_________________________________________________________ VOLUME 2, ISSUE 3 PSYCHNEWS INTERNATIONAL May-June 1997 _________________________________________________________ ======================================================== THE FIFTH COLUMN (2/2) ======================================================== DON'T TAKE DRUGS, TAKE DRUGS Fox Morning News, WTTG Channel 5 TV Wash., D.C. April 11, 1997 Host: Lark McCarthy, Fox News 8:12am (live) MCCARTHY: The makers of anti-depressants may soon be taking aim at a whole new market - your children. Right now, the Food and Drug Administration has not approved anti-depressants, such as Prozac and Zoloft, for those under the age of 18. But drug companies are compiling data on whether these types of drugs are safe for children. Are drug companies responding to an urgent need, or, are we in danger of relying on medication for kids instead of healthy relationships? Joining us this morning is Dr. Lise Van Susteren, a psychiatrist, and Dr. Jeffrey Schaler, he's a psychologist, and a faculty member at Johns Hopkins and American universities. Thank you both for coming in. VAN SUSTEREN: Thank you. SCHALER: Thank you. MCCARTHY: Dr. Schaler let's begin with you, because you've got some concerns about this, that it may be heading in a wrong direction, even to be looking at, you know, opening up this market. Why? SCHALER: Well, my concern is that the problem we call "depression" really has to do more with the communication gap between parents and children and not the synaptic gap between neurons. I think that parents and authorities who are important to children have more to do with the unhappiness we label as depression than anything that's chemical in the person's brain. And my concern is that when we give Prozac to children, we help them to feel less badly in a bad situation, and perhaps perpetuate problems that need to be addressed psychologically. MCCARTHY: Dr. Van Susteren, do you want to respond to that? VAN SUSTEREN: Well yes, I certainly agree. I think that there is, there are often problems between children and their parents, and there is this communication gap, I don't think there's any doubt about that. I think, however, that there is a small, subset of children who are depressed, who are depressed because they do have problems with their brain chemistry, and they can profit from medication in a very controlled setting. It's not given loosely. We don't want to give people pills instead of talking to them. MCCARTHY: Yes, let's talk briefly about what's happening now, that psychiatrists in their discretion, right, can prescribe these for children, but they are now looking at what proper dosage and doing major trials. VAN SUSTEREN: Well, there is a problem because children are different from adults. Obviously we have the same bodies, but their bodies are growing. The uncertainty is what's going to happen when you give a pill to a child who has a growing body. MCCARTHY: Would you say they shouldn't be used at all for children? How far do you go with it? SCHALER: I think they should never be used, and we should always pay attention to what parents are doing with their children. The example set is the lesson learned. I believe firmly that parents cause the unhappiness that children experience as depression. They do it two ways: One, parents criticize children too much. And two, they set an example of low self-esteem and depression that children model. Now, those are the key issues which are often very difficult to address, but are avoided if we give Prozac. MCCARTHY: How widely accepted is it that some depressions are biologically-based and can be helped by medication? VAN SUSTEREN: Well, it's very widely accepted among the majority of my colleagues. There, I think, is also acceptance among my colleagues, that there are some children who have biologic depressions just as some children have diabetes. Mostly it's adults who have diabetes. Mostly it's adults who have biologic depression. But that doesn't mean that there aren't children who have [that] also. SCHALER: The problem with that is that it sounds good but there's no scientific evidence that shows that these individuals, in fact, suffer with low serotonin levels. Depression is not listed in standard textbooks on pathology. It's still a theory that serotonin is related. Yes, Prozac helps people to feel less badly, but Prozac also helps people to feel less in general. It blunts emotion. MCCARTHY: And that concerns you. SCHALER: Oh yes. MCCARTHY: One doctor from NIH was quoted as saying, in talking about this very issue, that "pills don't create skills," in other words, pills are no substitute for building self-esteem and social skills in children. Is that one of the things ... VAN SUSTEREN: ... That is absolutely true. That is a big danger, just giving a person a pill and thinking that all of a sudden everything is going to be perfect. It's not. But I still think that there are some children who without some form of medication can't get where they