An inherent aspect of financial capitalism is the perpetual creation of new needs: instilling dissatisfaction and
converting commodities that we might want into those we must and should have. Thus we are continually
bombarded by advertising that seeks to create and play upon dissatisfaction. As the sociologist Professor Bauman
writes: “Consumers must never be left to rest” and “need to be constantly exposed to new temptations to keep them
in the state of perpetual suspicion and steady disaffection 4." Misinterpreting this as depression and prescribing
antidepressants is not going to address the societal de-pression that is a natural response to this. Furthermore, our
sense of identity can be closely aligned with the goods we have: the pressure is on to have and to conform.
Like it or not, marketing tries to entice, seduce and deceive us. Working with children, I frequently ponder the impact
of growing up in a world like this. As a consumer culture offers the promise of instant gratification, it is not surprising
that there is an unrealistic expectation that pills will quickly solve our emotional troubles.
Sadly, I meet many families where one or other parent seems able to move on (sometimes without warning in the
middle of the night) – leaving their children as if they are mere commodities and starting off with a new partner and
life. Is this an aspect of an exploitive and self-interested belief system – consumer capitalism – whereby
relationships can be discarded as outdated commodities?
Market forces and drug promotion – Profits before people
Not only is it helpful to understand ourselves within the context of our lives, it is also helpful to understand mental
health treatments within a societal, political and cultural context.
The facts show that we can’t believe all that we are being told - big business backed by aggressive marketing can
powerfully shape our thinking. We need our wits about us when it comes to the pharmaceutical industry who
“largely control the research agenda, i.e., what gets done as research and what gets reported in the journals and
they suppress what is contrary to their constricted self-interest 5." The drug companies are there primarily to
make a profit and our healthcare (including our mental and emotional well-being) is not necessarily their priority.
As Professor Valenstein writes: “Pharmaceutical companies almost always exaggerate the effectiveness of their
drug while tending to minimise their adverse side effects.” This is done by selectively citing the best results “and by
placing their own ‘spin’ on the way the data is presented 6." As we take the opportunity and time to understand
our lives in context, it would be naïve to assume that all the medicines (including those for mental health concerns)
are as safe and effective as we had hoped. We need accurate information to weigh up the risks. Unfortunately even
our doctors are largely reliant on information that is doctored by the drug makers.
Professor Tim Kendall, joint director of the National Collaborating Centre for Mental Health, points out that "In mental health
85% of all published trials are funded by the drug industry 7." It is also recognised that drug company
promotional literature (and bias) influences doctors’ prescribing much more than they realise and “they often use it
as a source of information about new medicines 8." 9, 10.
Guardian columnist Dr Ben Goldacre summarises some of these key concerns in an interview for The Economist:
“Pharmaceutical firms routinely bury unflattering trial results and publish only the good ones. Those trials are run on
unrepresentative patients, with dodgy statistical analysis, and then pushed on doctors with advertising budgets that
are often bigger than those of the firms' research-and-development arms. Meanwhile, medicine’s guardians—the regulators, the scientific journals, the professional bodies and the academic
establishment—either collude with such practices or turn a blind eye. The net result is that doctors must prescribe in
ignorance, patients are harmed, and vast amounts of money are wasted 11."
Beginning to understand our lives within their social and cultural context is a good place to start
As we have seen, our lives are largely shaped by the people and culture in which we live. I realise we have barely
touched the surface and there are many more questions that could be asked, for example: what is it like to be a
woman in such a male dominated society? What is the impact of growing up in a minority group? What about our
society's preoccupation with slimness and body image? These and many other matters lead to issues that are often
inappropriately diagnosed as if there was some failing or deficiency within the person rather than within our society.
The fact that prescription drugs are poorly regulated and that the drug industry is known to be economical with the
truth (their track record is reflected in the multimillion dollar fines against then, see here) leaves us uncertain as to
the safety and effectiveness of the mental health drugs on offer through our doctors. Personally, this makes me very
cautious and supports the need to search out reliable research data that is, as far as possible, independent of the
Of course there are other commmercial interests that influence our lives and thinking. The parenting industry is
marketing an over-simplified and sometimes unrealistic view of raising children that is popularised by TV
programmes. As with much of the rest of modern life, parenting is reduced to a series of problems to be solved and
techniques to be mastered. The wider picture and the subtleties of relationships are often missed.
The jury is out regarding the impact of genes and brain chemistry on emotional
or mental distress and disturbance. What is beyond dispute is that the cutural,
social, ethnic (including discrimination), familial, interpersonal and economic circumstances (social inequality included) of our lives have
an enormous impact on our mental and physical well-being. More specifically,
injustice - including various forms of abuse - may have been experienced.
In reality, our lives are largely shaped (and miss-shaped) by our experiences of life. Drugs (prescribed or illicit) can't mend the hurts of childhood violence
and abuse, or the circumstances that surround the anxiety, stress and distress of
modern-day living. But if we have
(incorrectly) been told that our emotional and
psychological concerns are caused
imbalances in the brain [more here], we are less likely to seek out and
discover other ways of finding balance
in our lives.
I recognise that as a society we have a tendency to favour medical explanations for our mental and emotional concerns. As the evidence supporting this approach is poor, maybe beginning to understand our lives within their
social and cultural and everyday context is a good place to start.
References - Bibliography - Further reading
1 Psychiatric Imperialism: The Medicalisation of Modern Living. Academy for the Study of the Psychoanalytic Arts. Full article
2 Thomas, P. (1997) The Dialectics of Schizophrenia. UK:Free Association Books
3 Harvey, D. (2010) The Enigma of Capital and the Crisis of Capitalism. London: Profile Books Ltd
4 Bauman, Z. (1999) The Self in a Consumer Society.
5 McHenry, L. (2008) Biomedical Research & Corporate Interests: A question of academic freedom. Mens Sana Monogr. Jan -
Dec 2008, p146-156. Full article
6 Valenstein, E.S. (1998) Blaming the Brain: The truth about drugs and mental health. New York: The Free Press.
7 The Guardian
8 WHO Dept of Essential Drugs and Medicines Policy (EDM) and Health Action International (HAI). (2004) Drug promotion: what
we know, what we have yet to learn.
9 Lexchin, J. et al. Pharmaceutical industry sponsorship and research outcome and quality: sytematic review. BMJ Vol 326 2003. Full article
10 Brodkey, A.C. (2005) The role of the pharmaceutical industry in teaching psychopharmacology: a growing problem. Academic
Psychiatry 2005; 29:222-229. Full article
11 The Economist