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The All-Engulfing Networks of Big Pharma

Posted April 26th, 2011 at 05:59 PM by Gile na Gile

When President Eisenhower on leaving office warned the American people to beware the disturbing expansion of the military-industrial complex he presumably looked to the executive and legislative branches of government as a bulwark. To whom or what do we look to today to spare us the invidious encroachments of the psycho-pharmaceutical complex? For the all-engulfing networks of "Big Pharma" are rapidly absorbing those independent institutions in whom we may have expected a counterbalance to its tapestry of market-led disseminations. We have a strumpeted research sector almost wholly beholden to corporate financing, a hamstrung legislative crippled by the threat of an internationally mobile capital, a psychiatric profession greased to the gills on junkets and prescription bonuses and a corporate-led media addicted to product placement features posing as "human interest" stories.

As a society, we have become so incapable of framing the discourse on well-being outside of the narrative of "mental illness" that pharmaceutical interventions have become the accepted norm. A functioning democracy needs powerful independent bodies not institutions that are the transparent extension of the will of corporate entities and their advertising departments.

The United States today consumes eighty per cent of the entire global production of pharmaceutical drugs. It is an almost unimaginably lucrative market. In Pattison and Warren's 2002 paper “Drug Industry Profits: hefty pharmaceutical company margins dwarf other industries”, published by Public Citizen Congress Watch, it was estimated that in that calendar year the top 10 drugs companies in the United States had an average profit margin of 17% compared to an average of 3.1% for all other companies in the Fortune 500. What is altogether more remarkable is that the profits of these 10 companies ($35.9b) were more than half the combined profits of the other 490 companies ($69.6b). You cannot even begin to talk about “mental illness” without reference to figures such as these. As the US market becomes increasingly saturated we may expect a steady migration of novel afflictions and disorders from across the Atlantic as US drugs companies aggressively target European markets.

The effects of this are that citizens are being coercively interpellated. We are being (mis)represented by an ideology of disease, disorder and affliction for the sorry and seemingly singular purpose of boosting share prices. The effects of this interpellation are most readily located wherever the concept of “mental illness” is discussed as though it were a concrete and easily discernible reality. In reality, “mental illness” is no more than a cleverly conceived advertising slogan but to see it thus in all its pathetic nakedness requires divesting a complex episteme of its supporting rationale. I will grant you that many of us have recurring problems in living but do each or any of them actually fall within the parameters of some 1,800 diagnostic categories - as the Diagnostic and Statistical Manual of the American Psychiatric Association would have us believe?

It follows from this that the whole business of challenging “the stigma of mental illness” engaged in so earnestly by patient advocacy groups does nothing more than further entrench the legitimacy of the psycho-pharmaceutical complex. It reifies and gives concrete form to an umbrella term from whose shade languishes a thousand overblown, poorly understood and potentially dangerous neuroleptics. The idea of mental illness itself is the minotaur that lies at the heart of the labyrinthine ideology of this Complex. It is, to use the phraseology of Foucault, its epistemic nexus, for from it flows all the irrational conceptualisations that continue to sustain the Complex's legitimation. Only when the acknowledged irrationality of these narratives become the accepted norm can this nexus be said to have exhausted the logical possibility of its continued reproduction.

Amidst the rush to find an appropriate pill for a perceived neurological "disease" it is the human dimension to human suffering that has been lost. Prof. Phil Barker, a former psychiatric nurse, on the contrary, encourages mental health professionals to adopt the view that patients “own their own experiences”, that they themselves are the best judges of how these crucial periods in their lives should be signified. This philosophy lies at the core of the Tidal Model of mental health reclamation developed by himself and his wife Patty Buchanan-Barker in the mid 90's. The approach is explained as follows;

“Psychiatry has established a professional vocation, and a powerful oligarchy, which purports to explain to people the meaning of their experience, primarily by attributing unusual, remarkable, enlightening or socially disturbing experiences to abstract notions of mental illness' or mental disorder. It is self-evident that people own their experience. Although others may frame views of their perception of the experience of others, only the person can ever come to know what such experiences really mean - in the context of their whole life”.

