Writings

Entries by Dr. Harriet Fraad (37)

Wednesday
Jun132012

Profiting from mental ill-health

First published in The Guardian, March 15, 2011.

The New York Times recently led with a front-page splash about psychiatry's propensity to prescribe pills, "Talk Doesn't Pay, So Psychiatry Turns Instead to Drug Therapy". That news is already widely known in the mental health field, but it has vast ramifications for Americans trying to maintain their sanity in our market-driven and medical system for delivering mental healthcare.

What does the turn to drug therapy mean for the mass of Americans?

Mental illness has not decreased with the change from talk therapy to drugs. In fact, as Robert Whitaker's book diagnoses, mental illness in America has become an established epidemic. So-called miracle drugs like Prozac are taken by 11% of the population – and Prozac is only one of the 30 available antidepressants on the market. Antidepressants are accompanied by anti-anxiety and anti-psychotic drugs. Xanax, America's leading anti-anxiety medication, is so ubiquitous that Xanax generates more revenue than Tide detergent, reports Charles Barber in his Comfortably Numb.

Anti-psychotics drugs alone net the pharmaceutical industry at least $14.6bn dollars a year. Psycho-pharmaceuticals are the most profitable sector of the industry, which makes it one of the most profitable business sectors in the world. Americans are less than 5% of the world's population, yet they consume 66% of the world's psychological medications.

Do these psycho pharmaceuticals work to restore mental health? Actually, the evidence is overwhelming that they fail. Antidepressants, the most popular psycho-pharmaceuticals, work no better than placebos. They work 25% of the time and stop working when the user stops taking them. In addition, they may actually harm patients in the long run. They disrupt brain neurotransmitters and may usurp the brain's organic soothing functions.

Psycho-pharmaceuticals are less effective in the long run than talk therapy. Talk therapy, like drugs, does change brain and body chemistry; unlike drugs, though, talk therapy has no side-effects. Instead, talk therapy gives a patient tools that usually help to solve future problems. The latest research is most clearly expressed in both Irving Kirsch's Antidepressants: The Emperors New Drugs and Gary Greenberg's, Manufacturing Depression, both published last year. Kirsch is one of the world's leading psychiatrists; Greenberg is one of the world's most prestigious psychologists. Their views are echoed by many voices in the field of mental health. Why is prestigious and extensive research so widely ignored by doctors and patients alike? Our market-driven healthcare system gives us clues.

All 30 of the available antidepressants have suffered lawsuits within five years of their appearance on the market. These suits are often settled with large payments and gag clauses. The new generation of anti-psychotics are the latest case in point. Anti-psychotics were the single biggest targets of the False Claims Act. Every major company selling anti-psychotics – Bristol Meyers Squibb, Eli Lilly, Pfizer, Johnson and Johnson and AstraZeneca – has either settled investigations for healthcare fraud or is currently being investigated for it. Two recent settlements involving charges of illegal marketing set records for the largest criminal fines ever imposed on corporations. Their corporate logic is expressed in the words of Dr Jerome Avorn, a medical professor and researcher at Harvard: "When you are selling a billion a year or more of a drug, it's very tempting for a company to just ignore the traffic ticket and keep speeding."

There is also the widespread practice of paying physicians and psychiatrists heavy subsidies to recommend psycho-pharmaceuticals to their colleagues in small meetings at which a drug company representative is present. If doubt or criticism of the discussed drug is expressed, the doctor's stipend stops. Another legally acceptable tool is to publish praise of a company's drug in a scholarly article, which is often written by drug company personnel and simply tweaked by the physician whose name appears on the article. The physician is paid handsomely for such a service.

Under the pressure of legal settlements and embarrassing disclosures, eight pharmaceutical companies began posting doctors' names and compensation on the web. ProPublica compiled these disclosures, totaling $320m, into a single database that allows patients to search for their doctor. Receiving payments for publishing articles written by drug companies is not illegal.

