Adonis Diaries

Archive for January 24th, 2016

Across the borders with Canada: Rising deaths among white middle-aged Americans

‘The American dream is dead but I’m going to make it stronger!’? Promises of the Presidential candidates

The border

You feel your whiteness properly at the American border. Most of the time being white is an absence of problems. The police don’t bother you so you don’t notice the police not bothering you. You get the job so you don’t notice not getting it. Your children are not confused with criminals. I live in downtown Toronto, in one of the most liberal neighborhoods in one of the most open cities in the world, where multiculturalism is the dominant civic value and the inert virtue of tolerance is the most prominent inheritance of the British empire, so if you squint you can pretend the ancient categories are dissipating into a haze of enlightenment and intermarriage.

Not at the border.

My son’s Guyanese-Canadian teacher and the Muslim Milton scholar I went to high school with and the Sikh writer I squabble about Harold Innis with and my Ishmaeli accountant, we can all be good little Torontonians of the middle class, deflecting the differences we have been trained to respect. But in a car in the carbon monoxide-infused queue waiting to enter Detroit, their beings diverge drastically from mine.

I am white. They are not. They are vulnerable. I am not.

Here’s the thing: I like the guards at the American border. They’re always friendly with me, decent, even enjoyable company. At the booth in between the never-was of Windsor and the has-been of Detroit, the officer I happened to draw had a gruff belly and the mysterious air of intentional inscrutability, like a troll under a bridge in a fairytale.

“Where are you headed?” he asked.

“Burlington, Iowa.”

“Why would anyone ever choose to go to Burlington, Iowa?” he asked philosophically.

“I’m going to see Donald Trump and Bernie Sanders.” Then, because it did seem to require an explanation: “They’re giving rallies within a couple of days of each other.”

“Why would anyone ever choose to go see Donald Trump and Bernie Sanders?”

I didn’t argue, because it was the border, but I could have said that the police chief of Birmingham estimated that 30,000 people showed up in Alabama to see Donald Trump in August and that in Dallas, he had filled the American Airlines Center, and that his counterpart, Bernie Sanders, has generated equally unprecedented numbers – vastly more than Barack Obama drew at comparable moments in the 2008 campaign.

“I’m curious,” I said instead.

At this point he asked me to roll down my window. But it was all fine. Like I said, I’m white.

As I drove through the outskirts of the ruins of Detroit, across the I-94, one of the ugliest highways in the United States, the old familiar lightness fluttered to my heart. I love America. America is not my mother. Canada is my mother. But America is an unbelievably gorgeous, surprisingly sweet rich lady who lives next door and appears to be falling apart. I cannot help myself from loving it.

For people who love to dwell in contradictions, the US is the greatest country in the world: the land of the free built on slavery, the country of law and order where everyone is entitled to a gun, a place of unimpeded progress where they cling to backwardness out of sheer stubbornness. And into this glorious morass, a new contradiction has recently announced itself: the white people, the privileged Americans, the ones who had the least to fear from the powers that be, the ones with the surest paths to brighter futures, the ones who are by every metric one of the most fortunate groups in the history of the world, were starting to die off in shocking numbers.

The Case and Deaton report, Rising Morbidity and Mortality in Midlife among White Non-Hispanic Americans in the 21st Century, describes an increased death rate for middle-aged American whites “comparable to lives lost in the US Aids epidemic”. This spike in mortality is unique to white Americans – not to be found among other ethnic groups in the United States or any other white population in the developed world, a mysterious plague of despair.

In one way, it was easy to account for all this white American death – “drug and alcohol poisoning, suicide, and chronic liver diseases and cirrhosis”, according to the report. It was not so easy to account for the accounting. Why were middle-aged white Americans drinking and drugging and shooting themselves to death? The explanations on offer were pre-prepared, fully plugged into confirmation bias: it was the economy or it was demography or it was godlessness or it was religion or it was the breakdown of the family or it was the persistence of antique values or it was the lack of social programs or it was the dependence on social programs.

Case and Deaton call it “an epidemic of pain”. Fine. What does that mean?

On the I-94, you do find yourself asking: what the fuck is wrong with these people? I mean, aside from the rapid decline of the middle class obviously. And the rise of precarious work and the fact that the basic way of life requires so much sedation that nearly a quarter of all Americans are on psychiatric drugs, and somewhere between 26.4 and 36 million Americans abuse opioids every day. Oh yes, and the mass shootings. There was more than one mass shooting a day. And the white terrorists targeting black churches again. And the regularly released videos showing the police assassinating black people. And the police in question never being indicted, let alone being sent to jail.

