It was way back in 1972 on a pleasant autumn day. As I stepped out of the sparkling sunshine into the shadowy confines of the Coney Island Child Psychiatric Clinic, I was greeted by three people who could have been movie actors. One was a beautiful social worker in her late twenties, with flowing brunette hair; another, a tall, handsome psychologist in his early thirties; and the third, a psychiatrist who looked like he was trying out for a part as Sigmund Freud, with his long, graying beard and pipe. Initially they were warm and friendly but, within a few minutes, switched to more earnest expressions. The psychiatrist took charge at this point, informing me that I would be working with eight very troubled male teenagers—two individually, and six in a group. My first job teaching conflict resolution under the auspices of a real life professional organization had begun.
It was a period of time before the current practice of converting the psychological concerns of all children brought to a psychiatric clinic into a language of illness believed to be due to chemical imbalances. The prescribing of pills as the main—oftentimes only—action offered was something I had never dreamed of. Instead, a staff of professionals and several advanced psychology students from Brooklyn College sought to provide empathic emotional support, understand the conflicts the children were experiencing, and guide them toward more mature coping. I was one of the Brooklyn College students.
Achieving the first two goals proved to be a breeze. The kids’ hunger for attention made it easy to develop genuinely enjoyable relationships. And the way the boys spoke and interacted readily revealed volumes on the topic of conflicts with which they struggled on a daily basis. Guiding the boys toward more mature coping, however, tripped me up.
I remember one of my first attempts. A burly thirteen-year old boy with wild, unkempt hair began to express his anger about a kid at school who had called him a jerk.
“Called you a jerk!?” I replied. “Yikes! What did you do about it?”
“I shoved him.”
“How’d that work out?”
“I got sent to the principal.”
“Do you like to get sent to the principal?”
“NO!”
“Hmm, if you don’t like it, maybe we can figure out how to respond to a name caller in a better way.”
“If someone puts me down, I ain’t gonna let him get away with it.”
“I can understand that. Let’s discuss a few ways to deal with name calling that doesn’t let the other guy get away with anything and yet won’t get you sent to the principal’s office.”
“Na. If that guy calls me a name again, I’m really gonna let him have it! He better not start with me again!”
“I can see just thinking about this is really making you angry.”
“Yeah, it is!”
“Well, I have good news for you. I think I can help you to come up with some ways that you can handle name calling that you would respect but won’t get you in trouble. Wouldn’t that be a good thing?”
“Listen, I don’t wanna talk about this anymore!”
At this point, I realized that, for now, to pursue this any longer would be counterproductive.
Shortly after this, I noticed that the two black kids in the group I was working with were frequently being put down by the four white kids.
Some words got thrown back and forth that could have made a Brooklyn boy blush. Well, okay, maybe not a Brooklyn boy, but most people. Anyway, my efforts to address this were, unfortunately, met with the boys shouting over me as their anger flamed into rage.
“You’re doing just fine,” my supervisor assured me. “Working with kids requires great patience.”
I would have preferred specific suggestions on how to better teach. Still, his comments at least temporarily took some pressure off of me.
But as time went on, my patience waned, and I began to have difficulty falling asleep. In the wee hours of the morning my mind kept going over and over incidents in which my efforts to teach something to the kids ended without success. And then, during one such night, amidst an experience of what felt like endless tossing and turning and excruciating frustration, suddenly I recalled an incident that happened to me in fifth grade. Back then I had recently seen the movie, The Pride of the Yankees, with Gary Cooper starring as the New York Yankees’ great baseball player, Lou Gehrig. Nicknamed “The Iron Horse,” Gehrig had his Hall-of-Fame career cut short at 36 years of age when he was stricken with a fatal disease. As the film comes to an end, it reenacts Gehrig’s farewell address in front of a packed, tearful crowd at Yankee Stadium. I’ll never forget his parting words. “People all say that I’ve had a bad break. But today…today I consider myself the luckiest man on the face of the earth.”
