When I was about nine years old, my parents went on a ten-day trip to Europe. They left my brother and me in the care of neighbors, parents of a girl my age and a younger boy who lived three doors up our suburban street. In the manner of the average nine-year-old, I didn’t like this much. Their house smelled funny. They ate weird food. Their dad would sit on an easy chair after dinner eating saltines and watching television while his wife bustled around and waited on him. And—here was the weirdest part—they were born-again Christians.
My liberal Jewish parents taught me that dads are supposed to help with the dishes and that every meal should include copious amounts of bread. They also taught me that people who believe literally in the Bible and in Heaven and Hell and the Devil and Creationism are delusional or simply unwilling to cope with cold, hard, scientifically proven reality. That Jesus was probably a nice guy and all, but that anyone who thought he was the actual son of God was just not willing to look at the facts.
Still, against all odds, their mom and my mom got along well. They were, as my mom tells me, "good friends who respected each other's beliefs."
During this kid-swap, I got sick with a cold. And the mom—let’s call her Betty—decided that she was going to do a laying-on of hands with me.
In my family, when we were sick, we went to doctors and got us some antibiotics, whether we needed them or not. This time, I reluctantly went into a darkened room and lay down and Betty gently put her hands on me and prayed over me for a while.
When I told my mother about it after they came back, she was angry—concerned that this born-again Jesus-freak stuff might have scared me. She was right about that: it did scare me, just as anything new and strange can scare a child. (This episode paralleled another kid-swap where Betty was furious with my mom for allowing her kids to watch an episode of Carl Sagan's Cosmos at our house--a brilliant PBS program that might have given those kids a notion that maybe the earth wasn't actually created in seven days.)
I have a very different view today of what that laying-on of hands was about. I know a lot more about the power of belief and about the way mo ern medicine works. I know that in many conditions, a placebo pill works just as well as a pill packed with side-effect-inducing medication—and that, if you tell people what side effects to expect before giving them a placebo, they often create those same side effects in their own bodies in response to that placebo.
Now I know that if I had believed in the power of Betty’s hands to heal me, I probably would have been healed, at least a little. That giving your children faith in something greater than themselves, something unexplainable and vast, can actually be good for their health (rabid, stupid fundamentalism aside). Now that I've lived a little, I've come to know that born-again Christians are some of the kindest, happiest people around. Studies show that people of faith are less likely to become depressed than people who think all that stuff's a load of bunk. (Are you listening, Bill Maher?)
The placebo effect—the power of belief—is especially strong in the treatment of depression. Studies of antidepressants show that these drugs work only slightly better than placebo pills for all but the most severe forms of depression. One recent study from the University of Pennsylvania reviewed six studies involving 800 patients who were given either paroxetine (Paxil), an SSRI; imipramine, a tricyclic antidepressant; or a placebo pill. When these patients had depression that was very severe and debilitating (over 24 on the scale used for the study), antidepressants reduced that depression score by an average of 13 points. The placebo reduced it by nine points. Placebo was pretty effective here, but there was enough of a difference between the scores to demonstrate a therapeutic effect for the drug.
Subjects with depression scores below 23 improved by eight points with antidepressants and seven with the placebo—not a significant difference.
Some 27 million Americans currently take antidepressants. According to IMSHealth, over 328 billion prescriptions for antidepressants are written each year worldwide (about half of these scrips are written in the US). There’s no social stigma around taking these drugs; they’re an accepted part of our culture these days thanks to a long-drawn campaign by the medical/pharmaceutical industry to cast mental illness as purely biochemical in nature. When you’re low, you can take a pill that will adjust your chemical balance, because we all know that it’s a chemical imbalance in our brains that causes depression. At least, that’s what the kind folks who make the drugs tell us.
Modern American medicine is all about finding the biochemical reasons for illness and making a diagnosis that can be treated with drugs or other modern methods. Psychiatry is no exception. Psychiatrists and psychologists are trained to look at symptoms and diagnose according to the most current edition of a ginormous book called the Diagnostic Statistical Manual (DSM). Mental health advocacy organizations have fought long and hard to remove any stigma from people with mental health diagnoses. The belief has been that if we make the American standards for diagnosis and treatment of mental illness universal, we’ll remove blame, shame and stigma from those who suffer from these illnesses.
I'm thankful that we have modern medicine, and I can see how our culture is shifting to incorporate ages-old notions about belief, touch and spirituality into the biomedical model. It's kind of a cool time to be alive.
Still, it appears that we, in our role as global superpower, are exporting far more than American Idol and corn to other nations. We’re also exporting biomedical ideas about what constitutes mental illness and how to cure it.
In a brilliant piece on this subject, published in the New York Times on January 8, 2010 (http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html), Ethan Watters describes how different cultures have, until recently, had their own forms of mental illness:
In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro, which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that brings forth dissociative episodes of laughing, shouting and singing.
