Societal Values and the Medicalization of Personality

To be successful in America, there are certain implicit characteristics an individual should exude to earn respect and riches. A farcical dichotomy exists in that individuals strive to present similar, valued characteristics while maintaining individuality when in reality, the mass personality adaptation causes the homogenization of society by filtering out a range of unique traits. In our capitalist, free-market economy, the mantra of the “American dream” purports that an individual from any socioeconomic class or race cannot only qualify as a competitive participant in the “rat race” towards success but can even receive the social status and recognition that accompanies the endorsement of being the best or at least, of beating the other participants. Thus, the emphasis on self-presentation clearly stems from our society’s structure. The self-awareness encouraged among children in their formative years begins the pattern of self-serving behavior that benefits one person’s advancement as opposed to community-oriented societies that function by collective efforts to better society.

In no particular order: What do the characteristics we value demonstrate about our value system as a whole? How does dominant society address the exceptions to the rule, the outliers who resist the social pressure to conform? And finally, how is America’s global standing as hegemon maintained through the narcissism that our society cultivates in individuals? Stephen Colbert of “The Colbert Report” in the video below addresses this last question. He parodies narcissistic American culture and the ethnocentricity that accompanies it.

Stephen Colbert's "Me Time: American Narcissism"

Colbert suggests that one of the obvious outcomes of our self-centered approach to life includes the self-importance we feel as a nation when measured against others, and more importantly, the influence that our attitude has on foreign diplomacy and how other nations perceive us. Individually, we act in ways that allow our self-advancement instead of working towards the betterment of our society and collectively, we hinge on our superiority as a country and seek to further our role as hegemon instead of aiming towards global improvement.

Carl Elliott in “The Face Behind the Mask” speaks to the characteristics that our society values by highlighting the ones that we dismiss through medicalization, a scientific basis that condones this societal rejection. He studies the sudden prevalence of social phobia among diagnosed mental disorders in the late 1980s. “In this case”, Elliot opines, “we are medicalizing a personality trait called shyness, which has been with us for a quite a well but has not previously been called a mental disorder” (Elliott 58). He cites the historical presence of self-help literature that suggests ways for us to optimize our qualities. While this literature potentially influences the attitudes and actions of readers, the medicalization and treatment of social anxiety or of excess energy (as discussed in Tuesday’s articles about A.D.H.D.) actually alters the chemical balance in our brains. The resulting alterations in personality and emotion prove harmful to individuals because they imply that changing one’s innate nature is necessary not only for societal acceptance, but also to attain a limited form of success. Elliott calls these tendencies, “partly a matter of American cultural style” but warns that it encourages Americans to “consider barriers to self-presentation, like shyness, to be social handicaps” (Elliott 70). Thus, dominant institutions reward valued characteristics like self-confidence and magnetism by casting a shadow over traits like sensitivity and introversion.

In a Washington Post article entitled “A Rush to Medicate Young Minds” by Elizabeth Roberts, she broaches similar concerns about the harmful effects that the medicalization of less socially desirable personality traits will have on children. Roberts argues that most entities supporting aggressive treatment have ulterior motives in doing so and that none of these involve the well-being of the individual. She writes,

“Unfortunately, when a child is diagnosed with a mental illness, almost everyone benefits. The schools get more state funding for the education of a mentally handicapped student. Teachers have more subdued students in their already overcrowded classrooms. Finally, parents are not forced to examine their poor parenting practices, because they have the perfect excuse: Their child has a chemical imbalance.”

I wonder, what will this generation of over-medicated children look like once they reach adulthood? Will an individual who would have been considered healthy 50 years ago not produce a groundbreaking novel or an emotionally-charged piece of art because medication stripped that person of his or her ability to feel deeply and to experience a wide range of emotions? That will be hard to measure. However, I attempted to gain insight into how medicated individuals feel now, as we are riding the first wave of subjective diagnosing and aggressive drug-prescribing. I came across the thread excerpts posted below entitled “inadequacy..poor me” (Courtesy of VBulletin's addforums).

Elduderino writes: "I recently received an 80% disability rating from VA. Major depressive disorder, ADHD, OCD, GAD, social phobia, and alcohol dependence-in remission. I have moved back in with my mom, due to being unable to function independently. I have no friends, I underachieve quite severely, and I am generally a 24 year old loser. I spend a lot of time thinking about how my life is slipping by and I have nothing to show for it. No success. I'm not even following a normal developmental path. I see women in my peer group who are strong, independent, accomplished, etc. And they terrify me. What I go for the intelligent, science-y, literati girls. But what the **** could I offer a woman like that? For all my above average intelligence, I'm still a low performing student, and grossly uneducated. I feel like a boy in a fat bearded guy's body. **** sucks man. Anyone else feel inadequate, or like a loser whose wasted a huge chunk of life?"

