University of Iowa

Iowa Research Online

Theses and Dissertations

Summer 2014

Take a chill pill: a cultural history of Attention

Deficit/Hyperactivity Disorder
Jonathan Herbert Hansen
University of Iowa

Copyright 2014 Jonathan Herbert Hansen

This dissertation is available at Iowa Research Online: http://ir.uiowa.edu/etd/2088

Recommended Citation
Hansen, Jonathan Herbert. "Take a chill pill: a cultural history of Attention Deficit/Hyperactivity Disorder." PhD (Doctor of
Philosophy) thesis, University of Iowa, 2014.
http://ir.uiowa.edu/etd/2088.

Follow this and additional works at: http://ir.uiowa.edu/etd

Part of the American Studies Commons

 TAKE A CHILL PILL:

A CULTURAL HISTORY OF ATTENTION DEFICIT/HYPERACTIVITY DISORDER

by
Jonathan Herbert Hansen

A thesis submitted in partial fulfillment

of the requirements for the Doctor of
Philosophy degree in American Studies
in the Graduate College of
The University of Iowa

August 2014

Thesis Supervisor: Associate Professor Laura Rigal

 Copyright by

JONATHAN HERBERT HANSEN

2014

All Rights Reserved

 Graduate College
The University of Iowa
Iowa City, Iowa

CERTIFICATE OF APPROVAL

_______________________

PH.D. THESIS

_______________

This is to certify that the Ph.D. thesis of

Jonathan Herbert Hansen

has been approved by the Examining Committee

for the thesis requirement for the Doctor of Philosophy
degree in American Studies at the August 2014 graduation.

Thesis Committee: ___________________________________

Laura Rigal, Thesis Supervisor

___________________________________
Douglas Baynton

___________________________________
David Depew

___________________________________
Kembrew McLeod

___________________________________
Lauren Rabinovitz
 ACKNOWLEDGEMENTS

First, I would like to express my immense gratitude towards my dissertation

advisor, Laura Rigal, whose enthusiasm, patience, and understanding is only matched by

her keen intellect and academic rigor. Her unfailing confidence and guidance have been

indispensable to the completion of this project. I am also very grateful to the members of

my dissertation committee, David Depew, Kembrew McLeod, Douglas Baynton, and

Lauren Rabinovitz, each one of whom has offered me invaluable insight, encouragement,

and opportunities for success. A number of other scholars have had a profound influence

on this project and my academic development while at the University of Iowa, including

Rob Latham, Ken Cmiel, Rich Horwitz, Susan Lawrence, Naomi Greyser, Miriam

Gilbert, Kim Marra and John Raeburn. I am thankful to have learned from each.

I have been supported throughout this project by a number of institutions within

the University of Iowa, including the American Studies department, the General

Education Literature program, the Project on Rhetoric of Inquiry, the department of

Gender, Women’s, and Sexuality Studies, the Graduate College – and Laura Kastens,

who is an institution unto herself. Additionally, I have benefitted from the material and

emotional support of Dr. Robert Wesner and Dr. Frank Gersh. For the understanding,

compassion, and patience that have been extended to me, I extend my sincere thanks.

A number of colleagues and friends have contributed to this project with their

critical perspectives, questions, research assistance, and willingness to listen as I talked

through my developing thesis – some, perhaps, without knowing the degree to which our

conversations influenced me. Though I cannot list all these individuals, I would like to

acknowledge my special appreciation of Orion Meyer, Sarah Ono, Charlie Williams,

Matt Thomas, Rob Albanese, Derek Thorn, Kelly McKay, Shaun Frentner, Scott

ii
Oltrogge, Jaime Berger, Clayton Schuneman, Joe Henzel, Rich McNinch, Stephanie

Vallez, Shelley Smith, Chris Bohlen, and Ryan Oyloe.

Finally, I would like to thank most deeply my family, including my parents, who

have been constant as both my supporters and my role models as lifelong teachers and

learners; my brothers and my sister, who have inspired me with their own tenacious

spirits; my beloved son Gabriel, whose optimism I strive to emulate and whose respect I

value above all things; and, crucially, my partner Monica Basile, a brilliant scholar and

gifted healer, who, with tireless trust and integrity, has taught me the most and taught me

the best. I couldn’t have done this without you.

iii
 ABSTRACT

During the last thirty years, millions of Americans have come into contact with

Attention Deficit/Hyperactivity Disorder (ADHD), if not through their own diagnosis or

the diagnosis of a friend or family member, then through the perennial and occasionally

passionate debate this behavioral disorder has inspired in U.S. popular culture since its

inauguration in 1980. The competing claims of this debate are many and varied, and they

revolve around a number of subtle distinctions that have emerged from diverse discourses

and institutional histories. It is among the aims of this project to excavate and clarify

these multiple, often contradictory and disjunctive claims by resituating them within their

disparate (indeed, still emerging) rhetorical and historical contexts.