Shortly after seeing the film, I decided to read a Lou Gehrig biography and learned that his parents were from Germany. Because I had grown up on war movies that depicted Germans as the vicious enemy, I had, at that time, come to hate Germans. But, when I began to read Lou Gehrig’s biography, I found my hatred undergoing a dramatic change. The story tells us that Lou’s parents were from Germany, spoke with a German accent, and this led the kids in his neighborhood to incessantly torment him.
Somehow, my heart went out to Lou, and from that day on, I came to believe that it wasn’t right to judge a person by their nationality.
Lying in bed recalling having read that biography so many years ago, my mind, at one point, returned to thinking about teaching kids coping skills. It seemed to me that there was something about that Lou Gehrig story that enabled me to reconsider attitudes that I had firmly held for so long. Perhaps if I could tell the kids at the clinic stories about a hero who portrayed higher levels of maturity, they might identify with the hero. I figured that kids like to try out the behaviors of their heroes. I know I did. Criticizing the actions of characters in the story would produce less defensiveness than when I had directly criticized the actions of the kids at the clinic. If I told the stories when the clinic kids weren’t already in a defensive state, maybe they would be open to a real discussion. Once they had thought the issues through, perhaps then they would be better able to integrate what they had learned into their own lives.
Soon afterwards, each time I saw the kids at the clinic dealing with a different conflict in a way that struck me as immature, a story dealing with the conflict in a more mature way just came to me in some strange, effortless manner. The hero of the stories, Cool Steve, has many of the attributes that the clinic kids admired.
I made it a point to tell each story at some point in our session when things were relatively calm. And it turned out that the kids loved them. When I told the stories to the group of kids I worked with—kids well known for their rambunctiousness—they settled right down and you could hear a pin drop as the tale unfolded. They discussed them, grappled with the issues, and oftentimes came to agree that Cool Steve had handled the conflict in a way they respected.
An interesting discovery that I made when I was teaching conflict management to graduate students at the University of Minnesota was that the adult students there enjoyed the stories every bit as much as teenagers. And so, with that encouragement, the stories grew and grew so that they now comprise a series of three novels collectively called The Cool Steve Stories that you can learn about HERE.
Readers of this blog know that as I provide lessons on conflict management, I often illustrate the ideas with newspaper comic strips. Although these comics are very helpful for introducing basic ideas, to really learn the subtleties of applying the ideas of conflict management in actual situations it is hard to beat the longer narratives that novels provide.
The first novel in the trilogy is A Hero Grows in Brooklyn. Most of the action occurs when the main characters are junior high school students. If it was a movie, it would likely be rated “PG.” Fights in the Streets, Tears in the Sand, the second novel in the trilogy, deals with some more mature themes. The main characters are now beginning an urban high school and there is a modest amount of cursing, and some talk about sexual feelings and fantasies. It would probably be rated “PG13” if it was a movie. Love, Sex and Respect, the final novel in the trilogy, takes the main characters through to their high school graduation. If the book was a movie, it might be rated “R.”
You can learn more about the novels at this blog’s NOVELS page toward the top of this page. There you will find that the first novel in the series can be downloaded for free on any iPad, Nook, Kindle or computer, or you can order a paperback version HERE.
I encourage my students to check these books out because they provide memorable adventures that are not only fun and exciting, but teach some profound lessons as well.
Have a great week!
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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.
The evidence supporting learning these skills includes studies demonstrating that prolonged stress is related to adverse psychological and physical health effects, as well as an increased risk of premature mortality (See 
There is some support for the “more skillful” theory. For example, in the Keller, et al. article, most of the people that these researchers studied believed their stressful experiences could make them ill, and indeed these folks did often experience more illnesses when they faced high chronic stressful experiences. However a resilient subgroup of individuals tended to not support the stress-illness connection. When faced with high stress, they had learned to believe that the physical sensations they experienced with stress was their body’s way to help them to rise to the challenges that they face.
