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Cruise's rant under analysis
DAILY NEWS HEALTH WRITER
Wednesday, July 6th, 2005
When Tom Cruise railed against psychiatry and antidepressants on the "Today" show, many people wondered if the high-strung actor wasn't in need of a shrink himself.
But the "War of the Worlds" star was really giving voice to widely held suspicions that Freud and his followers are quacks - and that drug companies are concealing important information about their mind-mending products.
Cruise went a step further and criticized actress Brooke Shields for taking antidepressants to treat the postpartum depression she suffered after the birth of her daughter. Cruise also declared there was no credible science to back up most claims of mental illness, an assertion that flies in the face of a century of documented research.
"These questions have been answered" by technology that reveals mental illnesses as diseases, said Dr. Peter Kramer, a psychiatrist and author of "Against Depression."
For Cruise and others who attack psychiatry, therapy and the use of drugs to treat mental illness, their criticisms may disguise an ideological agenda that is not really about medicine at all.
POSSIBLE POLITICAL LINK
Some have speculated that Cruise has been influenced by Dr. Thomas Szasz, who is associated with libertarianism and believes that mental illness is a myth used to justify state-sponsored social control through medical treatment. Szasz co-founded an advocacy group that is sponsored by the Church of Scientology, a religion Cruise adheres to.
The church's position on mental illness includes striking similarities to that of Szasz. But the Rev. John Carmichael, president of the church's New York branch, insists that its stance is not based on Szasz's writings.
"These attacks tend to have some political or religious agendas thrown in where it's not always clear that the ultimate target really is psychiatry," Kramer said. "There really may be some other, ultimate target."
Cruise's remarks came on the heels of "One Nation Under Therapy: How the Helping Culture Is Eroding Self-Reliance," published in April. Co-written by a psychiatrist and a philosopher, both of whom are scholars at the politically conservative American Enterprise Institute, the book argues that an entire industry built on our presumed psychological trauma is threatening the American "character" of stoicism and courage.
The authors, Dr. Sally Satel and Christina Hoff Sommers, diverge from Cruise in that they acknowledge mental illness exists and that therapy and medications are appropriate for some people.
But they wonder what Americans' unquestioning acceptance of therapeutic techniques in classrooms and other nonmedical settings - a phenomenon they call "therapism"- says about how we think of ourselves as human beings. Much of the time, such self-examination turns ordinary human experiences of sadness, anxiety and neurosis into pathology, the women write.
"Psychotherapy has oversold itself as offering salvation," Sommers said.
"This country was forged on the American creed: a combination of self-reliance, problem-solving, personal responsibility, striving for excellence.
"'Therapism' is an alternative life philosophy. It does not emphasize stoicism and reticence and problem-solving. It's about self-absorption, it asserts the essential fragility of human beings," she said. "In a way, what we're seeing is that American society is now somewhat divided: The creed's still alive, but you also find those who are very much trying to replace it with therapism."
Americans may be especially receptive to such arguments at this moment in U.S. history. In the past year, drug companies have faced mounting criticism over their concealment of damaging information about the effects of antidepressants on children, as well as what they knew about the risk of suffering a stroke or heart attack from using arthritis medications.
Those scandals, arising out of a backdrop of multibillion-dollar campaigns to market prescription drugs to consumers in advertisements and the tendency of industry to test its own products, are stirring intense debate within the medical community about how doctors and patients alike should interpret information about these medications.
Critics of the drug industry, while careful not to endorse Cruise's views, said he has nonetheless forced a national conversation about the regulation, marketing and use of the drugs in the United States.
"By raising this question, he has put it on the table," said Dr. John Abramson, a family doctor and author of the book "Overdosing America," which takes the pharmaceutical industry to task for its marketing strategies.
"He has put it on the table in a way that's easily rejectable, but I am sympathetic with Tom Cruise's position because doctors and the public really can't get the accurate information, so the perception that these drugs are supposedly overused is a reasonable one and is a product of the best scientific evidence not being available," Abramson said.
COMPETING POINTS OF VIEW
But if Cruise's rant hit an already-sensitive nerve in America, the source of his criticism of the drugs - rooted in his belief in Scientology - is separate from that of consumer watchdogs who are challenging the companies on the basis of their business practices.
That's a distinction the average person won't make when they consider Cruise's position, but it is one that makes all the difference in whether someone will reject the concept of treatment outright or take a more measured view, Kramer said.
In many ways, the "War of the Worlds" actor's comments reflect broader societal battles between faith and reason, Kramer said. In addition to the therapy-prescription drug debate, conflicts are raging over whether to teach children creationism or evolution, as well as over whether abstinence-only education or curricula that discuss a variety of options, including condoms and contraceptives, best reduce rates of teen pregnancy and sexually transmitted diseases.
Which means that observers can't chalk Cruise's stance up to, well, mental illness. Instead, it shows the often uncomfortably close relationship between philosophy or politics and the behavioral sciences.
"I don't think one has to be mentally ill to hold false beliefs," Kramer said. "There's a broad problem in this country regarding science on the one hand and emotion, religion and idiosyncratic beliefs.
"As a culture we don't always give science or medicine primacy and that's problematic. We endanger ourselves."
Ironically, scientists used to be called on to offer opinions about issues of the day, rather than celebrities, Kramer noted.
"Freud and Einstein wrote about matters of war and peace. Here, we have the excess in the opposite direction where you have people with very little scientific background giving opinions about medical and scientific matters," he said.
"Probably we are better off without either," he added.