Two doctors, Dr Joseph Biederman and Dr Timothy Wilens of Harvard University Medical School, illustrate the close and cozy relationship between medical "scholarship" and drug companies. Drs Biederman and Wilens netted $1.6m each from drug companies for their work in recommending powerful anti-psychotic drugs for children. Biederman, Wilens and other extremely well-rewarded child psychiatrists are in part responsible for giving children the diagnosis of paediatric bipolar disorder for which anti-psychotic drugs like Risperidal and Zyprexa are used.

Experts agree that there is no long-term improvement in children's lives from taking anti-psychotic drugs. In fact, these drugs have a substantiated pattern of metabolic problems and rapid weight gain that often leads to diabetes. The use of bipolar diagnoses and bipolar medications is one small example of how market-driven mental healthcare works in the United States. It illustrates the transformation of US healthcare into a system dominated by some of the richest corporations in the world.

Caring about profit is first, and that is why psychiatry has turned to drug therapy.

Wednesday
Jun132012

Feminism Today - A Socialist View

First published in the Socialist WebZine, March 2011.

As a woman and a socialist who is a founding mother of what was then a decidedly socialist “Women’s Liberation Movement” I look at our many triumphs and some tragedies as well. Our triumphs have been that we won some positions of equality. We wanted equality in the labor force and as far as our percentage of the labor force goes, we have equality. We are half of all US employees. However, we have achieved equality within a system of gross inequality. Our vision as socialists was that if we on the bottom rose up, we would bring everyone with us. That has not happened. The reverse has happened.

The quality of life for both male and female workers has degenerated. The United States went from being the most egalitarian nation in the Western industrialized world in 1970 to the most inegalitarian nation now. Wage differences between rich and poor have vastly increased. CEOs, who were paid about forty times more than average employees in the 1960s and 1970s, now make about 400 times more money even as they drive their corporations into the ground. Work hours have increased for all Americans, women included. Americans work 20% longer hours than do our compatriots in the rest of the industrialized world.

We now earn 77.1% of what men earn for comparable work. Men still have 22.9% wage supplement for being male. That is a big improvement over the 59% of men’s wages we earned at the beginning of our movement in 1968 when men got a 41% financial bonus for their maleness (Institute for Women’s Policy Research, Sept. 2010). Sixty-seven percent of us are still concentrated in pink collar jobs in social service work, and the health care and food service industries (Lindell, Dec. 17, 2010). These industries are low wage industries. However, they are the industries that are growing while typical male stereotyped, more testosterone driven jobs are increasingly outmoded. Construction, heavy machine operating and finance jobs have been decimated. Managers are increasingly female. Female skills in social relationships, teamwork and connection building are in greater demand than the aggressive confrontational behavior that conforms to a machismo stereotype.

Our rights as independent women have expanded. Our personal lives have radically changed. We are no longer constrained to stay home, nor are we able to. We need to be financially independent because men can no longer support us. White men used to be bread earners able to support dependent wives and children on sufficient wages. Minority men and single women never received a family wage, even though, they too supported families. Women maintained domestic, physical and emotional well-being for men and children within households while, as in the case of white men, men supported women financially. Women provided emotional support for each other as well as for the rest of the family. We still do domestic and emotional jobs at home in addition to our paid work outside of the home.

We have adjusted to the need for our paid labor in the marketplace. We also had a movement to support us in that economic role. Men have not made a similar adjustment or commitment to share domestic and emotional. Women still do 70% of the housework and 82% of the childcare labor (Fraad, Resnick, Wolff 2009, p.17-70). We are also rejecting marriage. For the first time in US history most women are single and most divorces are initiated by women. For the first time since the US began collecting statistics in 1880, most people of prime marriageable age, from 18-34 years old, are not married. Fully 40% of US children are born outside of a marriage. Marriage has broken down. Half of young people of marriageable age think marriage is obsolete (“New Vow: I Don’t Take Thee” Wall Street Journal, 9/29/2010, “Marriage Rate Falls to About 50% As People Say Institution Is Obsolete” Bloomberg, 11/18/2010, and “Recession Rips at US Marriages, Expands Income Gap Associated Press, 10/20/2010).