And you know what Americans were worried about while all this shit was raining down on them? While all this insanity was wounding their beloved country? You know what their number one worry was, according to poll after poll after poll?

Muslims. Muslims, if you can believe it.

‘The American dream is dead but I’m going to make it stronger!’

My body is white and it is male. It is six foot tall and weighs 190lb. It is 39 years old and it has had to start running. It has had to start counting calories. There is a tingle in the joint of my right thigh, so I try not to think about my body. The tingling comes and goes. I know my body is going to kill me.

“A man who fears suffering already suffer what he fears,” as Montaigne said. That’s one of the reasons why men die so much younger than women – six years younger on average in America. Ninety-two percent of men say they wait at least a few days to see if they feel better before they go to a doctor, but I know what they mean by a few days. They mean a few more days than makes sense. It is hard to have a male and white body and to conceive of its weakness. In the same breath, my body cannot bring itself to believe it is the personification of power, though it evidently is in any rational accountancy of social status. It feels like a mere body. It feels mortal.

Why French Kids Don’t Have ADHD

French children don’t need medications to control their behavior.
Posted Mar 08, 2012

In the United States, at least 9 percent of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5 percent. How has the epidemic of ADHD—firmly established in the U.S.—almost completely passed over children in France?

Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the U.S. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological—psycho stimulant medications such as Ritalin and Adderall.

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.

French child psychiatrists don’t use the same system of classification of childhood emotional problems as American psychiatrists. They do not use the Diagnostic and Statistical Manual of Mental Disorders or DSM. According to Sociologist Manuel Vallee, the French Federation of Psychiatry developed an alternative classification system as a resistance to the influence of the DSM-3. This alternative was the CFTMEA (Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent), first released in 1983, and updated in 1988 and 2000. The focus of CFTMEA is on identifying and addressing the underlying psychosocial causes of children’s symptoms, not on finding the best pharmacological bandaids with which to mask symptoms.

To the extent that French clinicians are successful at finding and repairing what has gone awry in the child’s social context, fewer children qualify for the ADHD diagnosis. Moreover, the definition of ADHD is not as broad as in the American system, which, in my view, tends to “pathologize” much of what is normal childhood behavior. The DSM specifically does not consider underlying causes. It thus leads clinicians to give the ADHD diagnosis to a much larger number of symptomatic children, while also encouraging them to treat those children with pharmaceuticals.

The French holistic, psychosocial approach also allows for considering nutritional causes for ADHD-type symptoms—specifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens. Clinicians who work with troubled children in this country—not to mention parents of many ADHD kids—are well aware that dietary interventions can sometimes help a child’s problem. In the U.S., the strict focus on pharmaceutical treatment of ADHD, however, encourages clinicians to ignore the influence of dietary factors on children’s behavior.

And then, of course, there are the vastly different philosophies of child-rearing in the U.S. and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts. Pamela Druckerman highlights the divergent parenting styles in her recent book, Bringing up Bébé. I believe her insights are relevant to a discussion of why French children are not diagnosed with ADHD in anything like the numbers we are seeing in the U.S.

From the time their children are born, French parents provide them with a firm cadre—the word means “frame” or “structure.” Children are not allowed, for example, to snack whenever they want. Mealtimes are at four specific times of the day. French children learn to wait patiently for meals, rather than eating snack foods whenever they feel like it. French babies, too, are expected to conform to limits set by parents and not by their crying selves. French parents let their babies “cry it out” (for no more than a few minutes of course) if they are not sleeping through the night at the age of four months.

French parents, Druckerman observes, love their children just as much as American parents. They give them piano lessons, take them to sports practice, and encourage them to make the most of their talents. But French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer—something that is congruent with my own experience as both a therapist and a parent. Finally, French parents believe that hearing the word “no” rescues children from the “tyranny of their own desires.” And spanking, when used judiciously, is not considered child abuse in France. (Author’s note: I am not personally in favor of spanking children).

As a therapist who works with children, it makes perfect sense to me that French children don’t need medications to control their behavior because they learn self-control early in their lives. The children grow up in families in which the rules are well-understood, and a clear family hierarchy is firmly in place. In French families, as Druckerman describes them, parents are firmly in charge of their kids—instead of the American family style, in which the situation is all too often vice versa.

Copyright © Marilyn Wedge, Ph.D.

 


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January 2016
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