The skeptics would like to see studies that first identified people who were having ill effects from too much stress, and then, after learning stress management skills, they ended up having better health outcomes than a randomly assigned control group who were not taught these skills. Without such studies, it can be argued that it is just a coincidence that those who appear to be skillful at dealing with stress happen to be individuals who are also healthier. These skeptics point out that there are already a few randomly controlled studies that have been completed that provided some brief stress-skill training to people experiencing heart problems. The results from these studies turned out to be discouraging.
Circulation, one of cardiology’s premier journals, published an article on March 21, 2016 titled, “
Patients engaged in aerobic exercise three times a week for 35 minutes. Patients also received education about coronary heart disease, nutritional counseling, and two classes devoted to the role of stress in this disease.
Patients in CR+SMT received the identical comprehensive CR intervention plus SMT. The SMT program combines education, group support, and cognitive-behavior therapy. The intervention is delivered in 12 weekly one and a half hour sessions in groups of 4 to 8 participants. Strategies for reducing demands are presented including prioritizing, time management, establishing personal values, and avoidance. Participants are encouraged to apply the skills that they have learned to address their own everyday problems.
Subsequent sessions focus on modifying responses to situations that cannot be readily changed. Several sessions are devoted to training in progressive muscle relaxation techniques and the use of visual imagery to reduce stress. Emphasis is placed on the importance of cognitive appraisals in affecting stress responses, with recognition of irrational beliefs and cognitive distortions such as overgeneralization, catastrophizing, and all-or-nothing thinking.
Hopefully, the above discussion will increase the chances that you will take up the challenge of mastering stress management skills. I can tell you that from my own experience it is possible to transform many old entrenched habits, which typically escalate stressful experiences, to new ones that leave me in a far more comfortable state of mind.
Many soon become cognitively convinced of this, and yet the next time they come in contact with such a snake their bodies still become as stressed as ever. Such individuals, with guided practice, and a little patience, do learn to become comfortable when they see nonpoisonous snakes.
I suggest the following format for such groups. Everyone in the group would come prepared having read the post that will be discussed for the week. After 5 minutes of greeting each other, take twenty minutes to have a group meditation. A simple form of meditation is described 
William James explained that certain children, if they do not succeed immediately in doing something just right and are then criticized, flare up in anger and refuse to cooperate. Such children are oftentimes treated as sinful and are punished; or else the parent pits his or her will against the child’s will.
“It is in no other way that we overcome balkiness in a horse,” said James. “We divert his attention, do something to his nose or ear, lead him around in a circle, and thus get him over a place where flogging would only have made him more invincible.”
Well, it just so happens that if you use the William James approach consistently, you really don’t reinforce balkiness because children soon realize that they have not won. They simply come to the understanding that “dropping the subject” does not mean that anyone has won. Instead, they soon connect the “dropping the subject” fact with the “bringing the topic up again later” fact. Dropping the subject, comes to mean their parents will be returning to the subject after they and their parents have some time to calm down and think about the issues in a more calm state.
See to it now, I beg you, that you make freemen of your pupils by habituating them to act, whenever possible, under the notion of a good. Get them habitually to tell the truth, not so much through showing them the wickedness of lying as by arousing their enthusiasm for honor and veracity. Wean them from their native cruelty by imparting to them some of your own positive sympathy with an animal’s inner springs of joy. And, in the lessons which you may be legally obliged to conduct upon the bad effects of alcohol, lay less stress than the books on the drunkard’s stomach, kidneys, nerves, and social miseries, and more on the blessings of having an organism kept in lifelong possession of its full youthful elasticity by a sweet, sound blood, to which stimulants and narcotics are unknown, and to which the morning sun and air and dew comes as sufficiently powerful intoxicants. 
The general idea here is that in the arena of the moral life, whenever a positive ideal is aroused, it is as if the whole scale of values change its equilibrium. As James makes this point, he declares that at such times, “The force of old temptations vanishes, and what a moment ago was impossible is now not only possible, but easy.”
Middle school students can read A Hero Grows in Brooklyn on their own, and it can be downloaded on a computer or any of the popular electronic readers for free 
“Be patient, then, and sympathetic with the type of mind that cuts a poor figure in examinations. It may, in the long examination which life sets us, come out in the end in better shape than the glib and ready reproducer, its passions being deeper, its purposes more worthy, its combining powers less commonplace, and its total mental output consequently more important.” 