The central questions animating this debate tend to advocate for one position or

another, within the limitations of a single field and its defining questions, making it

nearly impossible to gain a balanced or nuanced understanding of ADHD. Moreover,

dominant accounts fail to consider the diagnosis within a wider socio-cultural and

historical context. This project therefore analyzes this under-theorized behavioral

disorder from a rhetorical and cultural perspective. In doing so, it aims to go further than

other critiques or defenses of the diagnosis and its chemical therapies. It does so by

bringing discourse analysis to bear on ADHD, thereby illuminating how this assemblage

of rhetorics and questions – centered as they are on the Mind/Body continuum –

constitute what Michel Foucault refers to as biopower – or a process of social control

exercised on and through the technological manipulation of life itself. Considering it

from such a perspective will allow us to situate ADHD within modern debates over the

definition of consciousness, a debate that is inseparable from the history of technology

and the technological systems in which minds and bodies are thoroughly implicated.

This dissertation demonstrates that a biopolitics of consciousness structures the

iv
emergence of and the debate surrounding ADHD and the administration of stimulant

drugs for the purpose of managing attensity.

v
 TABLE OF CONTENTS

LIST OF FIGURES ......................................................................................................... viii

INTRODUCTION ...............................................................................................................1

What is ADHD? ................................................................................................4!

Psychopharmacology in American Culture ......................................................7!
Popular Expression in Commodity Culture: Cultural Studies and
Technology .....................................................................................................10!
American Culture and Technosciences of the Mind/Body .............................17!
Interdisciplinarity and a Multiperspectival Approach ....................................23!
The “Reality” of Mental Illness ......................................................................30!
Why Write a Cultural History of ADHD? ......................................................33!
Chapter Overviews .........................................................................................36!

CHAPTER 1: THE INSTRUMENTALIZATION OF CONSCIOUSNESS AND

THE EMERGENCE OF ADHD: CYBERNETICS,
PHARMACOLOGY, AND SOCIAL CONTROL.........................................42

Cybernetics and the Rationalization of Human Behaviors .............................44!

A Brief History of Mind Control – Part I: The Advent of Chemical
Technology, 1842-1952 ..................................................................................59!
A Brief History of Mind Control – Part II: The Military Use of Human
Beings, 1942-1974 ..........................................................................................65!
A Brief History of Mind Control – Part III: The Humanist Subject and
The Fifth Freedom, 1963-1980 .......................................................................71!
Antipsychiatry.................................................................................................76!
The Diagnostic Turn, 1980-1997 ....................................................................83!
Diagnostic Pharmacy ......................................................................................89!
Direct-to-Consumer Marketing ......................................................................91!
School/Children ..............................................................................................94!
Attention/Distraction ......................................................................................99!
Ritalin ...........................................................................................................101!

CHAPTER 2: PAYING ATTENTION TO INDIVIDUAL DIFFERENCES IN

AMERICAN STUDENTS: A SURVEY OF THE JOURNAL OF
EDUCATION, 1959-1971.............................................................................105

Individualized Instruction: John Dewey, Eugenics, and the Scientific

Management of Public Education .................................................................108!
Education and the Cognitive Science of Attention: “The Concept of
Attention in Education” (1968) ....................................................................126!
The Interlocking Directorate.........................................................................143!
Chemical Pedagogy ......................................................................................166!

CHAPTER 3: MAKING HISTORY: ADHD ON TRIAL ..............................................172!

The Ritalin Lawsuits .....................................................................................173!

First Case Filed .............................................................................................177!
First Ruling Returned: Federal Rules of Civil Procedure 9(b) &
12(b)(6) .........................................................................................................183!

vi
 Second Ruling Returned ...............................................................................188!
The Remaining Cases ...................................................................................194!
Aftermath of the Ritalin Lawsuits ................................................................194!
Challenging the Origin Story: The “Science” of History .............................199!
George Frederick Still, 1902.........................................................................202!
Brain Damage, Amphetamines, and the Myth of “Paradoxical
Efficacy”: 1917-1970....................................................................................211!

CHAPTER 4: ADHD IN U.S. POPULAR CULTURE SINCE 1980 ............................224!

Brainwashing: Brain Candy, “Pillz” by Lyrics Born, The Whitest Kids

U Know, and Scientology .............................................................................224!
Let Kids Be Kids: “The Last Calvin and Hobbes” Hoax and Captain
Underpants ...................................................................................................243!
The Gift of ADHD: The Hunter/Gatherer Gene Theory and The
Lightning Thief..............................................................................................259!
ADHD Culture: The Joker and Kendrick Lamar ..........................................266!
ADHD as Brand Identity ..............................................................................291!