The US women who are at greatest risk are mothers (Lerner, 2010). There are scant social supports to help the mass of working women who have children. We are the only Western industrial nation that does not provide paid maternity leaves to working mothers. We are the only nation that does not routinely provide free medical and maternity care (UNICEF 2007). Consequently, one of the best predictors of poverty in the US is having a child.

The women’s movement created equality for women within a nation of inequality. The mass of women have been freed from restrictive roles within the home. The failing US economy and our wish to be part of a fuller life, have combined to propel us into the labor force without the social supports that would give us the time to enjoy our fuller lives, our partners, or our children. Our personal lives are overwrought, overworked and desperate. Men are in trouble as well. Their jobs are even more precarious and more easily outsourced. They are losing their wives and children who were once their emotional anchors. Only privileged women can afford to stay married with the domestic relief and child care provided by other women poorly paid as maids, nannies, daycare workers, etc.

In order to achieve the socialist goals of the original Women’s Liberation Movement, which were full, productive and loving lives for all women, we would need to mobilize our government to expand the domestic and child care supports that permit us to participate in the labor force and also enjoy our lives, have sharing partnerships with our husbands, wives or lovers and nurture our children. If we embraced socialist programs, that would be possible. Funds for the free quality childcare and health care enjoyed by other nations are available. We need to tax the rich, stop costly endless, wars, and create: quality child care centers, after school and summer programs, low cost attractive quality restaurants, free quality universal medical care and mandatory paid vacations. The nations that best provide the lives we need are not as rich as the United States. The Netherlands, Sweden, Denmark, Norway, Finland, and France are either governed by socialists or
have powerful well organized socialist and communist parties. It is up to us to create a nurturing socialist society for women, children and men, for everyone.

Bibliography
Fraad, H. Resnick, S. and Wolff, R. 2009. “For Every Knight in Shining Armour, There’s A Castle Waiting to be Cleaned: A Marxist-Feminist Analysis of the Household.” In Class Struggle on the Home Front. Ed. G. Cassano. New York: Palgrave.Institute for Women’s Policy Research. Sept. 2010.
“The Gender Wage Gap: 2009-Updated Sept. 2010. Washington, DC: Institute for Women’s Policy Research.Lerner, S. 2010. The War on Moms. Hoboken, NJ. Wiley and Sons.Lindell, R. Dec. 17, 2010.
“Pink Collar Jobs Spare Women from Recession.” Global Banking Alliance for Women.

Wednesday
Jun132012

The Great Recession and Gender Marriage Transformation

First published in Tikkun Daily, February 23, 2011.

The latest census figures (9/28/2010) have resulted in such mainstream articles as “New Vow: I Don’t Take Thee” in the Wall Street Journal, “Marriage Rate Falls to About 50% As People Say Institution Is Obsolete” in Bloomberg, and “Recession Rips at US Marriages, Expands Income Gap” from AP. The articles cite census figures showing that US marriages fell to record lows in 2009.

For the first time since the US began tracking marriage statistics in 1880, unmarried people of prime marrying age, 25-34, out numbered those who are married.

What has happened to create this tectonic shift in American marriage?

Two related changes are important to consider. One is in the US economy and the other is in North American gender relationships.

What Happened in the US Economy?

