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The parallel with drapetomania is ominous. Children, after all, are in a form of captivity and as they get older may naturally resent having decisions made for them. They may especially dislike being confined most days in stifling government institutions allegedly dedicated to education (“public schools”). Some may rebel, becoming vexatious to the authorities.
Is that really a mental, or brain, disorder? PubMed Health, a website of the National Institutes of Health, discusses treatment and prevention in ways that suggest the answer is no. “The best treatment for the child is to talk with a mental health professional in individual and possibly family therapy. The parents should also learn how to manage the child’s behavior” (emphasis added), it says, adding, “Medications may also be helpful.”
As for prevention, it says, “Be consistent about rules and consequences at home. Don’t make punishments too harsh or inconsistent. Model the right behaviors for your child. Abuse and neglect increase the chances that this condition will occur.”
It seems strange that an illness can be treated by talk and prevented by good parenting. And how was four arrived at as the minimum number of behaviors before diagnosis? Or six months as the minimum period? Odd, indeed.
While ODD is discussed with reference to children, one suspects it wouldn’t take much to extend it to adults who “have trouble with authority.” Surely one is not cured merely with the passing of adolescence. Adults are increasingly subject to oppressive government decision-making almost as much as children. Soviet psychiatry readily found this disorder in dissidents. Let’s not forget that the alliance of psychiatry and state permits people innocent of any crime to be confined and/or drugged against their will.
So we must ask: Do we have a disease here or rather what Thomas Szasz, the libertarian critic of “the therapeutic state,” calls “the medicalization of everyday life.” (Szasz’s chief concern is commonly thought to be psychiatry, but in fact it is freedom and self-responsibility. See my “Szasz in One Lesson.” )
It seems that the common denominator of what are called mental (or brain) disorders is behavior that bothers others which those others wish to control. Why assume such behavior is illness? Isn’t this rather a category mistake? Why stigmatize a rebellious child with an ODD “diagnosis”? (Let’s not forget what psychiatry not long ago regarded as illness and abetted control of.)
In our scientific age, many people find scientism, the application of the concepts and techniques of the hard sciences to persons and economic/social phenomena, comforting. In truth it is dehumanization in the name of health.
Szasz, a prolific author who celebrated his 92nd birthday earlier this week, writes,
People do not have to be told that malaria and melanoma are diseases. They know they are. But people have to be told, and are told over and over again, that alcoholism and depression are diseases. Why? Because people know that they are not diseases, that mental illnesses are not “like other illnesses,” that mental hospitals are not like other hospitals, that the business of psychiatry is control and coercion, not care or cure. Accordingly, medicalizers engage in a never-ending task of “educating” people that nondiseases are diseases.
No one believes drapetomania is a disease anymore. Slaves had a good reason to run away. We all have reasons—not diseases—for “running away.”
Sheldon Richman is editor of The Freeman, where this article originally appeared.