So, that said, in what is to follow, I’m not suggesting that the first time you lose your temper with your kids you have suddenly turned them into a future serial murderer, or anything of that sort. Both of my boys are now fully grown, and they are wonderful. Nevertheless, I do think it is worthwhile for parents to think about the most helpful approaches for bringing up their children, and to be guided by the best information available.
According to the most recent UNICEF study, 80% of children are spanked or otherwise physically punished by their parents. Is this a wise way to be raising children?
As this body of work on spanking and physical punishment has accumulated, supporters of spanking have argued that the current studies do not clearly distinguish spanking from more serious physically abusive parenting behaviors. They claim that it is probably only “real physical abuse” that leads to harm. Additionally, spanking, they have argued, has only been linked with detrimental outcomes in methodologically weak studies.
First, they looked separately at studies of parents’ behaviors labeled as “spanking” defined as noninjurious, open-handed hitting on the buttocks or extremities with the intention of modifying child behavior. This definition therefore excluded the use of objects, the use of methods that have a reasonable expectation of causing harm or injury (e.g., beating, burning, choking, whipping), and the use of methods that are gratuitous expressions of parent displeasure without a clear disciplinary component (e.g., pulling hair, shaking, shoving). In this way, the researchers were able to determine the extent to which ordinary spanking is linked with child outcomes.
Then they examined the ways in which the strength and direction of the associations between spanking and child outcomes compare with the strength and direction of the associations between clearly abusive methods and child outcomes.
Spanking was associated with more aggression, antisocial behavior, externalizing problems, internalizing problems, mental health problems, and negative relationships with parents. Spanking was also significantly associated with lower moral internalization, lower cognitive ability, and lower self-esteem.
As expected, although spanking was associated with negative outcomes, physical abuse was found to have even greater negative outcomes. Said in a more technical manner, weighted mean effect size for spanking was d .25, while for physical abuse it was d .38. Both were significantly different from zero and both were positive in sign, indicating that both spanking and physical abuse were associated with greater levels of detrimental child outcomes. The magnitude of the mean effect size for spanking was 65% of the magnitude of the mean effect size for physical abuse.
Four of the studies compared adults who were spanked as children to those who were not. In three of the four, adults with a history of spanking from parents had more difficulties with controlling antisocial behavior, had more mental health problems, and came to believe physical punishment was a proper discipline strategy for their children.
Now, as consistent as these findings are, they could very well have been far stronger if they had looked separately at a group of parents who not only didn’t use any form of physical punishment, but also didn’t use other forms of harmful approaches for raising kids. Said another way, within the group of non-spanking parents there may have been some who don’t spend much quality time with their children, or most frequently interact with them by screaming whenever they catch them misbehaving. If those parents were eliminated from the group of non-spankers, the difference between non-spankers and spanking parents probably would have been even far more impressive. Why do I say this? For several reasons.
In another 
This is one of the reasons I’ve written a novel called A Hero Grows In Brooklyn. It can be downloaded on a computer or any of the popular electronic readers for free 
Just because some people have a difference in their genetic makeup that might be involved in a specific behavior pattern does not mean these people have a disease. I know that some say, it is only if the behavior pattern can be linked in some way to some risky behavior would we properly label those with such a pattern, diseased. But the risky descriptor is highly problematic for the following reason:
Let’s say we can find a reliable gene difference in some people who enlist in the military. We then find that joining the military places these people at greater risk of harm, and even death. Would the finding of this type of connection require us to say that this means all who join the military have a genetic disease? I think that would be wrong and unfair.
How about being a male? Being a male is clearly due to some genetic difference when compared with the other sex. Males are clearly at a greater risk of violence, and they are more prone to dying from a number of diseases at an earlier age than women. Therefore, does it make sense that all males have a genetic disease? Not in my opinion.