From 1820-1970, the United States experienced a unique period of ever-increasing prosperity. For 150 years, US salaries rose together with ever-increasing worker productivity. For one and a half centuries, each generation was able to afford a better standard of living than the generation that preceded it. That was the unique American dream (see Resnick and Wolff in my bibliography at the end of this post). Americans accepted our capitalist system in which each generation had relatively prospered. American labor fought for an increasing amount of income that would permit workers to consume more goods and services, a system in which each generation could move to jobs considered more prestigious and lucrative within the capitalist hierarchy. Blue-collar workers’ children could become white-collar, and white-collar children could become professionals in the next generation (particularly if they were not just white-collar but white, period). For a long time, there was a relative scarcity of white male workers available for the jobs reserved for white males in America’s racially and sexually segregated job markets. That phenomenon ended in the 1970s (see my article “American Depressions” in the Jan/Feb 2010 Tikkun).

By 1970 the introduction of computers, automation, more sophisticated telecommunications, and more efficient transportation enabled jobs to be outsourced. Outsourcing and sophisticated computer and telecommunications meant that employers no longer had to increase wages. In addition, minorities and women won the legal right to compete as equals in a diminishing marketplace. Wages froze. Profits continued rising and were accumulated at the top. White male workers, who were accustomed to receiving a family wage and living a lifestyle of ever-greater consumption could no longer support their families or their dominant bread earner positions on their now frozen real wages.

American white men lost a good deal of the male hegemony that accompanied family wages. In addition, the greater physical strength men have and their greater aggression are far less welcome in our changing labor force and in personal relationships as well.

US women adjusted to our changed role in the marketplace. In 1975, only 40% of US mothers with children under six years old were in the labor force. By now, 63.5% of mothers of children under age six and 60% of women with children under one are in the labor force (“Working Mothers Need Child Care”). Women now constitute half of the labor force (“A Woman’s Nation Changes Everything“).

Our changed roles have not been matched by men’s participation in childcare or home maintenance. The average unemployed man currently does less housework than his fully employed wife (“Class Struggle on the Home Front“). Many men want additional domestic and emotional services to compensate them for their lost manly provider roles.

To be fair to men another reason men have not stepped up to the plate is because we feminists did not figure out and publicize enough the enormous value of our traditional contributions to life. It is still not understood what valuable lessons are learned from maintaining life whether maintaining the physical basis for life in food and feeding people, in cleanliness and order and providing comfort or in the emotional labor of connecting deeply either with infants or children or intimate women friends or emotionally bonded lovers. Human life literally fails to thrive if infants have no emotional connection. Emotional bonds are crucial to mental health at every age. We have not done the work to understand our traditional contributions and insist that they be valued at home and in the marketplace. If we did that work, more men would see what they are missing and aspire to more of the traditionally female roles.

As if men’s current problems were not difficult enough, 75% of the 8 million jobs that are lost have been male jobs, in construction, manufacturing, and finance, all of which share a machismo identification (“American Depressions“).

Women now occupy most of the seats in higher education as well as at least half of the nations’ jobs (“A Woman’s Nation Changes Everything“).

Women have responded to men’s financial incapacity and refusal to share equally in housework and childcare. We now increasingly refuse to marry the men who cannot provide for us and still want full domestic and emotional services. Women now initiate most US divorces as well as refuse to marry in the first place (“American Depressions“).

We have the highest divorce rate in the world. We also have the weakest family supports amongst wealthy industrial nations. Women no longer can stand the extra work in caring for men who cannot support them and do not substantially lighten women’s triple shifts in domestic labor, emotional labor and childcare. The state does not step in as it does in Europe. There are no massive quality free day care centers, after-school programs and elder care allowances. Those jobs are still up to women. We can’t do it all.

As if that were not bad enough, men’s traditional roles in the home and marketplace are both becoming obsolete. Only two of the fifteen most rapidly increasing US jobs are male jobs, janitor and computer engineer (“A Woman’s Nation…”). All the rest are traditionally women’s jobs: nursing, home health care, child care, food preparation, etc. Nurturance and the ability to cooperate and socially connect are qualities associated with women and required in America’s new service economy. Male privilege lingers. The vestiges of male hegemony are found in such misogynist institutions as the military, The Christian Right, The National Rifle Association, The football industry, and heterosexual pornography.