Barker also details many of the concrete social problems that accompany people's breakdowns'; marauding youth gangs, racial abuse, domestic violence, rape, intimidation, issues around drugs and firearms; in fact all the unpleasant realities that accompany life in those areas where development planning has been less than visionary. However, within the drug-orientated institution of psychiatry instead of the incipient crisis point or “ontological juncture” being regarded as a complex metaphor in whose contours and shadings may be observed an ingenious coping strategy and if one cares to look an actual critique of these socially embedded problems the entire by now “psychoticised” or “schizophrenesized” episode has become an epiphenomenon of a genetically determined disease - a disease moreover that will have its own ready-made (and lucrative) pharmaceutical solution.

Such an approach ensures that the institution of psychiatry remains part of the problem rather than the solution. Instead of being a vital register of the maladies that afflict society thereby being a potential harbinger of positive societal change it;

(i) offers in too many cases no state-subsidised course of psychotherapy for low income groups and the unemployed;

(ii) offers a dogmatic nature over nurture philosophy that ensures a steady stream of lucrative drugs contracts for pharmaceutical companies at the expense of the taxpayer;

(iii) offers the genetic deficit card guaranteeing that the individual now becomes a lifetime service-user and worst of all;

(iv) psychiatric practice’s alliance with the pharmaceutical industry is guilty of feeding into a patient's insecurities by inserting this genetic sword of Damocles over their heads at precisely the most vulnerable moments in their lives.

From the moment the neophyte psyche struggles to assert itself in the fog of thinking that comprises this appalling neuroleptically-induced feebleness it is exposed to the most desultory and depressing range of literature, explanations and enforced behaviour imaginable. In the end the will itself becomes eroded; routinization, daily ritual, the inescapable pressure of consensus, all of these things and more besides soon have our emotionally vulnerable patient happily joining in with the chorus of other patients in extolling the virtues of this tablet over that tablet.

And so it is depressing to note the lack of response, particularly in the practice of public-sector psychiatry, to the wealth of evidence amassed on this importance of the environmental or “nurture” factor. The common defence, which cites lack of financial resources for the absence of in-house psychotherapy, regardless of theoretical orientation, rings particularly hollow when we think that drugs companies can charge the exchequer up to eighty euros per patient daily. The pervasive influence of big business can be easily glimpsed when the promised efficacy of the latest neuroleptics are amply-advertised on cups, notepads, calendars and other paraphernalia in mental health settings or through sponsored symposia in surroundings that contrast sharply with those enjoyed by ordinary patients.

The vast profits to be made from the crisis of an individual's failure to adapt to the world around them ensures that the idea of “mental illness” will continue to be viewed in almost exclusively biochemical, neurological and genetic terms. If the onset of psychosis, for example, is evidently a psycho-environmental phenomenon then no one seems to have told the politicians and public servants who continue to underwrite enormous cheques on the exchequer's behalf. It's little wonder that recurrent hospitalisations and relapses occur when only half the problem is being addressed in the first place. But even this is to concede that something proper, after all, is being done.

When problems in living are being treated only with recourse to physical explanations and their concomitant drug-based solutions then this implies either a fundamental misunderstanding of the nature of emotional disturbance by psychiatry in general or the perception that psychological insights are too complex to be grasped by the majority of mental health users thereby rendering practitioners impotent in the face of severe disturbance.

There are some professionals to whom the former charge is undoubtedly applicable; the pseudo-scientific reductionist spin has become so alluring that they've forgotten where the ball has come from - a corporate sponsored research lab. In the main, we would like to say that psychiatry like most other professions is composed of well-intentioned souls who operate admirably under the usual occupational constraints but in Ireland, for example, the only cause to which the psychiatric profession has publicly rallied and dedicated their energies has been the blockage of the effective implementation of the 2001 Mental Health Act - a long overdue piece of legislation that seeks to guarantee a right of appeal to involuntary patients.

If the Stockholm Syndrome isn't an applicable explanation for this volte face in values orientation then I'm afraid the concept has no application anywhere.
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