Nova2012 responds: "Yes, and same disorders here (except alcohol dependence). It's pretty awful. The depression keeps me from enjoying life. The social phobia keeps me from enjoying others. The OCD keeps me from enjoying my own thoughts. The GAD keeps me from enjoying my own company. What is left? No one can tell me. They just issue platitudes like "it will get better" or "you'll look back on this and laugh." Yeah, right."

The anguish of feeling inadequate that these bloggers write about exposes another possible motive of dominant institutions for medicalizing individuals: disorders sanction the societal dismissal of these nonconformist members. No wonder they feel inadequate. Society in the form of medical professionals told them that their true selves needed personality alterations and if this failed to produce them into an active participant of our capitalist empire, society views them deviants, holding their diagnoses against them and continuing to treat them with drugs and with disregard.

Elliott introduces a twist to this flawed system in “Amputees by Choice”. He discusses apotemnophilia, a condition likened to gender-identity disorder in which individuals crave amputation. Society ostracizes this group similarly to the individuals with social anxiety disorder.  Except in an apotemnophiliac’s case, he or she must convince society that the condition is legitimate instead of society pushing diagnoses on patients with questionable symptoms.

The increasing medicalization of common personality traits compounded with American self-consciousness and the desire to “get ahead” results in overdiagnosing, overmedicating, and the loss of our individuality that we tweak to fit society’s mold.

Bibliography:

Carl, Elliott. "The Face Behind the Mask" and "Amputees by Choice." Better Than Well: American Medicine Meets the American Dream. New York: Norton and, 2003. 54-76, 208-236. Print.

Roberts, Elizabeth J. "A Rush to Medicate Young Minds." Washington Post. 08 Oct. 2006. Web.

Changing Lifestyles and Health Inequities

Unnatural Causes, an acclaimed video series, identifies practices and mindsets that perpetuate racism and inequities in health. The episodes portray the widened gap between affluent and impoverished populations in the U.S., specifically exposing the trends in society that allow the health of undervalued communities to decline like the strategic placement of fast food joints and liquor stores in inner-city areas. In a video clip entitled “Impact of Poverty and Stress on Diabetes among Native Americans”, Dr. Donald Warne explains that impoverished conditions and high levels of stress contribute to an unhealthy lifestyle that almost guarantees chronic health conditions like diabetes and hypertension (Impact).

Courtesy of Unnatural Causes

A tally of the suffering Native Americans endured could stretch miles long. The forced removal off their land and the resulting loss of culture and identity that it spurred still damages the physical and emotional health of their communities nationwide. As industrialization and urban migration become increasingly common, which lifestyle features indicate unhealthiness? Why does the highest rate of chronic conditions like diabetes and heart disease continue to occur in the most marginalized of communities in the U.S.?

Dennis Wiedman in “Globalizing the Chronicities of Modernity” delves into the questions I posed above by studying the adapted cultures and lifestyles of communities, particularly indigenous, that have experienced declined health due to the rise of industrialization and globalization. He names the recent emergence of MetS, metabolic syndrome, as directly related to lifestyle change. Most individuals are not predisposed to these disorders, he argues. “No particular foods, genes, socioeconomic class, ethnicity, or other inequality can consistently explain the initiation of metabolic disorders in modernizing populations worldwide”, Wiedman opines of the enigmatic nature of MetS (Wiedman 38). This quote contradicts the remaining content of his article where he develops the theory that Native Americans suffer from a disproportionally high amount of stress due to the forced adaptation of a modern lifestyle.

Several studies exist today that prove the correlation between stress and health conditions. Wiedman cites studies specific to Native American health and their findings that “multiple generations of stressful events are associated with continued loss of identity, demoralization, and ongoing emotional suffering, key elements that maintain the chronic stresses resulting in metabolic disorders” (Wiedman 50). Clearly, he supports the conclusion that the historic oppression of these indigenous communities factor into their accumulation of stress, a scientifically proven causal agent of MetS. While I do agree that the genetic basis for these disorders remains less notable, I feel that undervalued groups in society are victims to social constructs and structural violence that predispose them to poor health and Wiedman’s so-called “chronicities of modern disease”. What are the main mediums that modern diseases use to reach populations? One way is through food.

