s when you saw these idealistic people who maybe didn’t ultimately accomplish a lot, but at least they kept themselves out of having emotional difficulties by acting on their cause and meeting some people.
When you have a cause, you get obsessed with what you’re trying to accomplish—and even if you don’t succeed, you’re mutually supporting each other emotionally, possibly even economically. And you keep yourself sane.
Earlier you mentioned psychiatry’s merger with Big Pharma. Can you say more about that?
The merger continues between psychiatry and big pharmaceutical: Big Pharma contributes money to their journals; they contribute money to the continuing education of psychiatrists.
There was a story recently in the Boston Globe about how Big Pharma—not just psychiatric drug companies, but all pharmaceutical companies—was contributing a significant amount of money to Harvard Medical School. If you go around medical schools, these drug rep people are hovering around mailboxes there. Now, if you were in marketing and sales, you would ask: Who do we want to feel great about us and our product? You want the general public, but you definitely want all these doctors to feel really great about you. You’re going to do everything you can possibly get away with legally—and sometimes they do things that are actually illegal.
They’re very aggressive. Every once in a while they go over the top, like Prozac maker Eli Lilly did in Florida, where they actually mailed out free samples of their products, including to one 16-year-old boy who had never been on any kind of a drug or antidepressant.
All of that said, I think it would be a mistake for folks to view pharmaceutical companies as being any different from any other companies. They’re all boringly the same: Their goal is to do whatever they can to increase market share, and make money. Right now, Big Pharma is contributing about 80% to Republicans and about 20% to Democrats—they’re just sort of covering their bets. They’re basically seeking control over government agencies that are critical of their goals, like the FDA or the National Institute of Mental Health.
For example, the Bush family has a long connection to one drug company in particular, Eli Lilly, but they’re actually connected to a lot of drug companies. Down there in Texas, they started this program for mental health screening, and you’re going to hear more and more about that as a national issue.
It’s schools screening for mental illness the same way they do for vision or hearing, right?
Yeah. Once you buy the idea that mental illness is an illness like any other, then it makes a certain sense—it’s just like a kid with bad eyesight who can’t see the blackboard, or a kid with bad hearing. The next step is, why don’t we have this in all the schools? At a very early age, we could get that ADD or ODD or depressive kid, before it gets out of hand. For a lot of the general public, that sounds reasonable, because they don’t know that unlike problems with vision or hearing, which are very reliably scientifically diagnosed, these things are very subjective—and they lead to treatments that are ineffective and dangerous.
Of course, the pharmaceutical companies are throwing money at mental health screening. This would be a dream come true for them, if everybody was being screened for it, because the more you’re getting screened for it, the more folks are getting diagnosed with diseases, and they’re going to be put on drugs. So it’s more money for Big Pharma. They want the whole world to get screened. And if the world gets crazier, there are going to be more and more people with problematic behaviors. There will be more and more depressed kids, kids who aren’t paying attention, et cetera, and that’s a larger and larger consumer base for Big Pharma.
You’ve written about some World Health Organization findings comparing the treatment and prognoses for recovery in so-called underdeveloped nations to those in the US and other “first world” countries.
Yes, this is a hugely important story. In two different studies, the WHO decided to take a look at psychoses and recovery rates in “underdeveloped” societies—India, Colombia, and Nigeria were three of the countries classified as underdeveloped—and compared them to “developed” societies. What they discovered was that the recovery rates in “underdeveloped” countries were twice as high as in the US.
The obvious areas of speculation for me are in the two big differences between the countries studied. One: They’re not drugging everybody there on a long-term basis. In the US, when somebody is classified with a psychosis like schizophrenia, for example, that’s considered an incurable disease. You have to be on medication for life. At least, that’s more or less the party line of the American Psychiatric Association. And that’s not true in the other countries the WHO studied.
But the other huge factor that seems obvious to me is that in those other societies, there’s much more direct community support, and there’s more family involvement. One person from Colombia was telling me this story about a relative who “flipped out.” When this relative came out of the hospital, instead of going back to their family, with whom they had flipped out, they went to another relative’s home.
For organizations like the National Alliance for the Mentally Ill, that solution would be heresy, because a lot of what they’re all about is: It’s not the family’s or parents’ fault. And that helps them team with the drug companies. They’d have you believe it’s all a biochemical imbalance.
You’ve also written about “psychiatric survivors.” What does that term mean?
“Psychiatric survivors” is a term used by a lot of people who have received psychiatric treatment—especially drug and electroshock treatment, [that was] often forced upon them—who are angry about it, and who want to inform the public about the dangers of such treatment. One of their major organizations is called Support Coalition International, which is an umbrella group of perhaps 100 smaller organizations. They have their own journal called MindFreedom.
So is the logical endpoint of your positions that society is bad for people’s mental health?
Our current atomized society is definitely bad for quite a lot of people. There are many pro-depression, and pro-psychosis aspects of our culture, but the breakdown of extended families and the relative lack of community are probably the two greatest factors.
What are you working on now?
With a lot of talks I gave about Commonsense Rebellion, I felt myself needing to cheerlead more than to inform. So over the last year or two I’ve been working on a book about depression. And the specific components of how you can get your act together: generally, issues of how you build up morale and heal your wounds so you don’t engage in compulsive behaviors. That’s what I’ve been doing: trying to give an alternative to depressed and anti-authoritarian people who don’t believe in the mumbo-jumbo of psychiatry, but who also realize that [psychology’s] cognitive-behavior therapy is a generally weak alternative.
What are the solutions? You’ve talked about people increasing their participation in “real” community, but what does that look like?
Part of what you’re trying to do, on as many levels as possible, is reconnect yourself to yourself and to life around you. That’s what mass industrial society has disintegrated. It’s hugely important for folks to recognize that there’s some degree of autonomy that they need to have in their lives, some kind of control.
I think a lot of what gets people really down are economics. The jobs that they work. The struggle to make money in this culture—let’s face it, most of American society is working meaningless, crap jobs. I think part of what people have to do is forgive themselves for being in jobs that are meaningless, and not making much money, and think slowly about how they can move towards finding some meaning, finding some community, and doing something they really care about. As they move into that process, they might be surprised that, along with some other folks, they might be able to make enough money to survive. Then you’ve really beaten the system. Not many pull it off, but it’s something to aspire to.
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