CHAPTER 5: EMERGING IDENTITIES: SMART DRUGS, CYBORG

SUBJECTIVITY, AND SELF-IMPROVEMENT .......................................293!

Imminent Futurism .......................................................................................294!

Posthumanism v. Transhumanism ................................................................300!
Enhancement vs. Prosthesis ..........................................................................304!
Brain Boosterism ..........................................................................................310!
Becoming Limitless ......................................................................................323!
Conclusion ....................................................................................................336!

CONCLUSION ................................................................................................................338!

BIBLIOGRAPHY ............................................................................................................345!

vii
 LIST OF FIGURES

Figure 1: A differential diagnostic chart of ADHD beliefs ...............................................29

Figure 2: A promotional movie poster for The Kids in the Hall: Brain Candy
(1996). .....................................................................................................................225!

Figure 3: Bill Watterson’s final Calvin and Hobbes strip (December 31, 1995). ...........245!

Figure 4: A hoaxed “final strip” of Calvin and Hobbes, widely circulated on the
Internet. ...................................................................................................................246!

Figure 5: An alternate iteration of the Calvin and Hobbes “final strip” hoax. ................247!

Figure 6: Bill Watterson’s Calvin and Hobbes strip (July 13, 1989) that served as
source material sampled in the “final strip” hoax. ..................................................248!

Figure 7: An example of Dav Pilkey’s Captain Underpants book-within-a-book,

from The Adventures of Captain Underpants (1997). ............................................252!

Figure 8: An example of Dav Pilkey’s use of anagram as a source of humor, from

Captain Underpants and the Invasion of the Incredibly Naughty Cafeteria
Ladies from Outer Space (1999).............................................................................253!

Figure 9: Pages 14 and 15 from Captain Underpants and the Perilous Plot of
Professor Poopypants (2000), in which a biodeterminist model of ADHD is
dismissed in favor of social and institutional explanations for the disruptive
behavior of some students.......................................................................................255!

Figure 10: An example of the dark tone of Alan Moore and Brian Bolland’s
Batman: The Killing Joke (1988)............................................................................268!

Figure 11: “You’re going mad.” Alan Moore and Brian Bolland’s Batman: The
Killing Joke (1988). ................................................................................................269!

Figure 12: “All it takes is one bad day.” Alan Moore and Brian Bolland’s Batman:
The Killing Joke (1988). .........................................................................................270!

Figure 13: “It’s all a joke!” Alan Moore and Brian Bolland’s Batman: The Killing
Joke (1988). ............................................................................................................271!

Figure 14: “Some kind of super-sanity…” Grant Morrison and Dave McKean’s
Arkham Asylum: A Serious House on Serious Earth (1989). .................................273!

Figure 15: “Out there, in the asylum.” Grant Morrison and Dave McKean’s Arkham
Asylum: A Serious House on Serious Earth (1989). ...............................................275!

Figure 16: “[A] psychopath…with attention deficit disorder.” Kevin Smith and
Walt Flanagan’s Batman: Cacophony (2009). .......................................................277!

Figure 17: Marvel Comics’ character Deadpool struggles with his own brain
chemistry.................................................................................................................281!

viii
Figure 18: “Building a Better Brain.” Discover Magazine April 2009, p.55. .................296!

ix
 1

INTRODUCTION

During the last thirty years, millions of Americans have come into contact with

Attention Deficit/Hyperactivity Disorder (ADHD)1, if not through their own diagnosis or

the diagnosis of a friend or family member, then through the perennial and occasionally

passionate debate this behavioral disorder has inspired in U.S. popular culture since its

inauguration in 1980. The competing claims of this debate are many and varied, and they

revolve around a number of subtle distinctions that have emerged from diverse discourses

and institutional histories. It is among the aims of this project to excavate and clarify

these multiple, often contradictory and disjunctive claims by resituating them within their

disparate (indeed, still emerging) rhetorical and historical contexts. For the moment,

however, we can observe that the central questions animating this debate fall into roughly

three general categories – or questions:

• How should ADHD be treated? Are the stimulant medications most often

prescribed children with ADHD safe? Do they really work? Is it appropriate to

administer highly addictive and frequently abused drugs to young children? Are

there alternative ways to treat ADHD?

• Who should be diagnosed with ADHD, and on what grounds should diagnostic

distinctions be made? How does one distinguish between ADHD behaviors and

normal childhood behaviors? Is ADHD over-diagnosed? Alternately, is it under-

diagnosed? What proportion of the population should we expect to have ADHD?

Should this expectation be different for different regions, states or countries?