Consumerism and capitalism are intertwined with the American food industry. In “On the Ideology of Nutritionism” by Gyorgy Scrinis, she cites Marion Nestle’s findings that that the constantly changing food politics obscure the message of recommended nutrition and healthy diet. Methods of coercion include lobbyists ascertaining the agendas of the food industry get passed by the U.S. government so that they can “shape the official dietary guidelines in ways that undermine criticism of processed foods and of high meat and dairy consumption” (Scrinis 39). The reductionism of nutrition Scrinis discusses involves the categorization and manipulation of various foods without context so that they serve to support theories about bodily health or “nutri-biochemical level” (Scrinis 41).

Courtesy of "The Tyanny of Choice" from The Economist

The abundant choices and ambiguity that shape modern-day food marketing further add to the confusion that consumers experience when trying to make health-conscious decisions about diet. The image above depicts the large quantity of items we must sift through, each with respective labels announcing the unique mix of nutrients they offer.  For individuals that already feel overwhelmed by society and their designated status in it, like Native Americans, the unreasonably difficult path they must navigate down to eat healthily proves daunting.

A well-known study by Dr. Dean Ornish entitled “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease” investigates the effects of a complete lifestyle change on patients’ health who suffer from coronary atherosclerosis. The treatment involved a “10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support” with the research team tracking their progress after the first 5 years then after the next 4 years (Ornish). The results shocked the medical and scientific communities. The treatment proved far more effective than medication as the patients’ atherosclerosis actually reversed its course. The findings proved so significant because they linked MetS (the conditions Wiedman discussed in his article) with lifestyle factors like stress and diet.

Devalued communities like Native Americans in the U.S. who have historically endured stress due to forced migration and a shift in culture like subsisting on processed foods instead of traditional meals causes their rates in chronic diseases to spike above most groups. Wiedman specifically addresses this point when he introduces the Cultural Consonance model that links “social status inconsistencies with chronic diseases such as hypertension and circulating levels of stress hormones, the catecholamines” (Wiedman 50).

How can society progress forward in a way that identifies marginalized communities and addresses the societal forces that perpetuate health inequity? “Chronic Conditions, Health, and Well-Being in Global Contexts” by Frank, Baum, and Law suggests that the merging of medical anthropology and occupational therapy could help initiate the process of addressing and improving the quality of life for communities effected by health disparities. The authors consider, “in calling for deeper conversations and more active institutional linkages we perhaps tread a pioneer path for other health professions that are inherently more interested in health and well-being than in elimination of disease”, which seems to me a perfect place to start (Frank 246). 

Bibliography:

Frank, Gelya and Carolyn Baum and Mary Law. "Chronic Conditions, Health, and Well-Being in Global Contexts: Occupational Therapy in Conversation with Critical Medical Anthropology." Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. 2010. 230-246. Print.

"Impact of Poverty and Stress on Diabetes Among Native Americans." Unnatural Causes. California Newsreel, 2007. Web. 15 Feb. 2011.

Ornish, Dean. "Intensive Lifestyle Changes for Reversal of Coronary Heart Disease, December 16, 1998, Ornish Et Al. 280 (23): 2001 — JAMA." JAMA, the Journal of the American Medical Association, a Weekly Peer-reviewed Medical Journal Published by AMA — JAMA. American Medical Association, 21 Apr. 1999. Web. 15 Feb. 2011. <http://jama.ama-assn.org/content/280/23/2001>.

Scrinis, Gyorgy. "On the Ideology of Nutritionism." Gastronomica 8.1 (2008): 39-48. Print.

Wiedman, Dennis. "Globalizing the Chronicities of Modernity." Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. 2010. 38-53. Print.

Overanalyzing Sexual Behavior

In this 2007 news clip from CNN, the host investigates the binary of “Nature vs. Nurture” as it relates to the development of homosexuals in American society. Paula Zahn introduces research studies that attempt to answer the controversial question of how homosexually identified people “become” that way- whether it happens at birth or is a result of learned behavior. The first research study shown involves the observation of children’s behavior in home videos and the subjective estimation by the researchers of the subjects’ present sexual orientation, years after the studied footage. Another more scientifically based study examines the sexual orientation of young adults who qualify as fraternal twins, identical twins, or adopted siblings. The historic and present search for scientific solutions to pertinent issues relating to sex and gender is a theme in both the assigned articles for this week and CNN’s broadcast.