These include tumors, microbe infections, tissue tears, bone fractures, and blockages to organs such as the heart. If some genetic difference is correlated to one of these pathological conditions, we say that the genetic difference is a risk factor for the particular disease.
With regards to the individuals who are now being classified as having ADHD, the vast majority have no identified scientific pathology. Moreover, often we find that once they get out of a setting in which they are forced to sit in school for hours and hours, they find a career and life style that many value.
In my view, the motivation behind physicians classifying the behavior pattern now referred to as ADHD has nothing to do with science, but rather, to make money. The pharmaceutical companies make billions of dollars by promoting the disease concept of ADHD, and many physicians have found their medical practice has enormously benefited as well.
In contrast, Director Martin Scorsese put out a statement saying he was “overjoyed” that Dylan was awarded the prize. He went on from here to say:
Alfred Nobel was the inventor of dynamite and was one of the original (to quote from one Dylan song) “Masters of war/You that build the big bombs” — i.e. he not only was a major producer of modern cannon, but also was one of the first modern armament producers. In addition, a premature obituary of Nobel, calling him a “merchant of death,” presumably inspired Nobel to turn philanthropist by creating the prizes.
If he ends up landing on the other side, he’d end up in the mucky manure of folks who think that he would be disrespectful of a bunch of fine folks, such as Martin Luther King, Jr. and Albert Einstein. Such folks were as passionate as anyone with regards to promoting peaceful ways to work out human problems and yet chose to accept a Nobel Prize.
At 39-years of age, Ron had been a respected employee in a department store for nearly ten years. If he had made it to ten full years, he would have qualified for some extra benefits. Upper management chose to replace him with someone new a week before the ten years were up. Discovering that landing a new job was leading to one rejection after another, Ron fell into an anguishing depression.
“You’ve been paying for mental health coverage on your health policy for over fifteen years. You might as well take advantage of it and see if a professional can help you through this.”
At his first appointment with Dr. Sigmund, a cigar smoking psychologist, Ron discovered that to access mental health services with his health policy, he would have to be labeled as a person with a mental disorder. “I don’t want that kind of nonsense in my medical record,” he told Dr. Sigmund. “I’m not mentally ill! I’m just going through some tough times right now and I can use some professional help getting through this.”
“Listen, Doctor, I’ve been paying for this mental health coverage for years and no one ever told me I had to be given a stigmatizing label to access services. That’s not fair.”
In fact we have recently learned that these disorders are properly viewed as genetic diseases. The evidence is pretty plain. We have learned that these types of conditions run in families, and genetic research has even identified the actual genes that are involved.”
First, Dr. Sigmund declares that “Without a mental disorder diagnosis, which I must place on the insurance form, I can’t see you.” This is pretty often true. In the United States, if you want to take advantage of your mental health insurance coverage, insurers require a mental disorder diagnosis [see 
In my opinion, it is not sound science that came up with these types of labels, but rather, a business model that serves the pharmaceutical industry and psychiatry. Psychologists have gone along with the plan for practical reasons. Additionally, some actually are convinced that the labeling system is indeed based on principles of science. For a full critique of their position, see 
In the parable, Dr. Sigmund declares that “these disorders are properly viewed as genetic diseases.” Is this a fair statement? The simple answer is no. To reasonably arrive at this answer, we’ll have to spend some time going step by step through some basic ideas.
Even identical twins won’t always have the same set of these types of characteristics despite the fact that a pair of identical twins have the same set of genes.
To understand why the answer is no, we have to first understand that all species have a great number of characteristics, and each of their characteristics vary to some extent between different members of their species. For example, human beings have a typical height, they can run at a typical speed, etc. The average height of male humans is about 5 feet, 9 inches. Some, men are, however, somewhat taller, others are somewhat shorter, and some are quite a bit taller or quite a bit shorter. Similarly, some men can run at the average speed for men, while others can run at various rates that are different from average.
