Friday, July 11, 2008

Dr. Thomas Szasz, ADHD Is Not a Disease

Dr. Thomas Szasz has been quite the critic of modern psychology, especially the labeling of children with mental illnesses. Here's the video, then I have some thoughts below.

He has a point -- to an extent. We tend to pathologize a lot of fairly normal behaviors. This is especially problematic in children, where a label can shape identity for a lifetime.

However, as cognitive neuroscience continues to grow, we are learning that some things, such as ADHD, are actually brain chemistry dysfunctions, which fits even his definition of a disease.

The question then becomes -- and I think no one is really looking at this -- what is normal? Boys are diagnosed with ADHD at much higher levels than girls. But maybe boys just have less focused attention in general, and maybe this is a normal part of development.

There are some tough questions we need to be looking at as neuroscience begins to take over the field of psychology. We need to tease out in more detail what is adaptive and normal, even if it doesn't fit what we want to see, from what it truly not healthy in terms of who we are as human beings.

The failure to do this will result in a chemical version of Harrison Bergeron, where "everyone is finally equal."


Bob said...


With all due respect (and you're due a lot!), it seems to me that when you make a statement like:

"some things, such as ADHD, are actually brain chemistry dysfunctions"

you are perpetuating the very thing that a truly "integral" approach to psychology is trying to combat. Just because PhDs and other so-called experts are willing to jump to similar conclusions doesn't make it true. I challenge you to come up with anything in cognitive neuroscience or anywhere else for that matter that supports the conclusion that ADHD is a brain chemistry dysfunction.

Studies showing differences on brain scans and Functional MRI images need to be interpreted carefully, and not by people who stand to profit from simplified and distorted conclusions.

Sorry for the fiery tone man, but this is a pet peeve of mine. The same brain scans, MRI images and twisted logic could actually be used to make the case that my sense of outrage is nothing more than a brain dysfunction. And that just pisses me off more. (Wait, is that a syringe you got behind your back? No… Nooooooo!!! ☺)


william harryman said...

Hey Bob,

Thanks for sharing your outrage -- I hear you.

The question, to me, is not whether or not the brains of children with ADHD are abnormal -- they are by almost every measure available, not just fMRI.

The real question, again, to me, is whether or not it needs to be treated with drugs. I don't think so.

My guess is that kids aren't born ADHD -- it develops as a result of poor nutrition, parenting issues, environmental toxins, social and cultural expectations and so on. It is an integral issue. But it shows up not just as a behavioral issue, but as a brain size issue (smaller less developed brains), function issue (dopamine), and in other metrics.

I oppose the widespread use of Ritalin and Adderall. I support the use of omega-3 fats and attention training, such as meditation.

Anyway, feel free to share your outrage any time -- I'm very open to criticism.


Bob said...

Thanks for taking the time to respond, Bill. I'm sure the Gafni drama has been enough to sort through this week. Your response makes sense and--as usual--is a fine expression of integral thinking.

I suppose I'm easily triggered by anything that rings of the "it's all about the brain" mentality I see sweeping the field of Psychology. Of course, lip service is usually paid, and few would deny the bio-psycho-social nature of human experience and behavior. When you look at how discussions are presented in the media, however, it seems clear that the message is more like "Yeah sure, it's complicated and social stuff factors in somewhere, but we all know it's really mostly a brain chemistry thing."

You hit the nail right on the head when you brought up the treatment implications--which in a reductionist paradigm usually means drugs. The APA is finally being called on their unholy ties to Big Pharma, which will help a lot, I think.

Thanks again for keepin' it integral and hammering out the best blog out there.