1 While this diagnosis is currently known as Attention Deficit/Hyperactivity Disorder

(ADHD), it was initially called, simply, Attention Deficit Disorder (ADD). The change from
ADD to ADHD was semantic, rather than substantive; there is effectively no distinction between
the two. Note that some documents and organizations (e.g., Children and Adults with Attention
Deficit Disorder – ChADD) continue to use the original nomenclature.
 2

What explains the remarkable gender disparity in ADHD diagnosis, resulting in

far more boys being diagnosed than girls? How young is too young to diagnose a

child with ADHD? How old is too old?

• Is ADHD “real”? Or is it “cultural”? Can it be both? Is it better understood as

something other than a mental disorder? And if so, then does the manufacture

and promotion of ADHD as a mental disorder constitute some form of fraud?

Such questions have generated an impressive collection of books, journal articles,

magazines and web sites aimed at a range of audiences. However, these publications

tend to advocate for one position or another – within the limitations of a single field and

its defining questions – when accounting for ADHD, making it nearly impossible to gain

a balanced or nuanced understanding of ADHD from anything less than a library of

medical, educational, psychological, and popular cultural resources. Moreover, the

dominant accounts – whether popular or professional, skeptical or apologist, legalistic or

aesthetic – fail to consider the diagnosis within a wider socio-cultural and historical

context. While there has been insightful scholarship recently produced on other
behavioral disorders and behavioral disorders more generally,2 very little has been

written on ADHD from a critical cultural studies and historical perspective.3

This project therefore analyzes this under-theorized behavioral disorder from a

rhetorical and cultural perspective. In doing so, it aims to go further than other critiques

or defenses of the diagnosis and its chemical therapies. It does so by bringing discourse

analysis to bear on ADHD, thereby illuminating how this assemblage of rhetorics and

2 For example, see Christopher Lane, Shyness: How Normal Behavior Became a Sickness
(New Haven: Yale University Press, 2007); Alan V. Horowitz, Creating Mental Illness
(University of Chicago Press, 2002).
3 ADHD has been discussed critically as an aspect of larger studies, such as in the third
chapter of Peter Conrad’s The Medicalization of Society (John Hopkins University Press, 2007),
and has been the subject of at least one critical anthology, Sami Tamimi & Jonathan Leo, eds.
Rethinking ADHD: From Brain to Culture (New York: Palgrave Macmillan, 2009), but it has less
often been the subject of a study of its own.
 3

questions – centered as they are on the Mind/Body continuum – constitute what Michel

Foucault refers to as biopower – or a process of social control exercised on and through

the technological manipulation of life itself. Considering it from such a perspective will

allow us to situate ADHD within modern debates over the definition of consciousness, a

debate that is inseparable from the history of technology and the technological systems in

which minds and bodies are thoroughly implicated. This dissertation demonstrates that a

biopolitics of consciousness structures the emergence of and the debate surrounding

ADHD and the administration of stimulant drugs for the purpose of managing attensity.

While its roots in the history of consciousness extend much earlier, the debate

over ADHD has emerged recently; we have yet to see the first generation of children

diagnosed with ADHD mature beyond early adulthood. Since the early 1980s, however,

we have seen an amphetamine treatment regime emerge that targets consciousness

through chemical intervention: especially Ritalin. This generation – my own generation

– might fairly be called the Ritalin Generation, for even though more school-age children

were not diagnosed ADHD than were, the ubiquitous presence of ADHD in popular
culture has, by 2014, normalized the expectation of chemically-induced cognitive

regulation for a portion of the population between the ages of ten and forty. This is made

most apparent to me as I recall the oft-repeated playground taunt of my grade school

years in the 1980s, “Take a chill pill!” So commonplace was the use of behavior

modifying drugs for ADHD that it never occurred to me or my friends as potentially

incompatible with Nancy Reagan’s platitudinous injunction to “Just Say No.” Neither

did it occur to us that the use of Ritalin to treat elementary school children was

particularly novel, though in truth, the exhortation to “take a chill pill” hailed an entirely

new subject position to which we had already been interpolated, a subject position so

inextricably intertwined with extended and complex networks of pharmaceutical

technologies and institutional power that we were, arguably, as much “playground

cyborgs” as any character from the Arnold Schwarzenegger or Jean-Claude van Damme
 4

movies my friends and I re-enacted during recess. As the mass media, entertainment

narratives of “the cyborg” suggest, however, chemical technologies directed at the

mind/body interface of consciousness were market-driven and directed at a new

generation of (attentive) consumers.

What is ADHD?