want to go. So all of the talking in the world, which is very helpful, isn't going to be enough for them. MCCARTHY: ... would not be enough ... SCHALER: Well, it's peculiar, you know we're such a drug culture today. On the one hand we tell children they shouldn't use illegal drugs to change the way they feel. On the other hand, psychiatrists, parents, and other authorities tell children they should take legal drugs to change the way they feel. It's a profoundly confusing and double-message, that I think, perhaps, may create depression and confusion in kids in and of itself. (5) MCCARTHY: Is that a confusing message? VAN SUSTEREN: Well, it's confusing in the sense that we all suffer from a belief that there are easy solutions. We have technology which fixes things very quickly for us. But the important thing is to have good people, intelligent people working with children if they need to be assessed for their depression and to have an on-going sort of relationship, so you can see whether or not medication is helpful. MCCARTHY: Yes. Why don't we end it with some tips. If you have a child you are concerned about, who may be depressed, what would you recommend? SCHALER: What I would recommend is that the parent look inside himself or herself, and see how he or she is depressed, and how he or she sets an example of depression for their children, and exercises some courage in terms of introspection and talking to their kids. MCCARTHY: ... you say certainly deal with it ... VAN SUSTEREN: I think that's an excellent idea, in addition to the consideration of the individual child. MCCARTHY: All right, thank you both for coming in. I appreciate it. SCHALER: Thank you. VAN SUSTEREN: Thank you. (8:17am. Finish.) ARE YOU LYING? I DON'T THINK SO "Good Morning Washington," WJLA NEWS 7 TV Wash., D.C. April 27, 1997 Hosts: Dale Solly and Pamela Davis 8:40am (live) DAVIS: ... A major battle is brewing in the tobacco industry. We'll talk with two experts that will help us understand where that battle is headed ... Stay right there ... [8:43am] SOLLY: And good morning and welcome back everybody. The news continues now. When U.S. District Court Judge William Osteen ruled Friday that tobacco products fit the federal definition of a drug, he cleared the way for the potential regulation of those products by the FDA. He also gave the tobacco companies a slight victory though in ruling that the government could not restrict cigarette advertising. All of this comes, as you know, as government and tobacco company lawyers continue talks on a settlement that would end on-going litigation to force cigarette makers to pay smokers and states for health damage already caused by smoking. However, the smoke in this controversy is far from cleared. Joining us this morning are Dr. Jeffrey Schaler of American University, a psychologist and expert on addiction, thanks very much, and Scott Ballin, the vice- president and legislative counsel for the American Heart Association. Thanks guys, very much, for being here today. SCHALER: Thank you for having us. SOLLY: I should point out that we tried, repeatedly, to get someone from the tobacco industry in, and they told us repeatedly that they were not interested, so we apologize for that. Neither of you thinks that this idea of a settlement is a particularly terrific idea, but you come at it from very different ways. Dr. Schaler, what's the problem with it? It sounds like a good idea to a lot of people. SCHALER: Well, there are a lot of myths surrounding this whole tobacco controversy. The anti-tobacco crusaders are basically lying to the American public. They're lying in two ways: One, they're lying about what addiction really means - and this is the basis upon which the FDA is trying to regulate tobacco, and it's also the basis upon which product liability suits are being carried out - SOLLY: ... You're one of those people ... SCHALER: ... They're also lying about the relationship between liberty and responsibility, and that has very serious legal and public policy consequences. SOLLY: Mr. Ballin, are you and other groups lying? BALLIN: No, I don't think so. I think the issue of addiction is well-founded and understood by all the medical groups in this country. Dr. Koop, in the Surgeon General's report back in 1988, looked at all the evidence, every organization including the American Medical Association, the Heart Association, Cancer Society, all agree that tobacco is a highly addictive substance and should be treated as such. We're not asking for a ban on the product. We're asking that the FDA regulate this product as it does every other legal product, such as foods or other prescription drugs. SOLLY: Dr. Schaler, that sounds reasonable to a lot of people, what's the problem with that? SCHALER: Well, the problem is that what they're saying about addiction is inaccurate. They're making a political ploy, defining addiction as saying that people ... SOLLY: ... Addiction is addiction though, isn't it? SCHALER: Addiction is not