ADHD and the Triumph of Marketing Over Matter
The New York Times’ special report on “The Selling of Attention Deficit Disorder” is one more reminder, in a long trail of breadcrumbs, that we become the stories we tell about ourselves.
Things that once seemed inevitable—hardwired in, biologically determined—were, in many cases, inventions to suit our life and times. “Childhood,” as a phase of life, is now recognized as a creation of post-industrial society even though it now seems obvious and inevitable. IQ was once thought to be so clearly tied to race that there were physiological manifestations of it in the ridges of the head. The idea that women are innately monogamous and chaste (or, in other times and places, wanton and insatiable)—all these were all at one point seen as scientifically verifiable facts on the ground.
Now we recognize that they were in fact the contingent creations of circumstance and social consensus.
Why couldn’t we see that at the time? Because they all supported a story we told about ourselves, and stories are powerful. As Thomas Kuhn suggested, there is a tipping point past which evidence to support a consensus paradigm will be found … no matter how wrong-headed future generations might find it. We look for things that confirm our worldview, and generally, we find them.
No part of our society understands that better than Madison Avenue, and in many ways the mass diagnoses of Attention Deficit and Hyperactivity Disorder (ADHD)—now found in some 15 percent of all children!—represents the triumph of marketing over matter. It turns out that when we spend billions of dollars over 20 years to convince parents, teachers, and doctors that children might have a condition, they find it everywhere.
After the Milgram experiments, and the Stanford prison experiments, and the success of marketing everything from pet rocks to power rangers, can we really be surprised?
We know better.
Yet, as the Times takes pain to lay out, in everything from the nature of ADHD symptoms (fuzzy at best) to the ADHDictive properties of the drugs that treat it (shown to be highly ADHDictive, though not labeled as such), to their side effects (often severe, though not labeled as such), to the impact ADHD in childhood has on the adults they become (little has been demonstrated), the storytelling of show doctors and advertising wizards has trumped both good science and common sense.
We may know better, but we have not yet stepped up to the responsibility of understanding that the way we talk about ourselves, the stories we tell ourselves about who we are and what that means, has a profound impact on who we turn out to be.
On the one hand, we can live up to our highest ideals. On the other hand—we are what we market.
One of humanistic psychology’s greatest contributions to our collective mental health may be the fact that it creates a space in which patients are allowed, encouraged—even required—to find their own story, their own sense of meaning. To put down the choices offered by catalogs and websites and even doctors, and instead find their own highest ideals.
Such a process simply cannot be replaced by a new pill or exercise regimen, or even a cognitive-behavioral procedure. There is no substitute for the process of an individual, thinking for themselves, in a space where there is no penalty for coloring outside the lines.
It’s not the only helpful thing a psychologist can provide, but it is a crucial element of the therapeutic encounter—and it’s one that modern life is increasingly hostile to. The consumer mentality—buy this product, take this pill, find happiness, live like a model in a commercial—is innately hostile to pauses, close inspection, and self-reflection. If you want what they can’t sell, the system breaks down.
Marketing has less power over someone who is already living their highest ideals, so the consumer system has a great deal invested in preventing everyone from discovering those ideals. That’s as true for pharmaceutical makers as it is for providers of electronics.
ADHD has become an industrial conveyer belt, a streamlined way of identifying customers (patients), feeding them drugs, and extracting money. But this is only possible because we have consented, tacitly, to the idea that children fit on an industrial conveyer belt—that they can be reduced to widgets. Reduced to a few variables, and then “fixed.”
As long as that’s the way we view our children, and view ourselves, there’s always going to be a problem like the over diagnosis of ADHD. So long as we think of ourselves as robots, or software, or bundles of neurons and neurotransmitters, we’re going to gravitate towards conveyor belt solutions, rather than treating people in the medical system as people.
Exposés of the obvious flaws in the assumptions behind disorders like ADHD are welcome to this struggle, and the Times is to be congratulated. But humanists and existential psychologists need to do more than win the facts on the ground—important as those are. We need to tell a story about who we are, about what it means to be human in the 21st century, that inspires us to go beyond quick fixes and bad science, and treat each other as people who cannot be reduced to components, given a pill, and sent on our way.
-- Benjamin Wachs