- Dworkin, Ronald W.
Artificial Happiness.
New York: Carroll & Graf, 2006.
ISBN 0-7867-1714-9.
-
Western societies, with the United States in the lead, appear to be
embarked on a grand scale social engineering experiment with little
consideration of the potentially disastrous consequences both for
individuals and the society at large. Over the last two decades
“minor depression”, often no more than what, in less
clinical nomenclature one would term unhappiness, has become seen
as a medical condition treatable with pharmaceuticals, and
prescription of these medications, mostly by general practitioners,
not psychiatrists or psychologists, has skyrocketed, with drugs such as
Prozac, Paxil, and Zoloft regularly appearing on lists of the most
frequently prescribed. Tens of million of people in the United States
take these pills, which are being prescribed to children and
adolescents as well as adults.
Now, there's no question that these medications have been a Godsend
for individuals suffering from severe clinical depression, which
is now understood in many cases to be an organic disease caused by
imbalances in the metabolism of neurotransmitters in the brain.
But this vast public health experiment in medicating unhappiness
is another thing altogether. Unhappiness, like pain, is a signal
that something's wrong, and a motivator to change things for the
better. But if unhappiness is seen as a disease which
is treated by swallowing pills, this signal is removed, and people
are numbed or stupefied out of taking action to eliminate the
cause of their unhappiness: changing jobs or careers, reducing
stress, escaping from abusive personal relationships, or
embarking on some activity which they find personally rewarding.
Self esteem used to be thought of as something you earned from
accomplishing difficult things; once it becomes a state of mind
you get from a bottle of pills, then what will become of all the
accomplishments the happily medicated no longer feel motivated to
achieve?
These are serious questions, and deserve serious investigation
and a book-length treatment of the contemporary scene and
trends. This is not, however, that book. The author is an
M.D. anæsthesiologist with a Ph.D. in political philosophy
from Johns Hopkins University, and a senior fellow at the
Hudson Institute—impressive credentials. Notwithstanding
them, the present work reads like something written by somebody
who learned Marxism from a comic book. Individuals, entire
professions, and groups as heterogeneous as clergy of
organised religions are portrayed like cardboard cutouts—with
stick figures drawn on them—in crayon. Each group the author
identifies is seen as acting monolithically toward a specific
goal, which is always nefarious in some way, advancing an agenda
based solely on its own interest. The possibility that a family
doctor might prescribe antidepressants for an unhappy patient
in the belief that he or she is solving a problem for the patient
is scarcely considered. No, the doctor is part of a grand conspiracy
of “primary care physicians” advancing an agenda to
usurp the “turf” (a term he uses incessantly) of first
psychiatrists, and finally organised religion.
After reading this entire book, I still can't decide whether the author
is really as stupid as he seems, or simply writes so poorly that he comes
across that way. Each chapter starts out lurching toward a goal,
loses its way and rambles off in various directions until the requisite
number of pages have been filled, and then states a conclusion which
is not justified by the content of the chapter. There are few cliches
in the English language which are not used here—again and again.
Here is an example of one of hundreds of paragraphs to which the only
rational reaction is “Huh?”.
So long as spirituality was an idea, such as believing in
God, it fell under religious control. However, if doctors
redefined spirituality to mean a sensual phenomenon—a
feeling—then doctors would control it, since feelings
had long since passed into the medical profession's hands, the
best example being unhappiness. Turning spirituality into a
feeling would also help doctors square the phenomenon with
their own ideology. If spirituality were redefined to mean a
feeling rather than an idea, then doctors could group spirituality
with all the other feelings, including unhappiness, thereby
preserving their ideology's integrity. Spirituality, like
unhappiness, would become a problem of neurotransmitters and
a subclause of their ideology. (Page 226.)
A reader opening this book is confronted with 293 pages of this. This
paragraph appears in chapter nine, “The Last Battle”,
which describes the Manichean struggle between doctors and
organised religion in the 1990s for the custody of the souls
of Americans, ending in a total rout of religion. Oh, you missed
that? Me too.
Mass medication with psychotropic drugs is a topic which cries out for
a statistical examination of its public health dimensions, but
Dworkin relates only anecdotes of individuals he has known personally,
all of whose minds he seems to be able to read, diagnosing their
true motivations which even they don't perceive, and discerning
their true destiny in life, which he believes they are failing to
follow due to medication for unhappiness.
And if things weren't muddled enough, he drags in “alternative
medicine” (the modern, polite term for what used to be called
“quackery”) and ”obsessive exercise” as other
sources of Artificial Happiness (which he capitalises everywhere), which is
rather odd since he doesn't believe either works except through the
placebo effect. Isn't it just a little bit possible that some of those
people working out at the gym are doing so because it makes them feel
better and likely to live longer? Dworkin tries to envision
the future for the Happy American, decoupled from the traditional
trajectory through life by the ability to experience chemically induced
happiness at any stage. Here, he seems to simultaneously admire
and ridicule the culture of the 1950s, of which his knowledge seems
to be drawn from re-runs of
“Leave it to Beaver”.
In the conclusion, he modestly proposes a solution to the problem
which requires completely restructuring medical education for general
practitioners and redefining the mission of all organised religions.
At least he doesn't seem to have a problem with self-esteem!
October 2006 