Men are in limbo. They are afraid of heterosexual love relationships in which the rules have changed. They do not know how to function as equal partners. Men increasingly turn to pornography and away from relationships (“Porn addiction destroys relationships, lives” and watch Bill Maher on porn addiction).

Potential partners withdraw from a dismal picture, which adds an additional reason for the majority of people of prime marriage and childbearing age (18-34 years old) to remain unmarried.

These changes have a huge impact on American emotional and family relationships. Children will grow into a vastly reconfigured world. Psychology and economy interact with vast ramifications for us all. Families have shifted. Most US children will grow up without two present parents and without quality childcare provisions.

Marriage and the workplace must change and be more egalitarian or women will either elect not to marry, or they will divorce. Men’s more aggressive roles need to change to fit our current economy. Men need to function within egalitarian households. Women need to develop our understanding of the powerful lessons learned and gifts received in caring for people emotionally and physically. We need to teach each other and men the value of our labor as well as make sure that labor is richly compensated when it is marketed. For one example, because I cannot resist giving the example, is that jobs that require intense emotional labor like daycare and early childhood education and being a nurse or nursing aide or worker in elder care are among the worst paid jobs in America. A different explicit value system and political pressure could change that. Americans are experiencing tectonic shifts in personal life. Their ramifications are huge.

Dr. Harriet Fraad is a psychotherapist and hypnotherapist in New York City. Her articles appear in Clio’s Psyche, The Journal of Psychohistory and Tikkun. With Professors Stephen Resnick and Richard Wolff, she co-authored the book, Class Struggle on the Home Front.

Bibliography
Boushey, H. “The New Breadwinners” in A Woman’s Nation Changes Everything-The Shriver Report. Washington DC: Center for American Progress.

Dougherty, C. September 28, 2010. ”New Vow: I Don’t Take Thee” Wall Street Journal.

Fraad, H. “American Depressions” January-February 2010 Tikkun, p. 17-24

Fraad, H., Resnick, R, and Wolff, R. 2009. ” For Every Knight in Shining Armor, There’s a Castle Waiting to be Cleaned” in Class Struggle on the Home Front, Graham Cassano, Ed. New York: Palgrave, p. 19-70.

Hochschild, A. 2000. “Global Care Chains and Emotional Surplus Value.” In Global Capitalism, Hutton, W. and Giddens, A. Eds. New York: The New Press, p.140-141.

Lopatta, E. November 18, 2010. “Marriage Rate Falls to About 50% As People Say Institution Is Obsolete” Bloomberg News.

Lipsyte, R, February 5, 2011. “Why Our National Superbowl TV Party Has Become the Last Supper for the US Empire.” Tomdispatch.com

Nelson, M. Burton. 1994. The Stronger Women Get, The More Men Watch Football. New York: Houghton Millflin Harcourt.

Resnick, Stephen, & Richard Wolff (2010). “The Economic Crisis: A Marxian Interpretation”. Rethinking Marxism: A Journal of Economics, Culture & Society. 22, 170 – 186.

Stafford, E. 2008. “Panel Study of Income Dynamics, Detailed Study of Housework, University of Michigan Institute for Research.” Ann Arbor MI: Regents of the University of Michigan, Ann Arbor.

Yen, H. Oct 4, 2010. “Recession Rips at US Marriages, Expands Income Gap” Associated Press.

Wednesday
Jun132012

November election results – unreported news and possibilities

First published in Tikkun Daily, November 8, 2010.

An important feature of our recent vote went unreported. The vast majority of Americans voted by staying home. Only 41.3% of eligible voters bothered to vote (national turnout rate among those eligible to vote (the voting-eligible population or VEP) of 41.3%). If we add to them the potential voters who did not even bother to register, very conservatively another 10%, we will see that about 70% of Americans virtually boycotted our elections. The youth stayed home in even greater numbers than older Americans. Only 20% of registered eligible young voters voted. More than 80% did not bother. Why?