addiction. It depends on what you mean. If you mean there are physiological changes in the body that occur through smoking, yes, of coursethat's true. But, if by addiction you mean people cannot control their behavior, that is absolutely false. Now, smoking is a choice, and because it's a choice it's based in values. What the FDA wants to do is regulate morality here and I am very much opposed to that. That is very much against what our Founding Fathers created this country for. SOLLY: We have about a minute left. Mr. Ballin, take out your crystal ball for us and give us your take on what's going to happen with this settlement. BALLIN: I think, first of all, the FDA issue will be upheld in the courts. It's very clear the FDA does have the authority. I think with respect to the settlement, we have to wait and see what happens. There's going to be a lot of talk and discussion going on. I think that the attorneys general who brought these suits will eventually win as well. And I think that the FDA will win. That will bring the tobacco industry to the bargaining table in a way that they've never been brought before. And I think we're going to see some major victories in public health from the settlement. SOLLY: Dr. Schaler, our last ten seconds go to you. SCHALER: I think this settlement is going to bring disaster in terms of public and legal policy. And I think that the tobacco industry should not settle. And I think the American public should be aware of what the FDA and the attorneys general are really trying to do, that is, legislate morality. SOLLY: And just for the record gentlemen, the settlement, whatever it may be or may not be, is still some ways away. So the controversy, Pamela, continues this morning. And we're going back over to Ken right now. No controversy about the weather, right? (8:47am Finish) PROZAC CURES CHAIR-SMASHING DISORDER! Wisconsin Public Radio, Madison, WI. May 1, 1997 The Kathleen Dunn Show 5:00 p.m. to 6:00 p.m. EST (live, with call-in) ... DUNN: When you say that you've seen the medication work in your school ... how does it work? You mean you've seen kids in better control? OSHKOSH CALLER: Some kids will get up and walk around the room, throw chairs, throw desks, refuse to cooperate ... and you just know that the days ... I've seen kids break desks in half, in the fifth grade, a kid broke a desk in half. On the days when they're on the meds, this is after a year, I think the worst time of your life is the first year of medication, because it's so hard to monitor something, that after it's working, and the kid's are more focused, the kid can learn and does have the ability. So I've seen it work. And again, I'm against the drugs, but if you can't help the parents, and you can't get the parents to parent properly, what can you do? SCHALER: You know, one thing I'm curious about when you bring up this example of the kids smashing chairs and breaking desks, what do you think these kids are objecting to? What do you think they're rebelling against? OSHKOSH CALLER: I would have to say, 95 percent of the cases, these kids come from backgrounds where this is common in the home place. The violence is common. SCHALER: Oh, so you think they're modeling behaviors they've learned? OSHKOSH CALLER: Right. Exactly. SCHALER: When does that ever get addressed? OSHKOSH CALLER: When does that get addressed? SCHALER: Right. OSHKOSH CALLER: It's hard for us to address it and keep our jobs. SCHALER: Yes. OK. I appreciate your honesty on that. That's certainly true. DUNN: Thanks Oshkosh very much for your call. Let's pause for a moment and return. Dr. Jeffrey Schaler is our guest, psychology professor at Johns Hopkins University, a psychologist, and we're looking at the issue of whether or not the FDA should approve the use of Prozac for children. 1-800- 486-8655, 227-2050 in Milwaukee. Twelve minutes now before five. I'm Kathleen Dunn. You're listing to The Ideas Network of Wisconsin Public Radio. ... DUNN: Dr. Schaler, if it were up to you, would you just get rid of, keep these drugs totally off the market until somebody is 18 or should they not be on the market at all ... SCHALER: Well, I'm a firm believer in the free market availability of all drugs. My concern is that people are well informed and that we have more talk shows like this which are opportunities for people to challenge the psychiatric status quo and make informed choices and not be brainwashed by psychiatrists and psychologists into thinking every problem they have has some medical origin that needs to be treated. These are problems in living. These are existential problems. And we need to talk about this in public forums. That's my real concern ... DUNN: ... yeah ... SCHALER: ... not the establishment of regulation, prohibition, etc. That's not the issue. DUNN: I'm just astounded. I don't do very many shows that have this kind of material as subject matter, but I'm astounded, just in the past hour, how many calls there were from people who were very familiar with