The same is true as individual cultures change over time. Watters uses this example: in the 1800s in the US, thousands of women were afflicted by leg paralysis that was termed “hysterical”—caused mainly by the natural fragility inherent in femaleness. Such paralysis does not exist on any large scale anymore. Watters explains this as “the troubled unconscious minds of a certain class of women speaking the idiom of distress of their time.” It’s not difficult to make a stretch here to include not only many of the ailments listed in the DSM (which has grown enormously in bulk with each edition), but also mysterious body-mind ailments that cause pain, restlessness, or other symptoms that defy any biochemical explanation or cure: more idioms of distress as expressed by the body.
Across the world, the incidence of depression, anxiety disorders, ADHD, bipolar disorder, anorexia, and a host of other mental illnesses is steadily rising. Cultures are losing their indigenous forms of mental illness and—ever so conveniently for the companies that make the drugs that treat the disorders largely defined within American culture—are politely suffering according to the guidelines of the DSM. (Interestingly, the relapse rates for these increasingly popular diseases are greater in the US than in developing nations. We might be exporting these diseases to those nations, but they are more likely to get better than we are.)
The flip side of the biomedical attitude towards mental illness—where we say, “Mental illness is like any other illness” rather than accepting that at least some mental illness may actually be an expression of spiritual crisis or awakening—is that the only thing we can do about it is medicate it with chemicals that don’t cure, but only treat. There’s no responsibility, but no control, no power.
A friend of mine told me an illustrative story about working at a Native American mental hospital in New Mexico. She was just out of college, a lay therapist who was mostly there to observe. When people were brought into the hospital in need of care, they were brought to a special place for a healing ceremony with a shaman, first thing.
“It would be three white people and 70 Navajos,” she told me. “And this ceremony would almost always cure the person. They would be brought back from frank psychosis by this ceremony.” She went on to tell me that in the reservations, the Navajos and the Hopis would gather around those who were having mental breaks and crises. They respected these breaks and crises as valuable, even vital expressions of spirit.
Imagine yourself, for a moment, having a horrible mental health crisis—a deep depression, a psychotic break, or anxiety so severe that you can’t tolerate it. You could go to your doctor and get your medication and if you take it, you’ll probably get things under control, at least for now. But what if your community all gathered around you in the name of your healing? What if you could, in your moment of crisis, feel honored and supported by your community?
Yeah, right, right, I know, we don’t do things that way in America. But maybe if we took a less biochemical approach to depression and let ourselves believe in the power of culture, relationship, and just plain willingness to be present and honor what IS instead of trying to slap a happy-face sticker on everything—we wouldn’t have to count so much on those little neurotransmitter-tweaking, libido-sucking pills that don’t even really seem to do us much good anyhow.
Whatever benefit most people get from those pills are due to their belief that they’ll work.
My liberal Jewish parents taught me that dads are supposed to help with the dishes and that every meal should include copious amounts of bread. They also taught me that people who believe literally in the Bible and in Heaven and Hell and the Devil and Creationism are delusional or simply unwilling to cope with cold, hard, scientifically proven reality. That Jesus was probably a nice guy and all, but that anyone who thought he was the actual son of God was just not willing to look at the facts.
Still, against all odds, their mom and my mom got along well. They were, as my mom tells me, "good friends who respected each other's beliefs."
During this kid-swap, I got sick with a cold. And the mom—let’s call her Betty—decided that she was going to do a laying-on of hands with me.
In my family, when we were sick, we went to doctors and got us some antibiotics, whether we needed them or not. This time, I reluctantly went into a darkened room and lay down and Betty gently put her hands on me and prayed over me for a while.
When I told my mother about it after they came back, she was angry—concerned that this born-again Jesus-freak stuff might have scared me. She was right about that: it did scare me, just as anything new and strange can scare a child. (This episode paralleled another kid-swap where Betty was furious with my mom for allowing her kids to watch an episode of Carl Sagan's Cosmos at our house--a brilliant PBS program that might have given those kids a notion that maybe the earth wasn't actually created in seven days.)
I have a very different view today of what that laying-on of hands was about. I know a lot more about the power of belief and about the way mo ern medicine works. I know that in many conditions, a placebo pill works just as well as a pill packed with side-effect-inducing medication—and that, if you tell people what side effects to expect before giving them a placebo, they often create those same side effects in their own bodies in response to that placebo.
Now I know that if I had believed in the power of Betty’s hands to heal me, I probably would have been healed, at least a little. That giving your children faith in something greater than themselves, something unexplainable and vast, can actually be good for their health (rabid, stupid fundamentalism aside). Now that I've lived a little, I've come to know that born-again Christians are some of the kindest, happiest people around. Studies show that people of faith are less likely to become depressed than people who think all that stuff's a load of bunk. (Are you listening, Bill Maher?)
The placebo effect—the power of belief—is especially strong in the treatment of depression. Studies of antidepressants show that these drugs work only slightly better than placebo pills for all but the most severe forms of depression. One recent study from the University of Pennsylvania reviewed six studies involving 800 patients who were given either paroxetine (Paxil), an SSRI; imipramine, a tricyclic antidepressant; or a placebo pill. When these patients had depression that was very severe and debilitating (over 24 on the scale used for the study), antidepressants reduced that depression score by an average of 13 points. The placebo reduced it by nine points. Placebo was pretty effective here, but there was enough of a difference between the scores to demonstrate a therapeutic effect for the drug.