The most salient characteristic of the psychiatric diagnosis known as Attention

Deficit/Hyperactivity Disorder (ADHD) is the controversy it engenders. So contentious

is this disorder that even setting forth a simple definition necessitates qualifications and

attributions of contested claims to competing parties of interest, all of which vie for

authority over the conscious experience of young Americans, establishing a prescribed

range of normative behavior in the process. Because the exercise of this authority bears

with it broad and profound ramifications, not only for those diagnosed with ADHD, but

for the population as a whole, a scholarly analysis of the controversy reveals constitutive

issues at the core of American and post-national identity formation in the twenty-first

century, as we confront the implications of technological systems that, despite being put

in place by human institutions, nevertheless escape full understanding. A cultural history

of ADHD, then, cannot rely on any single institution as the ultimate authority over the

diagnosis, but must be grounded in the controversy itself, and wide-ranging in the fields

of knowledge, discourse, and scholarly methods it excavates.

Bearing this caveat in mind, allow me to offer a preliminary, working definition

of ADHD, with which any analysis must grapple: ADHD is classified in the Diagnostic

and Statistical Manual of Mental Disorders (DSM) as a "Disorder Usually First

Diagnosed in Infancy, Childhood, or Adolescence."4 This diagnosis was first widely

4 Until recently, ADHD was thought to be a disorder exclusively limited to childhood.

Children with ADHD were believed to grow out of their problems. In the past two decades, this
thinking has changed, as more adults find their childhood conditions to persist throughout their
lives. In addition, more people are being diagnosed with ADHD for the first time as adults.
Some sources suggest that the suffix "residual type" should modify the diagnosis of ADHD in
 5

recognized in the US upon its publication in the third edition of the DSM, or DSM-III, in

1980.5 According to DSM-III criteria, diagnosis of ADHD is based on the observation of

some combination of three behavioral tendencies: inattention, hyperactivity, and

impulsivity. Though diagnosticians have hypothesized that inattention, hyper-activity

and/or impulsivity is symptomatic of an underlying somatic disturbance, no consistent

neurological or biological markers of ADHD have been discovered.6 As a result, there

are no clinical tests that can assist in diagnosis, forcing a physician to make a diagnosis

solely on his or her evaluation of the degree to which a child’s behaviors deviate from

socially constructed norms.7 Because of this, the cultural norms themselves contribute as

adults, while others suggest that "adult ADHD" is a discrete subtype of the disorder, not
necessarily a vestige of a childhood disorder. Some authors have even suggested unique
diagnostic criteria for adults with ADHD. These criteria are similar in spirit to those applied to
children, with variations that accommodate the different environments adults find themselves in.
5 Prior to this, a number of similar disorders were hypothesized, but how many and
which of these deserve to be considered forerunners of the diagnosis is a matter of contention, as
is how far back in history one can trace scientific research into ADHD. The pre-history of
ADHD is addressed further in the chapters 1 and 2 of this dissertation.
6 This is, of course a developing issue, with several advances unfolding at the time of this
writing. One such development of note is the significant improvement of fMRI technology,
which enables the imaging of brain activity in real time, with greater ease and less expense than
previous technologies. Brain imaging of children diagnosed with ADHD appear to reveal a
correlation between attentive capacity and development of the frontal lobe, a result that has been
cited as further evidence of the physical nature of ADHD. While this conclusion sounds
reasonable on its surface, a more critical look at this technology reveals that it contributes little
new to our understanding of ADHD. Brain scans demonstrate a correlation between brain
development and ADHD, but do not necessarily establish causation, nor do they play a role in the
negotiating of boundaries between normalcy and pathology. In short, while fMRI images may
provide novel modes of self-perception, they do remarkably little to answer the most pressing
questions about ADHD, and serve no predictive, diagnostic or therapeutic function. Even more
recently, genetic studies have identified markers that are said to indicate predispositions to
ADHD and a number of other mental disorders. At the time of this writing, however, these
results have not yet been independently confirmed, let alone parlayed into any kind of predictive,
diagnostic or therapeutic application. In fact, even as long-sought genetic markers for ADHD are
being finally identified, the field of epigenetics is increasingly calling into question what
predictive power genetic markers will ultimately be able to sustain.
7 While researchers have developed many evaluative tools that attempt to rationalize and
standardize this process, there is no professional consensus regarding which of these tools are
most effective, rendering the process of ADHD diagnosis a subjective and idiosyncratic one.
 6

much to any understanding of this disorder as does clinical data, especially, for instance,

the racial (white) and gender (male) profile associated with ADHD. Once diagnosed,

children (and, increasingly, adults) are most often prescribed a daily regimen of

amphetamines or amphetamine-derivatives. The most frequently prescribed of these is

methylphenidate, marketed under the brand name Ritalin. Though its market position is

currently being crowded by competing products (which differ only in the details of their

chemistry – and, consequently, their patents – while functioning almost identically), for

the first two decades of ADHD diagnosis Ritalin was so commonly prescribed as to

become nearly synonymous with ADHD itself. 8

Many who have had a child diagnosed, or who have themselves been diagnosed,

welcome the label “ADHD” as an explanation of their frustrations and problems in life.