Ritalin and with Prozac. It's obviously something that's prescribed and a lot of people are using these drugs. SCHALER: Well, we are most certainly living in what Thomas Szasz calls the "therapeutic state," where medicine and the state have become engaged in an unholy matrimony and people are feeling the effects in all aspects of their lives. So, I think that's why you're getting the response that you are. DUNN: Yeah. What do you think the FDA is going to do about this? SCHALER: I suspect they will allow it to be on the free market and prescribed, because certainly they're under a lot of pressure from physicians and drug companies to market a drug they think is consistent with psychiatric diagnosis and treatment. So I suspect it will be on the open market for children. DUNN: So those people who are supposed to be looking at the family dynamics and the school situation and a person's relationship to greater society, just are going to skip that part of their jobs and just give them drugs? Hunh? Or what? SCHALER: It's all up to you. You've got to run more shows like this. DUNN: (Laughter.) We got to find somebody else on the other side, we're going to have to do that soon. SCHALER: There are plenty of them out there, I'm sure. DUNN: Are there? SCHALER: Yes. DUNN: Do people in your profession look askance at you? SCHALER: Oh yes. I'm considered a heretic, that's for sure. DUNN: Are you really? SCHALER: And I'm sure many people in your listening audience right now would agree. DUNN: Well, you're a great talk show guest. So, I thank you for your time this afternoon. SCHALER: Well, thank you very much. It's been a pleasure. DUNN: Thanks. Our guest Dr. Jeffrey Schaler ... We'll look at the other side of this issue at some point, if not during the afternoon, then sometime in the morning during the next few days. (6) SPEAK AGAINST CONTRADICTORS In the eight examples presented, four letters and four transcripts, some form of contradiction was used to effect a political outcome. People manipulating others through contradiction claim they are helping, not hurting people. They claim they are selfless not selfish. Exposing contradiction is not cruel. There is no rough or refined way of speaking against people who contradict themselves. A sincere person without hidden motives welcomes such awareness. One may be inclined to ask dictators how they reconcile their contradictions. The question is improper: No justification or explanation for maintaining the contradiction can suffice. Contradiction is contradiction. Moreover, dictators depend on persons being confused in order to maintain power. When a person thinks, "he is contradicting himself," he should challenge the dictator and render his rhetoric null and void. If one lingers and questions the dictator's contradictions, e.g. one says to oneself "I don't understand how he reconciles the contradiction," the dictator will use that hesitation and self- doubt to say you are incapable of understanding him. The dictator uses hesitation and self-doubt to maintain power over others. This is not to suggest that every time a person fails to understand someone it's because the person he is listening to is contradicting himself. "When a book and a head collide, and the resulting sound is a hollow one, it is not necessarily the fault of the book." Reality appears contradictory to confused persons. CHALLENGE YOURSELF I spent fourteen years training in the martial arts and was fortunate to have had a good teacher. He would invite me to attack him. At first I was scared he would injure me. Then I came to realize he was the person who would not injure me - lesser "teachers" would. So I threw myself at him and learned. I think the same holds true for those we fear will expose our contradictions. At first, there is a fear of taking risks. Then follows the realization good teachers may hurt but not injure. Dictators are easily exposed by their intolerance of difference of opinion, challenge, or "speaking against." The sayings of Buddhist Rinzai assist me in understanding this. I close here with one of my favorites: One day the master and Fuke went to a vegetarian banquet given them by a believer. During it, the master asked Fuke: "'A hair swallows the vast ocean, a mustard seed contains Mt. Sumeru' - does this happen by means of supernatural powers, or is the whole body (substance, essence) like this?" Fuke kicked over the table. The master said: "Rough fellow." Fuke retorted: "What place is this here to speak of rough and refined?" The next day, they went again to a vegetarian banquet. During it, the master asked: "Today's fare, how does it compare with yesterday's?" Fuke as before kicked over the table. The master said: "Understand it you do - but still, you are a rough fellow." Fuke replied: "Blind fellow, does one preach of any roughness or finesse in the Buddha- Dharma?" The master put out his tongue. (7) NOTES 1. Addiction comes from the Latin "dicere," which when combined with the preposition "ad" means "to say