If someone is above average in height, this does not mean he or she will be above average in running speed. Each of our numerous characteristics can be either within the average range, above average, or below, and because someone is below average in some set of characteristics does not mean that he or she will not have some characteristics that are average or even above average. And these differences are a great boom to the human race. If everyone was brilliant in academics and also had a strong genetic desire to be a professor at Ivy League universities, who would build the roads, drive our trucks, grow our crops, serve in law enforcement, cut our hair, tend to the sick, serve as fire fighters, staff stores, serve us in restaurants, etc.? People with different interests and talents enhance our own lives.
If you do end up shorter than average this does not mean you have a genetic disease, even if we can demonstrate that taller people tend to have some advantages over people who are shorter. Saying that people who are shorter than average have a dysfunction would be stigmatizing while clouding the fact that we cannot determine a person’s overall functioning based on just one set of characteristics. Being shorter, when combined with the rest of a person’s characteristics, can lead to him or her being more useful in a variety of ways.
Let’s move on now from discussing a person’s height to a more complex set of characteristics–athletic performance. There is some evidence that athletic performance might be a set of characteristics that, to some degree, 
Rather than pathologizing below average athletic skills, I’ve seen physical education teachers who encourage such children to participate in some after school programs that develop skills in sports that can be practiced non-competitively, such as running, bicycling, and golf. Some of these children take to such programs willingly and end up staying in fine physical shape the rest of their lives. If they don’t, they suffer the consequences and all of us end up paying higher health premiums because they are at an increased risk of getting sick. At the same time, their other sets of characteristics, when combined with their couch potato ways, may offer them and the rest of us some valued fruits.
I know that some psychologists say, it is only the sets of characteristics that can be linked in some way to a “dysfunction” that are properly labeled as a disease. But the dysfunctional descriptor is so vague that it can be applied to the vast majority of people, and, perhaps, everyone.
How about becoming a psychiatrist? This may run in the family. If we find that becoming a psychiatrist increases the likelihood of committing suicide, which some data suggests, are all of them to be viewed as having a genetic disease, or would it be clearer, and more scientific, to say their set of characteristics is a “risk factor” for some negative outcome? I believe the latter is more scientific.
Instead, psychologists have a conversation with the person seeking mental health services.
As I read the research on this issue, it became plain to see that genes can be likened to the buds of a beautiful flower. If they meet up with the right soil, sunlight, water, and care, they typically blossom into something beautiful. But even with a great deal of wonderful nourishment, sometimes they get tangled up with some surrounding weeds. Stigmatizing labels don’t help in such situations. Instead, some wise gardening can make a beautiful difference.
Dr. Kandel’s credentials are pretty impressive–he’s a Nobel Prize laureate and professor of brain science at Columbia University. Therefore, if you are among those who believe a person’s credentials should determine who is right and who is wrong, you need not read any further. You must simply conclude that what is referred to as mental illnesses are indeed brain diseases because you would be hard pressed to find someone with better credentials disagreeing with Dr. Kandel.
The argument that such labeling practices are not scientific, but, rather, value judgments, was intelligently made by William James when he defended the religious sentiment. He explained that pathologizing these sentiments as mental diseases was superficial medical talk. He called the reasoning doctors used to declare religious beliefs a type of mental illness, “medical materialism.”
assumes as a convenient hypothesis that the dependence of mental states on bodily conditions must be thoroughgoing and complete. If we adopt the assumption, then of course what medical materialism insists on must be true in a general way, if not every detail…. But now, I ask you, how can such an existential account of facts of mental history decide in one way or another on their spiritual significance? According to the general postulate of psychology just referred to, there is not a single one of our states of mind, high or low, healthy or morbid, that has not some organic process as its condition. Scientific theories are organically conditioned just as much as religious emotions are; and if we only knew the facts intimately enough, we should doubtless see “the liver” determining the dicta of the sturdy atheist as decisively as it does those of the Methodist under conviction anxious about his soul. When it alters one way the blood that percolates it, we get the Methodist, when in another way, we get the atheist form of mind. So of all our raptures and our drynesses, our longings and pantings, our questions and beliefs. They are equally organically founded, be they religious or of non-religious content.