This kind of reception is frequently and most clearly expressed in ADHD self-help

literature and in the media junkets surrounding the publication of such books. Perhaps

even more visible in popular print discourse, however, is the general skepticism that the

diagnosis arouses among a significant portion of the population. The consternation of

some parents encountering the diagnosis, as well as concerned on-lookers, was made

apparent in both print and television media from the early 1980s onward. A number of

factors contributed to this reception. Some of the commentary had the appearance of

moral panic: the introduction of new illnesses into the public sphere is often alarming,

contributing to a sense that the national community itself is more diseased now than in

the past. In addition, that ADHD is an illness category associated with cognitive

8 Other drugs prescribed for ADHD or ADHD-like symptoms have included

amphetamines (such as those marketed as Benzedrine), amphetamine stereoisomers (such as
those marketed as Dexedrine), and a range of amphetamine admixtures and amphetamine
derivatives, (such as those marketed as Adderall). With the exception of non-tricyclic
antidepressants (such as those marketed as Wellbutrin), the majority of these drugs are
dopaminergic stimulants, which are nearly identical in their pharmacological properties. While
Dexedrine was the second most commonly prescribed stimulant for ADHD in the 1980s and 90s,
Wellbutirn and Adderall are increasingly common prescriptions for ADHD since 2000.
 7

processes places it in an ongoing discourse of mental health in America, already marked

by controversy and dramatic change since the antipsychiatry movement of the 1960s. As

such, the public conversation about ADHD became another opportunity to debate the

merits and shortcomings of the larger ideological shifts within psychiatry, away from the

neo-Freudian talk therapy and towards an increasingly medicalized model of mental

health, reliant on pharmaceutical drug treatments. Furthermore, the use of

pharmaceutical drugs as a routine and continuing therapy (in contrast to, for example, an

exceptional prescription of a single course of antibiotics to combat an infection) has

challenged the American legal tradition of tightly regulating consciousness-altering

experiences, while exciting a general unease regarding the increasingly common

incorporation of technology into the bodies of Americans. That drugs to treat ADHD are

prescribed to children well below the age of consent exacerbates the previously

mentioned concerns, while simultaneously prompting new questions regarding the

appropriate expectations and guardianship of a sub-population systematically denied full

autonomy, even as this sub-population is obligated to represent the perceived “future of

the nation” among pundits, politicians and media prognosticators. Finally, any

suggestion that the behaviors associated with ADHD are manifestations of cultural

norms, rather than physical pathology, has enabled some in the media to lament what this

new illness implies about the medicalized direction in which our culture is headed, while

simultaneously emboldening others to dismiss the validity of the diagnosis altogether.

Psychopharmacology in American Culture

Since WWII, middle-class Americans, as a whole, have invested increasing

amounts of money into the development, distribution and consumption of technologies

designed to modify bodies, behaviors, and brain chemistry. Since the early-1980s in

particular, growing numbers of Americans consume drugs to alter their mood, their state

of mind, or their consciousness, as demonstrated by the steady growth of the

 8

pharmaceutical industry, which has seen sales increase every year since 1961.9 A central

argument of this dissertation as a cultural analysis of ADHD is that since the mid-20th

Century, the pharmaceutical industry has emerged as the dominant arbiter of chemically

formulated mind/body modification technologies, allowing it to emerge as one of the

most powerful social actors in American culture. This power is made apparent not only

by the industry’s profits, but by the coinciding cultural impact of the industry’s activity in

commercial and consumer markets. For example, the pharmaceutical industry –

particularly since the de-regulation and subsequent adoption of direct-to-market

advertising in 1997 – has made it thoroughly commonplace for Americans to hear or

watch advertisements stridently selling the ability to modify one’s own body, behaviors,

or brain chemistry to fit more closely his or her self-perception. As Carl Elliot has

described in Better Than Well (2003), such medical marketing resonates as the latest

iteration of the American Dream, the pursuit of which is presented as one’s national

responsibility.10 While the rhetoric of the “self-made man” has been a notable part of
American culture at least since Horatio Alger’s novels of the late Nineteenth Century,11

the technological means to so easily render dramatic changes, not only to one’s

circumstances but to one’s consciousness, is a relatively new phenomenon. This, coupled

with the level of social power now afforded to the pharmaceutical industry, signals a new

development in Americans’ relationships with technological systems installed within

their own bodies. While there is no single moment at which this newly technologized

9 As reported in the Kaiser Family Foundation, “Prescription Drug Trends, September

2008” (www.kff.org/rxdrugs/upload/3507_07.pdf) and Fortune 500
(http://money.cnn.com/magazines/fortune/global500/2009/performers/industries/profits/)
10 Carl Elliot, Better Than Well: American Medicine Meets the American Dream. (New
York: W.W. Norton and co., 2003).
11 Richard M. Huber, The American Idea of Success (Wainscott, NY: Pushcart Press,
1987).
 9

consciousness – what N. Katherine Hayles has called “posthumanity”12 – can be said to

arise, the increasing dominance of a psychopharmaceutical regime since the early 1980s

certainly places us well within the new paradigm, even while many of the intellectual

habits of previous “humanist” paradigms stubbornly persist. In fact, as this dissertation

will demonstrate, the contentious discourse around ADHD in US culture is marked

specifically by the co-existence and contradictions between posthumanist and humanist

paradigms of thought.

