My critics are providing me much material of late for this column and my weekly radio show.
Most recently, a family therapist in Kentucky pleads with the Lexington Herald-Leader to stop running my column, citing my “dangerous” belief that ADHD and other childhood behavior problems are not mental illnesses. According to Susan Bell, I “have not learned anything new in (my) nearly 50 years of advising parents.” Furthermore, she says, other mental health professionals share her opinion of me. She’s right about that, but wrong otherwise.
To begin with, I have learned a great deal over the past 50 years, not the least of which is that psychiatric/psychological diagnoses are not tangible realities; rather, they are constructs.
Cancer is a verifiable reality. A physician who diagnoses lung cancer can provide concrete proof — e.g. a biopsy — to support his verdict. But a mental health professional who diagnoses a child with, say, attention-deficit hyperactivity disorder can provide no such verification. If asked to prove that the child “has” something, said professional will claim that the symptoms — short attention span, impulsivity and so on — constitute the proof. That is equivalent to saying that a productive cough is proof of lung cancer and that said cough is all the evidence one needs to begin chemotherapy.
An illness is a biological condition of one sort or another. No research has ever proven that any childhood behavior problem is inherited or caused by faulty biology. Nonetheless, parents of children diagnosed with ADHD and other behavior disorders are often told that their kids have inherited biochemical imbalances. Is genetic testing done to verify heritability? Have the genes been identified? No, and no.
The same is true concerning the assertion that the chemicals in these kids’ central nervous systems are out of balance. No physical testing is done to support this claim, and no researcher has ever quantified said imbalance. The reason is simple: To speak with authority about an imbalance in a system, one must first precisely quantify a state of balance. As concerns the central nervous system, no one has ever accomplished that feat, which is why a leading psychiatrist has admitted that the term is “nothing but a useful metaphor.” His admission begs the question: How is it useful? Answer: The biochemical imbalance canard is useful in persuading parents to administer to their children potentially dangerous drugs that have never reliably outperformed placebos in clinical trials.
In the 1960s, American parents began looking to mental health professionals for child-rearing advice. Since then, an exponential per-capita increase in child mental health professionals has matched a dramatic deterioration in child mental health. No new therapy or drug has stopped this downward trend. The fact that I connect these dots is understandably unsettling to a lot of people in my field.