I believe in democracy. If a vast majority of Americans do not vote, there must be a good reason for it. I believe that the vast majority of Americans understand that their voices are not heard. Their votes don’t count. They ask, “Should I vote for the party that brought on the disaster that took my security, and can, or did take my home, or should I vote for the party that promised hope and change and did not change my precarity or loss?” Neither seems worth it.

Most Americans feel powerless. An extreme right Tea Party alternative was possible. Most correctly perceived that although such a vote registered a protest, it represented a leap out of the frying pan and into the fire. Somewhere they knew that since the overwhelming number of layoffs were in private corporations, not government, cutting government would just let those capitalists at the top pay even less taxes and laugh even louder on the way to the bank which our taxes subsidized – that very same bank that won’t loan us the tax money we gave them. That is enough to get people discouraged.

What can people do? People need a left political formation that speaks for the majority. It cannot be a political party. Another party will not work since one needs many millions of dollars to have a chance in party politics. Our last election in which most eligible Americans stayed home was also the most expensive election in our history. Candidates raised and spent 4 billion dollars.

Most people cannot imagine raising millions, still less billions, in order to be heard. What people can do is get organized, get out, and demonstrate our power in numbers. Our strength in numbers is the only kind of power the majority has. Here we can learn from France. Whatever people’s idea about the recent French movement are, all notice that the French Left is a power to reckon with while the right is not, quite the reverse of our situation. Almost 3 million French people with the support of 70% of French citizens said no. They voted with their power in numbers and demonstrated that they were unwilling to have their lives cut for the greed of banks and finance corporations. They did what many believed they would not be able to do. Their socialist and communist and liberal trade unionists united with the mass of workers and the youth to demand better lives. They exercised their democratic right to struggle for a solution that penalizes the richly profitable corporate and bank sectors not the mass of France’s current and future workers. France has about one fifth of our population. If Americans were mobilized with the magnitude of the French, there would be about 15 million Americans demanding change. I believe that would get results. In order to have real hope and change and democracy, we need to organize, mobilize and vote with our feet. We need to change our pattern, not stay home and give up, but demand that our taxes be used for peace and kindness and sacrifices from those who profited most. We would need to stop those who most profited from using their profits to buy politicians who shift the burden back onto average citizens. France is building alternative political formations that actually represent the majority of French people. We can too.

Wednesday
Jun132012

News from France that has not received attention here

First published in Tikkun Daily, October 13 2010.

On the 12th of October 2010, three and a half million people (the official French count) participated in demonstrations organized by the French trade unions. This is a record turnout. The media and the police recognizes that the demonstrations here are growing. There were 244 demonstrations around France this time as opposed to 230 on Sept 23. They kept up in spite of a huge effort by Sarcozy to sell raising the onset of early retirement for French retirees from 60 years old to 62. Sarcozy’s proposal raised the opposition higher. Students joined retirees and trade unionists. They closed schools around the nation. They are demonstrating against youth unemployment and the precariousness of their future. For many seniors new rules will prevent retirement until the age of 67. The transit sector unions are mobilized to strike. The government counted on the disaffection of masses of people inconvenienced by the demonstrations. However, 71% of the population is in full support of the demonstrations and strikes and 61% is in support of a continuing strike. Sarcozy’s ratings fell. 62% do not have confidence in Sarcozy as a leader. Bankers’ cheating and vast enrichment have been exposed in 2 high profile cases: one is of the owner of L’Oreal [the cosmetics company] who was caught bribing Sarcozy’s ministers and hiring a cabinet minister, Woerth, as her finance consultant. He advocated austerity for French workers while he counseled her to hide money off shore. The owner’s butler exposed the truth here. The next mobilizations are called for Oct. 16, 2010.

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