Therefore, this dissertation interrogates the interrelated economic, cultural,

political and technological components of this new mind/body paradigm by asking a

paradoxical question: what do various sectors of the American public think about their

newfound ability to modify bodies, behavior, and brain chemistry, even while their

ability to modify bodies, behavior, and brain chemistry affects how they think? Further,

and central to this project, how does this ability contribute to constructions of American

identity in interaction with other technologies of self, and constructions of race, class,

gender, sexuality and (dis)ability? To answer these questions I employ several methods

and tools associated with American Studies in general, and two other fields in particular:

cultural studies, and science and technology studies. These fields complement and

reinforce each other, because the technologies through which social subjects interact are

inseparable from the cultural meanings and values socially associated with them. Just as

any understanding of the rise of psychopharmacology, for instance, requires an account

of industrial science and technology, so too does it require an account of the stories

through which social subjects negotiate the potential good and ill of those technologies.

12 N. Katherine Hayles, How We Became Posthuman: Virtual Bodies in Cybernetics, Literature,

and Informatics (Chicago: University of Chicago Press, 1999).
 10

Popular Expression in Commodity Culture:

Cultural Studies and Technology

Since Vernon Louis Parrington’s Main Currents in American Thought (1927)

American Studies projects have, to a greater or lesser degree, presented a historical and

cultural context for the texts they examine. Henry Nash Smith explained how literature

“needs to be placed in a social setting before it can be understood,” and went on to

suggest that “one of the distinctive fields of American Studies is precisely this ambiguous

relation between works of art and the culture in which they occur.”13 Such an approach is

often associated with the term “cultural history,” which looks not only at a series of

chronological events in a particular sphere of knowledge or a singular institution of

knowledge production, but contextualizes those events in terms of contemporaneous

events and attitudes from across a range of experiences. While American Studies is not

as tied to the study of American literature as it once was, scholars in the field have also

continued to read cultural texts, often in order to capture the multiform discourses, actors,

and media that can allow us to account for radical socioeconomic change.

Furthermore, at mid-century, scholars began to rethink the uses of cultural history,

and of history itself. The anti-colonial liberation movements throughout much of the

world, as well as the civil rights and feminist movements in the US, prompted the

development of counter-histories from the critical perspective of previously colonized or

marginalized groups, and drew attention to the hegemonic power of history writing itself.

In response to these continuing developments, Warren Susman, for one, has proposed an

alternate way of using history. He suggests taking history itself as one’s object of study,

proposing “an examination of the cultural consequences of special attitudes toward the

13 Henry Nash Smith, “Can ‘American Studies’ Develop a Method?” American

Quarterly, Vol. 9, No. 2, Part 2 (Summer, 1957): 197, 199.
 11

past and the uses of history within a culture.”14 Susman also points out that history

serves an ideological function by legitimizing and privileging the social institutions that

work to produce it. This perspective echoes similar trends since the mid-20th Century.

For example, Hayden White’s Metahistory (1973) investigated the social conditions and

political structures that give rise to different tropes, metaphors, and myths that constitute

the practice of history.15 Similarly, Michel Foucault authored several well-known

genealogies – or counter-histories – of institutions of “power-knowledge,” with the goal

of exposing the covert and systematic domination that is written into the narrative

architecture that structures social life as history.16

While I rely upon these redefinitions of history in my own work, I increasingly

identify particular histories as the objects of my study. While Susman, for instance,

identifies the ideological function that history – writ large – plays on a culture-wide basis,

I observe that histories of institutions or technologies – writ small – often function to

legitimate, defend and help reproduce the institutions and technological systems that

produce them. Such histories, including, for instance, the popular “history” of ADHD,

are cultural objects in their own right, not to be understood simply as background

information for a text, but as texts themselves, necessitating interpretation, and bearing

meanings embedded in the process of their emergence through processes distinct from the

content or information they purport to communicate. I will demonstrate this by critiquing

the popular history of ADHD as it is presented in self-help literature and medical sources,

14 Warren I. Susman, “History and the American Intellectual: Uses of a Usable Past.”
American Quarterly, Vol. 16, No. 2, Part 2: Supplement (Summer, 1964): 243.
15 Hayden White, Metahistory: the historical imagination in nineteenth-century Europe
(Baltimore: Johns Hopkins University Press, 1973).
16 Michel Foucault, Madness and Civilization: A History of Insanity in the Age of
Reason (New York: Pantheon Books, 1965); Michel Foucault, Psychiatric Power: Lectures at the
College de France, 1973-1974 (New York: Palgrave MacMillan, 2006).
 12

and by offering a counter-history that destabilizes the objective status of the disease

category as it was defined in the 1980s.

