By no means do I have the whole story. That requires much more space and differing views. But we got to start somewhere.
Phyllis Chesler, one of the first of many women to enter the field of psychology in the 1960’s, states in her book, Women and Madness, that pathologicalizing IS traumatizing.
Previously, 75% of the patients were women, nearly none were children and near 100% of the ‘doctors’ and mental health professionals were men. (Women were not allowed, at first, as authorities. Later hired as carers they entered the field only after masses of women were given permission to enter all university disciplines, including ones for expertise training in identifying pathologies.) And children didn’t get pathologicalized for being children or any child ailment, except in very, very rare cases. They weren’t a market yet.
Virtually no medications were considered safe for children because of their body size – and lack of any tests or experience. For adults only. These were newer chemical experiments. Mass experimentation on public children wasn’t conceived and experimentation on someone else’s child was completely unacceptable. Children’s sickness was a private matter for the mother doing her job. In many cases, working fathers paid no mind either. It’s as it was. Sexism in work.
If you haven’t lived that time period or condition, you have to grasp that women’s work and anything to do with women was completely devalued including providing them services. Men, quite often, had nothing to do with babies. It was of no real concern for a social world dominated by men’s concerns of war, politics and business. Child care was women’s work and wasn’t on the list for honor even in medical science at first. Like restaurants that replaced home cooking, Medical doctors and associated professionals replaced 24/7 health care in the home with a mass production model in the doctor’s office. Psychiatry, a questionable profession as medical science, was even more delayed.
There had to evolve an actual respect for medical doctors that didn’t exist to begin with. So pathologicalizing wasn’t routine at all. And medication dosage was always adjusted carefully for children in the ‘rare’ cases you gave a child medication by going to a doctor with a serious problem. Not for everything and anything minor. Chemicals as a product exploded on the market.
Popping pills as far as children go was strictly restrained and then done by high school ‘druggies’, illegally, which came decades later, too. There was the time of extreme medical caution, Bayer Aspirin and nothing else. What change has happened is a whole book to write! But it’s important to note that popping chemicals in the form of a pill became not just a way to treat disease of the body, but a way to cope with life and fix anything humans didn’t like or suffer. Other actions fell by the way side. The behavior of ingesting chemicals replaced important life skills and common sense knowledge. Just as going to the grocery store replaced having a home garden and orchard. It omitted some life skills that humans had known for centuries.
As medical industry grew and changed, mothers listened to their doctors and often gave up the ‘ old wives’ tales’ (successes overlooked, and perceived as superstitious and of little value where there is little money) and handed over the role of emotional caretaking for quick medicine cures claimed as superior and more effective. It came along with never ending economic growth and inventions, like televisions, cars, automatic washing machines and dishwashers. Gadgets and products galore! Advertising. And chemicals in our entire world. And mothers leaving the home to do paid work was changing their obligations and ways of health care. It became fashionable for mothers to be guided by male professionals of higher learning first and foremost even if they never changed diapers, held a baby or had any experience. Like computers and internet today revolutionized communications, chemistry was taking over long held notions about health care and human behaviors. The sales pitch was that modern health was the latest, the newest, and the best in all of human health care in all of human history. Magic. Awesome things could happen. Evidence to the contrary disrupts the beliefs and trust in our society’s ways of being with technology.
Drugging and diagnosing, thus pathologicalizing, evolved directly by professionals and for profit businesses but out of specific academic specialities and their products. Often, those specific professionals had no child training, education or experience nor even daily, or long term concern for children. It was short sales with high beliefs and faith. Motivated by status, income, products with specialty educations, all this and more drove the phenomenon. But it was only done with unexamined, new, personal stereotyping of behaviors in children without regard to age, thus, it became fuel for a slew of systematic interests to participate in pathologicalizing children and expanding new avenues for services and businesses. Sure, most all good hearted folks cared and there were exciting positives. But the harm, the failures, and the lack was swept under the rug. Children were now a market to tap and the path was already laid down.