The apt title “Fluid Sexes” by Jennifer Terry corresponds to the enlightened idea that “sex anatomy, gender roles, and sexual practice” deserve reconceptualization (Terry 161).  Predominant views in Western society tend to stigmatize certain groups that fall outside of the strict dichotomy of heteronormative organization with a derogative label like “cultural deviants” (Terry 166). Terry cites the work of scholars from multiple disciplines. Each examined homosexuality in an attempt to either discredit it as a genetic abnormality or to find indisputable evidence that legitimized the behavior of undervalued members of society.

Like the scientists on CNN’s news segment who searched for genetic markers, endocrinologists in the early 20^th century used hormone research to clearly differentiate between males and females. This incited the creation of a continuum with “normal males concentrated on one side and normal females on the other”, which translated to the accepted heterosexual members of society (Terry 162). Structural violence against homosexuals ensued when scientists carried out experiments to normalize them by injecting hormones of the opposite sex into each subject in an effort to cure them of their socially misguided sexual orientation.

Not surprisingly, the discrimination does not stop at the homosexual population. Killing two undervalued birds with one prejudiced stone, the same dominant sector in society also oppresses women. In trying to determine how women’s reproductive anatomy contributes to conception, male scholars clumsily stumbled over concepts like the frequency of ovulation and the purported absence of female sexual desire in “Discovery of Sexes” by Thomas Lacqueur. He continues themes from the previously assigned article “New Science, One Flesh” by providing copious examples of anatomical sketches and chauvinistic quotations that express the woman’s primary role as the inferior-to-male child bearer.

While so many controversial quotes abound in Lacqueur’s article, Victor Joze’s opening passage describes a woman as “neither equal nor inferior nor superior to a man, that she is a being apart, another thing, endowed with other functions by nature than the man with whom she has no business competing in public life… A woman exists only through her ovaries” (Lacqueur 149). In Joze’s opinion the woman deserves due credit for her reproductive capabilities but any additional demands for social status or equality will fall on deaf ears. Lacqueur provides a fascinating juxtaposition to Joze’s initial statement. The only role that women fulfill and Renaissance scholars appreciate seems to be the very trait that lessens their status next to men. “What matters is the superior strength of men or, more important, the frequent incapacity of women because of their reproductive functions”, Hobbes opines about the weak biological function females serve (Lacqueur 157).

Those in power historically maintain it by the continued oppression of vulnerable groups. Attempts to medicalize female sexual desire and conception resulted in scientific experiments with harmful implications, both physically and socially. Surgeons removed thousands of ovaries before their physiological function was even understood. Lacqueur likens the women subjects to “humans worked like that ubiquitous experimental creature of the nineteenth century, the rabbit” (Lacqueur 187). Even as women endured pain to help science progress, males perpetuated their lowly social status, “many women are apt to imagine, out of hope or fear, that they have conceived- their reports on this matter are not to be trusted and can be of no practical concern” (Lacqueur 185).

Science can serve to legitimize homosexuality such as the study in CNN that identifies heritable traits that a homosexual person may possess like left-handedness or “hair that whirls in a counter-clockwise direction” (Nature). Terry summarizes Margaret Meads’ findings from her research in the South Pacific, “since there was no natural dictate as to how the sexes should be organized, there should be greater tolerance of variations”, an eloquent appeal for tolerance (Terry 165). However, the endocrinologists used scientific means to create a heteronormative scale that excluded homosexuals as dysfunctional and sexually aberrant.

The medicalization of homosexuality could potentially pave the way for its constitutional acceptance but alternatively, could allow power-preserving groups to use “science” to discredit it.  

Bibliography:

Lacqueur, Thomas. "Discovery of the Sexes." Making Sex: Body and Gender from the Greeks to Freud. Cambridge: Harvard UP, 1990. 149-92. Print.

"Nature vs. Nurture." Paula Zahn Now. CNN. June-July 2007. Veoh. Veoh Networks Inc. Web.

Terry, Jennifer. "Fluid Sexes." An American Obsession: Science, Medicine, and Homosexuality in Modern Society. Chicago: University of Chicago, 1999. 159-77. Print.

Timeless Domination of Feminity

One of my favorite television shows, NBC’s The Office, provides a satirical view of an average American workplace. Some background: The award-winning television series portrays an eclectic group of employees at a small branch of a paper manufacturing company. Steve Carrell plays Michael, the regional manager, an incredibly inappropriate boss whose sexist and tactless behavior regularly creates controversy in the office. Each character represents a stereotype in American media and culture, but the two characters that particularly exemplify stereotypical gender roles in a romantic relationship are the regional manager (Michael) and Jan, the boss he reports to at the corporate office, played by Melora Hardin.

