Escape from the 19th Century

My colleague sent me a link to a CNN story today about a pregnant young woman whose Roman Catholic high school attempted to prohibit her from walking with her graduation class. The father--a graduating senior at the high school--was not, however, prevented in any way from participating in the ceremony. The news story claims that the high school cited "safety concerns." I am still trying to figure out exactly who was at risk? The developing child? The mother? Or, the rest of the guests at the ceremony? Someone please clarify this for me.

The puritanical ideas re-circulating in our culture have one target: women's bodies. There are regular reports of pharmacists denying to fill women's prescriptions for birth control or Plan B, citing "moral conscience" as their defense. Good lord! As my friend Jessica pointed out, refusing to fill a doctor's prescription because you don't approve of the medication would mean, for example, that pharmacists could turn away prescription requests for antidepressants because they found such medication morally problematic.

What would be more interesting is to see if pharmacists will begin to refuse to fill prescriptions for Viagra, Cialis or Levitra to young, single men, who, afterall, shouldn't be sexually active before marriage. Why on earth would they need to treat their "erectile dysfunction" if they aren't married anyway? Would the men join us in our outrage at corporate policies of Wal-Mart and CVS?

This line of thinking is reminiscient of the Victorian culture that Sigmund Freud attempted to unravel in the 19th century--a culture so twisted about sex! Of course, Freud was no friend to women; women's unruly sexuality was largely responsible for men's mental illnesses as well as threatening to the work of culture building. Women certainly were incapable of developing "super egos," which would teach them the proper rules of cultural behavior.

I was reminded of the damage Freud did to women by a biologist who rode with Za and I to Charlottesville today. He asked me what I am working on this summer. I told him that I was writing about how women are more likely to be diagnosed and treated as depressed because in the handbook for diagnoses (the DSM-IV), the criteria could just as easily be construed as picking out pathological femininity as depression. Our cultural disease with unruly and emotional females might have found its way into the fuzzy criteria of the DSM. These diagnostic criteria are simply too inclusive. This is partly responsible for why so many women are targeted by pharmaceutical advertisements for antidepressants, as well as more likely to be prescribed anti-depressants.

I have to say, he had a very interesting reaction to my work. When he attended medical school, the students interested in psychiatry were trained to be psychoanalysts. He complained about how psychiatrists required patients to be in therapy three times a week for multiple years with very little (if any) outcomes. "Thank god that psychiatrists have finally turned to pharmacological therapeutic agents, whose results we can measure" he exclaimed. His passionate dislike of Freudian psychoanalysis was clear.

I agreed that psychiatry had come a long way, baby. But, what I found fascinating was how his hatred of the old days of psychiatry made it difficult for him to find fault with the excesses of psychopharmacology today. As far as he was concerned, psychopharmacologists could do no wrong in comparison to the pseudo-scientific days of Freudian psychotherapy (I may be overstating his case, but he was pretty impassioned). We had finally escaped from the 19th century.

Have we really escaped from the 19th century? For me, proof of this would require that our cultural fear of women's bodies had been significantly "worked through." I am not sure that a more effective agent (SSRIs that through an advertsing blitz convince women to request themselves) for keeping women's "hysteria" under control is a sign that psychiatrists have finally escaped the 19th century. Hell, we haven't escaped the 6th century B.C. . . .

**Disclaimer: My own views on the advances and gains of SSRI treatment are far more nuanced than this blog might sound right now. And, frankly, I am grateful that I was reminded by this biologist of the dark ages of Psychiatry.