The failures of psychiatry and psychology date back 200 years of recorded mistakes and this was underlying a business that advertised themselves as a health care rescue. In fact, the lack of consistency and failures in the field for diagnosis was well known and the solution was the DSM. The failures were used as a reason to create a mass produced diagnostic manual, the DSM. This book was a new main source of income for a questionable, failing profession. It was coming to awareness that if people were allowed to talk that some of the mental problems were ‘cured’. It was ‘the talking cure’ which would put psychiatry out of business for lack of need so it was really a business rescue.
The bible of psychiatry, the Diagnostic Manual, could only do one thing. Increase and mass produce diagnosis. It was the answer to bring the business model of psychiatry and chemical cures across the society. With new efforts of Robert Spitzer in the lead of task forces the DSM was created and then used for implementing a widespread, institutional way of pathologicalizing people and became a source for many professionals for systematic functioning in everything from schools to courts. Production of stereotyped mass produced behavioral labels devoid of context took hold. Friends started changing their own perceptions of friends to include disorders and treatments. The old fashion love, caring, relationship learning and paying attention were replaced. There was a originally a minimum of diagnosis to even choose from before the 1980’s which then soared to over 400 labels and logically began the question of where the line is drawn between normal and abnormal people.
I was appalled when I saw those young, newly trained professionals who were armed with these new labels and given a degree that allowed them to, for example, stereotypically diagnose a 2 year old with bipolar. As if a baby’s behavior was the same as an adult by these pathological stereotypes. This was done with absolutely no knowledge of normal child behavior. Let alone any other education beyond chemistry and medical diagnosing that might see behavior differently. Qualifications? Never even been a babysitter or spent time with children? Did being a parent matter? Who else would have serious experience with children? The problem was parenting was not a profession.
Pathologicalizing became the way for ordinary people to see each other and children while mother’s knowledge of raising children, seemingly worthless, was going extinct except for some lingering strong mother to daughter relationships. Mother to daughter knowledge without formal education institutions had long held the wisdom of women’s work. But that was getting disrupted as new businesses disrupt established ways of functioning. Many people were growing up in social segregation apart from other age groups, unlike before, which heightened the lack of knowledge and the problems – and increased stereotyping of various aging. Ageism flourished like never before in all of history.
That the selling of medications and diagnosing was brought to the public in the same way a new Disney movie, like Frozen, floods the market with popularity and products, this harm of diagnosing and pathologicalizing evolved quickly with media exposure of advertising of the stories and products.
Parents and other social workers were following these kind of leads under the trust of ‘professional and science education’ – and it’s encompassing social pressure for what was understood as good and right. And surely, part of the reason for need of the products, was the inheritance of social problems as well as social changes involved in managing such issues. I just saw, in the film, Streets with no Name, that a student said in his school today, the normal is children on pills. Don’t ask which child is popping pills anymore. Abnormal is medication abstinence in school.
But back then things were quite different and many other social changes, in a positive sense, mixed, have occurred since that time, too.
One such change, concerning harm, I point to directly.
Domestic violence had no name but the harm was among the general public. Victims of sexual assault and other forms of violent crimes (crimes committed 90% of the time by males noted in historical records) were underlying reasons people were given many of the diagnoses from paranoid, delusional to schizophrenic, but, with women, the large majority were given ‘Depression’ instead of Oppression or Repression. No, only feminists called out Oppression and it wasn’t diagnosing or pathologicalizing. The denial of the impact of violence was actually born from a taboo. That taboo was, in part, the result of the social rule that you don’t question the fathers’ authority, especially fathers that are socially honored. The don’t talk, don’t trust, don’t feel rule. No wonder the talking cure was the ‘cure’.