Click the link for clip from the last episode of Season 3 entitled “The Job”, courtesy of NBC via Youtube.

Courtesy of "Working in an Office Wonderland"

 In earlier seasons, Jan represented an independent, strong-willed woman who succeeded in reaching corporate level and contending with the male-dominated business world. However, this scene serves as the catalyst in which Jan reverts to the stereotypically female role in media: dependent on a male figure and prone to emotional outbursts. In “New Science, One Flesh” by Thomas Lacqueur, he also examines the stereotypical gender roles that were prevalent in an earlier time period. He references scholars, scientists, and artists, all of which exuded a male-dominated perspective on physiological traits.

Lacqueur emphasizes with several drawn depictions “the new anatomy displayed, at many levels and with unprecedented vigor, the ‘fact’ that the vagina really is a penis, and the uterus a scrotum” (79). Renaissance writers exclaimed with male-centric language that female reproductive anatomy merely resembles “a female penis” (64) or “an interior version of the male’s” (86). Ironically, Lacqueur concedes that the likening of female genitalia to male actually holds weight. He asserts that the proportions in the depictions were mostly correct and that the homologies suggested by the drawings seem quite plausible. “In fact, if they were more accurate, they would make their point even more powerfully”, Lacquer opines of the artistic comparisons (83). I disagree with this assertion because a woman’s anatomy is uniquely feminine and can exist as such without needing the support of female-male homologies. What cultural values did Renaissance writings portray by its male-dominated language on anatomy and why do these values persist today?

When examining these past depictions and words regarding male-reliant female genitalia, the context of the culture, society, and time period must be taken into consideration. Advanced scientific and medical knowledge lacked during the Renaissance so the structures and language developed mainly because of rudimentary conclusions from existing ideologies. Lacqueur supports this by stating, “Ideology, not accuracy of observation, determined how they were seen and which differences would matter”, “they” being physiological traits of women (88). The predominant view during the Renaissance era that females owed the existence and functionality of their reproductive anatomy to men perpetuates today but in dissimilar ways, as thousands of years have passed.

In The Office episode, Jan’s character takes a turn for the worse when she dramatically protests her termination by storming into her boss’s office in the middle of an interview. She pulls back her sweater, exposing recently implanted breasts through her revealing shirt. She points to her artificial breasts and asks, “Is it because of these? Is it? If it is, then I will see you in court… Because he likes them and that, that is all I care about!” Jan refers to Michael, her partner, who positively reinforced the merits of her plastic surgery by proudly bragging about her “boob job” to all of his employees. Previously, Michael had intentions of breaking up with Jan but when she returned flaunting her cosmetic addition, Michael immediately dismissed thoughts of ending the relationship. The episode, ironically titled “The Job”, could mean both the loss of her job as well as the boob job she experienced to lure Michael’s attention.

Lacqueur’s article also focuses on female anatomy, although his reports on Renaissance medicine and scientific thought clearly predate elective plastic surgery like breast implants. Regardless of the difference in time period, both examples further the values on women’s role in society, especially in contrast to men’s. In “New Science, One Flesh”, Lacqueur includes a 16^th century depiction by Vesalius of a crowd gathering around a dissected woman. He states, “The picture may seem to be, more narrowly, an assertion of male power to know the female body and hence to know and control feminine Nature”, an insight that provides possible motives for why men wish to dominate and define the gender role of females (73).

In the 15^th and 16^th centuries, domination in the rustic medical world meant declarations like “all parts that are in men are present in women” and “indeed if they were not, women might not be human” (97). The one-sex mindset that pervaded Renaissance thought alluded to the male-dominated and frankly, sexist, thought that women owed their physiology to their male counterparts. In modern time, The Office portrays similar gender roles. The American male population generally celebrates the physiological altering of women to enhance their appearance with the help of large breasts or full lips. Even now, with scientific advancements about anatomy and newfound agency that women experience with the right to vote and to undergo abortions, women still surrender their bodies to male-dominated views on the ideal female physique. 


Bibliography:

Laqueur, Thomas. "New Science, One Flesh." Making Sex: Body and Gender from the Greeks to Freud. Cambridge: Harvard UP, 1990. 63-113. Print.