All states of mind are related in extremely complex ways to neural functions. There is a crucial distinction to be made between a brain difference and a brain pathology. The significance of each state of mind must be tested, not by some neurological difference, but by the value of its fruits. When the term “pathological” is applied to an experience, rather than an identified physiological pathology, it wrongly implies a neutral science classification.
In contrast to biological arguments, 
Today, if your behavior, thoughts, or feelings begin to concern you or a family member, for a fee many doctors will translate your experiences into mental illness terminology. Synonyms for mental illness, are mental disease, mental sickness, mental disorder, and psychopathology. These terms, as metaphors for experiences someone doesn’t like, have been with us for centuries. When used in this way, it can communicate something about an experience that others relate to. However, when we move from using these types of concepts as metaphors to believing wholeheartedly that they are proper scientific terms, we begin to lose the respect of those well grounded in the principles of science.
Let’s consider The Tragedy of Hamlet, Prince of Denmark, which William Shakespeare wrote in about 1604. This play offers its audience a magnificent tale of adultery, fratricide, revenge, and feigned madness by a protagonist. When reading Hamlet, we see how Shakespeare uses metaphors to vividly evoke in us the experiences of his characters. Thus, when Hamlet becomes dissatisfied that his mind keeps identifying flaws in his plans for action, he describes these plans as becoming “all sicklied o’er with pale cast of thought.” By extension, the reader senses that when Hamlet’s plans become “all sicklied o’er,” he, too, becomes in a sense, “sicklied o’er” with feelings of frustration, anguish, and helplessness.
Literature regularly uses this type of metaphor. Ralph Waldo Emerson, to take another example, once wrote:
I actually like Emerson’s disease terminology here because the context in which he uses it so obviously reveals that he is using it metaphorically. Notice how he cleverly uses diseases associated with childhood to evoke the feeling that individuals who worry themselves over problems of original sin and so on are acting, in his view, childishly. In this context, disease, to Emerson, was a metaphor for immaturity. If he were a man of science, in contrast to a literary personality, we would expect that he would use terms with clearly defined, objective meaning, that avoid value judgements.
At the time, medical writers were already heavily pathologizing a great number of experiences. Thus, James cited W. Griesinger, the author of The Pathology and Therapy of Psychological Illnesses, and T. S. Clouston, author of Clinical Lectures on Mental Diseases. As James delved further and further into the experiences being pathologized in this way, he came to believe such terminology was “simple minded” and “superficial medical talk.”
Does it make sense to say that when people are suffering, they have a “mental disorder?” Well, consider the experience of giving birth. It is typically accompanied by suffering, and yet it makes more sense to classify this experience as a natural part of creating new life rather than a pathological condition.
When writers receive rejections from publishers, or a loved one dies, suffering often accompanies these experiences. Yet, we do not typically describe them with pathological terms.
For example, cortisol levels in saliva and heart rate variability has some connection with a person’s self-reports of how much stress they have experienced in recent days, while hair cortisol levels have some connection with longer term exposure to stressful experience. Other measures of stress utilize a list of stressors, such as the recent death of a loved one, living in poverty, etc. The person being assessed places a check mark next to each of the stressors on the list that applies to him or her. These check marks are then used to calculate how much stress the person has been experiencing.
Having indicated some of the problems of unambiguously, and non-subjectively applying the descriptors of suffering to the concept of mental disorder, we now turn our attention to the descriptor, “dysfunction.” As with the notion of suffering, the pathologizers almost never use the various scientifically validated measures of functioning to determine if someone has a mental disorder. A pretty good such measure is the Scales of Independent Behavior-Revised. It has norms for functioning in such areas as social interaction (communication skills, language comprehension, language expression), personal living skills (eating and meal preparation, toileting, dressing, personal self-care, domestic skills), community living skills (time and punctuality, money and value, work skills), and gross and fine motor skills. Rather than using measures of this type, pathologizers rely on their professional privilege to make a subjective estimate of dysfunction.