Subjects with depression scores below 23 improved by eight points with antidepressants and seven with the placebo—not a significant difference.
Some 27 million Americans currently take antidepressants. According to IMSHealth, over 328 billion prescriptions for antidepressants are written each year worldwide (about half of these scrips are written in the US). There’s no social stigma around taking these drugs; they’re an accepted part of our culture these days thanks to a long-drawn campaign by the medical/pharmaceutical industry to cast mental illness as purely biochemical in nature. When you’re low, you can take a pill that will adjust your chemical balance, because we all know that it’s a chemical imbalance in our brains that causes depression. At least, that’s what the kind folks who make the drugs tell us.
Modern American medicine is all about finding the biochemical reasons for illness and making a diagnosis that can be treated with drugs or other modern methods. Psychiatry is no exception. Psychiatrists and psychologists are trained to look at symptoms and diagnose according to the most current edition of a ginormous book called the Diagnostic Statistical Manual (DSM). Mental health advocacy organizations have fought long and hard to remove any stigma from people with mental health diagnoses. The belief has been that if we make the American standards for diagnosis and treatment of mental illness universal, we’ll remove blame, shame and stigma from those who suffer from these illnesses.
I'm thankful that we have modern medicine, and I can see how our culture is shifting to incorporate ages-old notions about belief, touch and spirituality into the biomedical model. It's kind of a cool time to be alive.
Still, it appears that we, in our role as global superpower, are exporting far more than American Idol and corn to other nations. We’re also exporting biomedical ideas about what constitutes mental illness and how to cure it.
In a brilliant piece on this subject, published in the New York Times on January 8, 2010 (http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html), Ethan Watters describes how different cultures have, until recently, had their own forms of mental illness:
In some Southeast Asian cultures, men have been known to experience what is called amok, an episode of murderous rage followed by amnesia; men in the region also suffer from koro, which is characterized by the debilitating certainty that their genitals are retracting into their bodies. Across the fertile crescent of the Middle East there is zar, a condition related to spirit-possession beliefs that brings forth dissociative episodes of laughing, shouting and singing.
The same is true as individual cultures change over time. Watters uses this example: in the 1800s in the US, thousands of women were afflicted by leg paralysis that was termed “hysterical”—caused mainly by the natural fragility inherent in femaleness. Such paralysis does not exist on any large scale anymore. Watters explains this as “the troubled unconscious minds of a certain class of women speaking the idiom of distress of their time.” It’s not difficult to make a stretch here to include not only many of the ailments listed in the DSM (which has grown enormously in bulk with each edition), but also mysterious body-mind ailments that cause pain, restlessness, or other symptoms that defy any biochemical explanation or cure: more idioms of distress as expressed by the body.
Across the world, the incidence of depression, anxiety disorders, ADHD, bipolar disorder, anorexia, and a host of other mental illnesses is steadily rising. Cultures are losing their indigenous forms of mental illness and—ever so conveniently for the companies that make the drugs that treat the disorders largely defined within American culture—are politely suffering according to the guidelines of the DSM. (Interestingly, the relapse rates for these increasingly popular diseases are greater in the US than in developing nations. We might be exporting these diseases to those nations, but they are more likely to get better than we are.)
The flip side of the biomedical attitude towards mental illness—where we say, “Mental illness is like any other illness” rather than accepting that at least some mental illness may actually be an expression of spiritual crisis or awakening—is that the only thing we can do about it is medicate it with chemicals that don’t cure, but only treat. There’s no responsibility, but no control, no power.
A friend of mine told me an illustrative story about working at a Native American mental hospital in New Mexico. She was just out of college, a lay therapist who was mostly there to observe. When people were brought into the hospital in need of care, they were brought to a special place for a healing ceremony with a shaman, first thing.
“It would be three white people and 70 Navajos,” she told me. “And this ceremony would almost always cure the person. They would be brought back from frank psychosis by this ceremony.” She went on to tell me that in the reservations, the Navajos and the Hopis would gather around those who were having mental breaks and crises. They respected these breaks and crises as valuable, even vital expressions of spirit.
Imagine yourself, for a moment, having a horrible mental health crisis—a deep depression, a psychotic break, or anxiety so severe that you can’t tolerate it. You could go to your doctor and get your medication and if you take it, you’ll probably get things under control, at least for now. But what if your community all gathered around you in the name of your healing? What if you could, in your moment of crisis, feel honored and supported by your community?
Yeah, right, right, I know, we don’t do things that way in America. But maybe if we took a less biochemical approach to depression and let ourselves believe in the power of culture, relationship, and just plain willingness to be present and honor what IS instead of trying to slap a happy-face sticker on everything—we wouldn’t have to count so much on those little neurotransmitter-tweaking, libido-sucking pills that don’t even really seem to do us much good anyhow.
Whatever benefit most people get from those pills are due to their belief that they’ll work.
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