Children were just seen as bad or disobedient when problematic. Personality flaws, yes, but Rarely sick. Problematic men were criminals, not mental health problems for society, with rare exception depending on the value of who the victim was and lack of understanding of motive. Of course, a person out of touch with popular realities in some cases existed. Insane is a legal term. Not a medical one. So, in court, actual mental health wasn’t the issue even if the term insane was used. Violent men were often understandable as their violence was seen as provoked by circumstances, problems or some idiot unless the provoker was some other highly honored person. Status and honoring played a large part in the dishonoring and low status that comes with diagnosing and pathologicalizing. Worse, discrimination and prejudice were mixed into the equation of what is abnormal and in minority status. This happens especially when the violence was confusing and not understandable to the general public. Once understanding is known, no diagnosing or pathologicalizing occurs. However, in a broader sense, abnormality or just being in a minority was fertile ground for pathologicalizing. So looking at how different ‘groups’ of people – men, women, and children – were diagnosed presents insights. Incomprehension of behavior is the door for pathologicalizing.
Problematic, aggressive women, unlike men, were not normally perceived criminals because of how society historically treated women. They were, however, abnormal by gender scripts and so deviant of their gender, either hated as bitches or scary as madwomen. Either way they were categorized as emotional and dangerous to society. Women were often treated as emotional children with limits on the decision making and their autonomy without a man. Courageous women defying the norm were seen as crazy because a woman’s reality and history was not comprehended. Emotional caretaking and talking through relationship problems, done quietly and passively, was the job of good, obedient mothers like doing the laundry and cooking and involved No diagnosing.
A man who was considered a non-emotional human and strictly rational by body part only fit the idea of having a mental problem to be pathologicalized if he ‘wasn’t acting like a man’ in extreme ways. And yes, in any serious sense, they existed as rare. They were challenged to ‘act like a man’ near 100% of the time. Being a man was a demand on all boys. But it was mothers who were assigned management of the emotional climate of the home, take the hits, yet were not given ultimate authority to do so. Fathers “ruled the roost’ or were suppose to – with no interference from the public or government. It was their right. With farming as normal, the rooster and hens was a well known analogy of the men and women.
It should be clear why depression and anti-depressants became so popularly diagnosed. But it’s not. Depression, socially a blanket, waste basket term was vague but came out of extremes behaviors of lack of voice, of obedience and masked fear of harm. In the midst of surrounding violence, it is absurd that those behaviors would be classified as mentally ill. They were socially created and demanded. (It is historically a pattern where behaviors seen as pathological are, at the same time, often the result of actual social demands.) In large institutional systems, that’s been named as the left hand not knowing what the right hand is doing. There are many examples of this throughout history and even today.
For this absurdity in diagnosing, you have to understand that the courageous heroic man was the undefined, and unexpressed standard of what was mental health. A universal man that stands for all man kind. Not a real individual man. However, every person thought they could identify what mental health was but beyond prejudice, discrimination, slurs and jokes there was no official diagnosis or definition of what mental health was or is today. Not for a real individual. Others, beyond a symbolic man, especially minorities, could be diagnosed as ill for being exactly what society demanded of them. Ignorance and unexamined lives is what caused such a mess.
No women and children had security against violence unless protected by their intimate male relationships. Nor were women or children organized in groups for protection against the one human group, men, that was organized in sophisticated lessons to harm other humans – which automatically resulted in who were the winners in conflicts in the system design. Men and their battles were the front line. They were the way countries were made. Important and famous people had their own body guards – or armies.
Men in war (No women allowed.) and the unintended spills from that into society became the norm while the violence within society as well as more conquering and wars grew out of WWII into global territories. New generations embraced aggressions as normal, every day living in new ways. The fear of being a disrespected person, like a disrespected mom, once called matrophobia, was everywhere. Sometimes it became necessary to have an inauthentic self to gain and maintain public respect. Men and behaviors were honored for their independence, and women, later, being thought equal to men, were demanded to be like men. Not the other way around. Never mind catch 22 scenarios and contradictions.