In the most current edition of the DSM, someone who is experiencing abnormal levels of distress might be considered to have a mental disorder. But the issue of the boundary between normal and abnormal experiences lies at the heart of the most contentious disputes in the field of psychopathology today. A major problem with using the term abnormal as one of the defining attributes of mental illness is that it leads us to forget the fact that natural to all organisms is substantial variability across individuals and within individuals. Having above average or below average functioning in various areas of our many areas of functioning is normal. Displaying rare behavior patterns that are highly valued, such as the great altruism of Mother Teresa, are not viewed as mental disorders. Psychopathology is applied when someone does not like a particular experience. Thus, a term that masquerades as a scientific term is really a value judgment masquerading as a scientific term.
Although there are some fairly well developed scientific measures of the three major factors (suffering, functioning, and abnormality) that the psychopatholgizers tend to claim are usually part of the mental illness experience, these measures are almost never used in their “diagnostic” determination. Instead, subjective indicators of these three factors are combined into an even more subjective abstraction called “mental illness.” This process is not scientific despite claims to the contrary.
Rather than a scientific concept, the mental illness concept has been very useful as part of a highly lucrative business plan for the pharmaceutical industry and medical doctors, which includes psychiatrists. This plan has doctors first convincing people that the experiences referred to as mental illnesses are scientifically real illnesses just like physiological pathologies. It then provides license for doctors, in as little as fifteen minutes, to declare that they have provided their patients a diagnosis, and to send them on their way with a prescription for pills. With this plan, billions of dollars flow their way.
A six-month investigation by The New York Times found that in the push to win customers, some Abbott managers instructed employees to pursue sales at virtually any cost. Among the ploys used to sell drugs, Abbott managers told sales staff to hold what the company called health camps, where representatives would perform tests on patients for various ailments in an effort to drum up business for doctors, who would then prescribe Abbott drugs.
Immediately on the heels of the suicide story, I began to hear the media uproar over the marketing strategy by the company that manufactures EpiPens.
Mylan has a veritable run of the market. It therefore, in a few short years, raised the price of EpiPens again and again. As of this May, they cost 
These latest two media stories are just a tip of the iceberg when it comes to how the pharmaceutical industry is treating its customers disrespectfully. Anyone who really wants to know the full story would do well to read Dr. Marcia Angell’s superb book, The Truth About the Drug Companies: How They Deceive Us and What To Do About It. The author has an M.D. degree, and for two decades was editor in chief of the prestigious New England Journal of Medicine. There she had a front row seat on the growing power and corruption of the industry.
As Dr. Angell powerfully demonstrates, claims that high prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into marketing of their products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.
How do the drug companies get away with this, since a patent is only supposed to be issued when the new drug is useful, novel, and non-obvious. The drug companies have the largest army of lobbyists in Washington, D.C. If you think the gun lobby has an unfair hold on politicians, it is small potatoes when it comes to the pharmaceutical industry.
How do drug companies justify all of their me-too drugs? They claim that it is good to have more than one drug to treat a condition, because if the first one doesn’t work, the second might. Here’s Dr Angell’s reply:
The solution to getting the drug companies to start treating us respectfully would be fairly easy if only Congress could fire up the will to stop listening to the industry’s lobbyists. Laws could simply be enacted that would replace the 20 year patents on new drugs with laws that would provide a patent that lasts only until the company recoups its investment in creating the drug. When the patent runs out, they could still continue to sell the drug without the patent. After all, companies that sell off-patent generic drugs do make profits, but just not as outrageous profits that allow the industry to employ more lobbyists on Capital Hill than there are congressmen.
Unfortunately, the influence of the lobbyists have been way too great for the lawmakers to resist going along with the drug companies. So, as is often the case, it is up to those of us who are being treated disrespectfully to stand up and powerfully advocate that we begin to be treated respectfully. 
This would entail making it known that we voters will only support candidates who are running for office who refuse to take money from the pharmaceutical industry. If there are no such politicians running in the district we live in, we must identify someone who is willing to run on this issue, and then we must work to get that person elected. Without such action, we folks will have to accept that being treated disrespectfully by the drug companies is just a sad part of life.