One of Freud’s primary themes in treatment of his patients was the separation of (idiosyncratic) neurotic anxiety from objective anxiety. Since anxiety disorders (along with depression and post-traumatic stress disorders) are widely present in our culture, I thought that the general subject was worthy of focus and exploration.
Keep in mind that many of Freud’s original writings were published before the events of the 20th century, with horrors such as the Great War leading to innovations in his repertoire, for instance “the death wish” or a general pessimism regarding the human condition (“everyday unhappiness”), not to speak of his attack on all religion as infantile regression in The Future of An Illusion (1928). But the Freudians today are few and cater to an older, usually moneyed urban clientele, while it is the Jungians whose influence has penetrated into popular culture and even school curricula, owing perhaps to Jung’s postulation of a racially-specific unconscious that blends well with racialist theories of multiculturalism. (For my numerous blogs on Jung and Jungians, see http://clarespark.com/2010/05/10/jungians-rising/.)
It is more often the case that Freud’s influence, if any, is filtered through the structural functionalism of Talcott Parsons and similar social theorists who are more interested in adjustment and functionality (stability in interpersonal relations), than in the tracking of personal traumas and intertwined social traumas that lead to troubling “symptoms” such as the anxiety disorders. Indeed, The Diagnostic and Statistical Manual of Mental Disorders has been funded by liberals and their foundations and related organizations, including the MacArthur Foundation, U.S. government agencies, the World Health Organization, and the American Psychiatric Association. Their approach is managerial, as opposed to an orientation to cure, for that could lead to radicalization or other postures deemed destabilizing to social order imagined by the moderate men.
NPR recently interviewed a psychiatrist in the know about changes to DSM-V, the diagnostic manual used by physicians of every kind in labeling and prescribing treatment for their patients. This psychiatrist stated that it was likely that grief (a subject that has not been previously “medicalized” as abnormal) would be limited to two months, after which antidepressants might be indicated. (For a general summary of proposed changes in DSM-V see http://www.goodtherapy.org/blog/controversy-changes-dsm-diagnosis-1205127, posted December 6, 2012.)
Some passages from the Introduction to DSM-IV bear quoting, especially as they are not only as indecipherable as Parson’s own famously awful prose, but are careful to avoid positing dualisms between mind and body, or labeling suffering “individuals”:
“In DSM-IV, each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. In addition, this syndrome or pattern must not be an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. Neither deviant behavior (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of dysfunction in the individual as described above.” [I have not yet found a definition of “the individual”; rather, progressives are careful to define the “individual-in-society.” See http://clarespark.com/2009/12/12/switching-the-enlightenment-corporatist-liberalism-and-the-revision-of-american-history/. CS]
[DSM-IV, cont.:] “A common misconception is that a classification of mental disorders classifies people, when actually what are being classified are disorders that people have. For this reason, the text of DSM-IV (as did the text of DSM-III-R) avoids the use of such expressions as “a schizophrenic” or “an alcoholic” and instead uses the more accurate, but admittedly more cumbersome, “an individual with Schizophrenia” or “an individual with Alcohol Dependence.” ( my emphasis, pp. xxi-xxii)
This is the language of progressivism, pretending that these experts believe in the discrete, unique individual, while all along using quantification and statistics that attempt to describe disruptive (mal-adjusting) group behaviors: “disorders that people have.” Moreover, their language is so vague and abstract that I for one, can barely decode their language. But I suspect that “defiant” individuals (who have their own section in DSM-IV) are deemed dysfunctional no matter how rationally based their nonconformity may be. (I was considered to be “defiant” or excessively “experimental” in graduate school by leading professors, sometimes in private, sometimes in public. See http://clarespark.com/2012/12/22/my-oppositional-defiant-disorder-and-eric-hobsbawm/.)
The language that I have quoted is so abstracted from the real life experience of classes, genders, or other groupings that one wonders if the suspicions of the anti-psychiatry theorists are not themselves more rational than the mental health practitioners who rely upon DSM’s diagnostic codes to prescribe pills and other remedies for symptoms that are imposed by the concrete life experiences of soldiers, abused and neglected children, or simply members of families that do not meet their individual emotional and biological needs.
But as I read the section in DSM-IV on post-traumatic stress disorders, I was struck by the usefulness of these causal situations to current day problems that are often global in nature: the direct experience of war and falsifying propaganda; the demoralizing teaching of history as non-stop atrocity; the hyper-sexualization of American culture that exposes children to sexual scenes at early ages; the crime shows on television or in the movies that are graphically violent and sexual in nature; the constant broadcasting of apocalyptic scenarios that blame industrialization for the imminent end of life on our planet; “rage against the machine” by rock bands and other counter-culture wannabe stars; gangsta rap; the barrage of images of the happy gift-giving, problem-solving family (especially from Thanksgiving on through Christmas)–families untroubled by generational conflict, misunderstanding, or sibling rivalry.
While I object to the introductory material that I have quoted, the many social-cultural-political sources of PTSD are useful to the understanding of “objective anxiety.”
How neurotic are we, or are most of us rationally reacting to an objectively terrifying world? (For a related blog see http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/. For a description of the controversy surrounding revisions of DSM-IV, see http://www.theatlanticwire.com/national/2012/12/inside-controversy-over-bible-mental-disorder/59849/.)