Militarization of the home by male standards, in conflict, by examples, with status concerns, and the duties of love helped give rise to what we have today. The military as profitably industrial complex, changes in marriage obligations/freedoms, and the peace and love movements not taken seriously as a movement against violence all evolved in varying ways.
The Peace and love movement of the 60’s, in contrast to the war movement, and against the seriousness of military and honor of men’s violence, was perceived in a reductionistic way as frivolous, and even silly and ridiculous, and as a bunch of hippies on drugs. Irrational. Opposing violence was not rewarded while love was desired in marriage and community. Even Free love as a movement, beginning in the 19th century, was never understood…and perceived as morally wrong. And that history is virtually unknown today. Think about that. The roots of a movement for peace, love and freedom in US society was seen as morally wrong and not seriously creditable! And still can be. Violence, Aggression and war always grew and demanded loyalty, even as supported by the highest of moral christian authority. Religious institutions wore the banner of promoting love, yet always cooperated with certain violences. No sacred religions had a history of ending acceptable violence in the home or against certain victimization of groups. Their participation was often in spiritualizing the results of violence. Pathologicalizing was necessary to mystify the results of socially accepted violence. Yet violence continuing had results.
In the home, violence was a private matter. When ordinary men became criminal and killed members in the home, most all responses were….’he was such a nice guy….can’t believe he did it’ and where did that come from. We didn’t see it coming. Terms as ‘crimes of passion’ quickly changed the killer from a cold blooded murderer to understandable, unfortunate, but sometimes necessary human actions. And it was always followed by rationalizing and reasoning that someone provoked it and then understanding was handed out inequitably for the perpetrator depending on who was the victim….because toughness in men was valued, not diagnosed. Pathologicalizing didn’t happen. Victim blame was essential when the whole goal was to have men as tough in power but obedient and law abiding citizens, particularly certain groups.
Mostly women and children obedient. Men, however, fight, understandably for their independence, freedom, control and power. Cat fights were near comical and amusing entertainment. Not serious fighting.
Then things changed.
Mental health began to count as important for children’s well being out of women in the mental health field and understandings from associated professions in studying deviants. It replaced obedience as a priority. I mean, what is mental health when a child is to not speak, ‘talk back’, be seen but not heard. That’s the well being our grandparents carried forward in their own silence.
Women, like Laura Brown and Elaine Showalter and many others entered the work force as mental health workers, and worked to count the harm against women and stop the diagnoses, and that’s where the movement for trauma and PTSD started.
It was a way to count the results of harm that was not an illness or character deficit. It was the rare diagnosis, among the 400 possible, that was understood to come from harm. But unfortunately, the carry over of sickness remained with the newer diagnosis of trauma and PTSD. The evolution of that pathologicalizing has gone through quite a bit of change and is still evolving.
The first mental health diagnosis, widespread, that was based in the fact that the patient was harmed came along with a movement to end stigma, stereotyping, of misunderstood behaviors.
Of course, No one, except a handful of authority, said mammals are designed to handle trauma. It was the violent community or it’s warriors that remained ‘unpathologicalized’. While war is not something humans are born to, but trained in, violence continued to be seen as part of mental wellness if within an unexamined idea of normal.
Paula Caplan, and a few others, worked to address the lack of pathologicalizing violent behavior. Legitimately, a diagnosis created, Dominating Delusional Personality Disorder, with valid evidence of considerable harm, but was not taken seriously and never became popular fashion because it was laughable to think of diagnosing and pathologicalizing many of our society’s leaders. All the while, NCADV (National Coalition Against Domestic Violence) made a public statement that they did not want any victims of violence, including trauma victims, being pathologicalized. They wanted their history counted and their responses to violence understood as perfectly normal. Not abnormal sickness that requires treatment. At best, injury.
In short, the victim of violence is pathologicalized as abnormal and sick while the perpetrator of violence is perceived as normally healthy, with the exception of the extreme rare forms of violence.