yes to," or "to consent." In other words, Nancy Reagan was right. Just say no to drugs. "Dicere" is also the root of the words "abdication," "dictation," and "dictator." In "abdication," "dicere" combined with the preposition "ab" means "to say no to," "to give up," "to surrender." That is, to relinquish, to disclaim, power or responsibility. "Dictation" and "dictator" come from "dictate," which in turn comes from the Latin "dictare" frequentative of "dicere": "to say," "to tell." To dictate is to prescribe expressly and with authority, to command or give a directive (American Heritage Dictionary). A dictator is one who dictates. Since addiction accurately refers to an iron will, denoting addiction as weak will, or even impaired will, implies the opposite meaning, and thus contradiction (Schaler, in press). Thinking is metaphorical self-talk. 2. Central-route processors tend to be a more heterogeneous and higher educated population. They may be less likely to conform to the status quo, and more likely to stand alone, contradicting the group. See also Kaufmann, W. (1973). From decidophobia to autonomy without guilt and justice. New York: Delta. Peripheral-route processors tend to be a more homogeneous and less educated population. They are more likely to value the status quo and engage in scapegoating. See Szasz, T. S. (1970). The manufacture of madness: A comparative study of the Inquisition and the mental health movement. New York: Harper & Row and Freud, S. (1965). Group psychology and the analysis of the ego. New York: Bantam Books. 3. Consider the contradiction in responses to my article entitled Selling Water By the River: The Project MATCH Cover-up (available at http://userpage.fuberlin.de/~expert/FTP_1_5/PNI5_1.c). My critics assert 12-Step Facilitation Therapy (TSF) is different from Alcoholics Anonymous (AA). TSF, Motivational Enhancement Therapy (MET) and Cognitive Behavior Therapy (CBT) proved no different in reducing drinking through Project MATCH. TSF is based on AA philosophy, MET and CBT are not. Yet, TSF, according to critics, differs much more from AA than from MET or CBT! Another way of looking at this is as follows: My critics assert TSF is more similar to MET and CBT than AA is. This despite the fact more subjects in the TSF group attended AA than those in the CBT and MET groups! Note: All subjects in Project MATCH attended AA during the study. See also Bruce Bower's article entitled "Alcoholics Synonymous," which appeared in the January 25, 1997 issue of SCIENCE NEWS, 151 (available at http://www.sciencenews.org/sn_arc97/1_25_97/bob1.htm); and Stanton Peele's recent article entitled "Pimping Project MATCH" (available at http://peele.sas.nl). 4. See "Should Employers Have To Accommodate The Mentally Ill?," Program #202 of DebatesDebates, taped June 3, 1997, aired on PBS television the week of July 9, 1997. Information available at http://www.debatesdebates.com 5. "So here's an ethical dilemma: Is it wrong to make people who aren't sick feel better? Is it more wrong if they are children? Yes, says Dr. Sidney Wolfe, director of health research for Public Citizen, a public-interest group in Washington, D.C. 'How can you tell kids to 'just say no' to drugs when everything in the culture, when every drug ad, is telling them tranquilizers will make them more normal? Talk about a conflicted message!'" (Leonard, May 28, 1997). Synchronicity? 6. A cassette tape of this one-hour show is available through The Radio Store, 1-800-486-8655. Ask for program 5/1/L, The Kathleen Dunn Show, May 1, 1997. 7. Fuke story adapted from (1975) The zen teaching of Rinzai, translated from the Chinese by Irmgard Schloegl. Berkeley, California: Shambala. REFERENCES Becker, E. (1973). The denial of death. New York: Free Press. Husemann, F. (1977). Das bild des menschen als grundlage der heilkunst. Stuttgart (Germany): Verlag Freies Geistesleben. Quoted in Bott, V. (1984). Anthroposophical medicine: Spiritual science and the art of healing. New York: Thorsons Publishers, Inc., p. 66. Leifer, R. (In press). The psychiatric repression of Dr. Thomas Szasz: Its social and political significance. Review of Existential Psychology and Psychiatry. Leonard, M. (1997). Children the hot new market for antidepressants. The Boston Globe, May 28. Orwell, G. (1981). Nineteen-eighty four. New York: New American Library. Schaler, J.A. (In press). The case against alcoholism as a disease. In W. Shelton and R. Edwards (Eds.) Values, ethics, and alcoholism. Greenwich, Ct.: JAI Publishers. Szasz, T.S. (1997). Medics in the war on drugs. Liberty, March, Vol. 10, No. 4. -------------------------------------------------------- Jeffrey A. Schaler, Ph.D., is an adjunct professor of justice, law and society at American University's School of Public Affairs in Washington, D.C.; an adjunct professor of psychology at Montgomery College in Rockville, Md.; and teaches psychology for Johns Hopkins University in Baltimore, Md. He lives in Silver Spring, Md. jschale@american.edu