This dissertation views popular texts and objects, such as the definition of ADHD,

on a continuum with other technologies of the self, the consumption of which contributes

to the construction of one’s social identity, negotiated in terms of gender, sexuality, race,

class and ability. I select objects of study that clearly demonstrate the process of subject-

construction in the course of their consumption. Such objects lend themselves to what

anthropologist Igor Kopytoff calls “cultural biographies of things.”17 This dissertation,

therefore, traces the different “life stages” of ADHD, as a cultural object, thereby

rendering intelligible the complicated circuits of consumption and production, as well as

the cultural processes of meaning making and knowledge production (including historical

knowledge). For example, I show that the process by which Ritalin structures the

subjective experience of one who consumes it is not only chemical in nature, but social,

just as the consumption of any text or object both reflects and contributes to one’s social

identity.

The social justice movements of the 1960s, followed by a series of institutional

realignments within the academy, have fundamentally altered notions of “identity” and

“the self.” In contrast to the enlightenment ideal of the autonomous, discrete self and an

essential, rational human nature, American Studies scholars now often embrace the

notion of the individual as a multivalent social construction caught up in systems of

structured dominance, constrained, but not determined by our material bodies.18 From

this point of view, identity is the intersection of multiple identity categories (including

17 Igor Kopytoff, “The Cultural Biography of Things: Commoditization as Process,” in

The Social Life of Things: Commodities in Cultural Perspective, ed. Arjun Appadurai (New
York: Cambridge University Press, 1986), 64–91.
18 Judith Butler, Gender Trouble: Feminism and the Subversion of Identity. (New York:
Routledge, 1990).
 13

gender, sexuality, race, class and ability) in a multivalent and participatory process of

difference production, resulting in various intersectional subject positions, which may

occasionally aggregate in local affiliations of convenience, but vary greatly across the

population as a whole. American studies scholars have adopted these categories (gender,

race, sexuality, class, ability, and others) as tools of analysis to be brought to bear on all

subjects of investigation. Just as Sandra Harding argues that including the situated

knowledge of multiple social positions lends itself to a stronger objectivity than the

traditional practice of suppressing subjective information,19 so too is the field of cultural

studies strengthened by responding to scholarship originating in Women’s Studies,

Gender and Sexuality Studies, Post-colonial Studies, Ethnic Studies, and Disability

Studies.

As cultural studies and American Studies scholars reconstruct the narratives

created by the emergence of discursive objects through social space, taking into account

the perspectives and contributions of heterogeneous subject positions, they reveal the role

that the cultural texts and objects play in the demarcation, performance and reification of

these subject positions. As objects pass through social space and multiple meanings, they

mark and are, themselves, marked by people in different social groups along the way.

While these processes of meaning-attribution are significantly constrained and shaped by

the media through which they find expression,20 they are also dynamic and participatory.

All texts participate in this process, regardless of how openly they acknowledge this

function. In fact, the apparent absence of clear identity markers in a text is perhaps the

most powerful demonstration of its embedded social, cultural, and historical character –

19 Sandra Harding, “Rethinking Standpoint Epistemology: What is ‘Strong

Objectivity’?” in Feminism and Science, eds. Evelyn Fox Keller and Helen E. Longino (New
York: Oxford University Press, 1996).
20 Marshall McLuhan, Understanding Media. : The Extensions of Man. (New York:
McGraw-Hill, 1965).
 14

the implied universality of the unmarked category is a function of privilege. In other

words, texts that do not readily appear to have been produced from a particular subject

position – in this study, scientific and medical research – thereby contribute to the

construction of whiteness, masculinity, heteronormativity and able-bodiedness. This

observation is particularly important to the study of science and technology, where

networks of power and domination frequently obscure their own social and historical

positionality by purporting to be “objective.”

This perspective compels me to acknowledge my own social and historical

subject position – a liberal, currently-abled, straight, white, middle class, Midwestern

male who, like most people, fails to fit entirely comfortably into any of the categories that

describe him. As a result, I frame my study in terms of the construction of the positions I

am compelled to perform – particularly whiteness, masculinity and ability. To this end, I

find inspiring recent scholarship in gender and ethnic studies, which asserts that the

privileged position in hierarchal power relationships are no less constructed and

disciplined than their underprivileged counterparts.21 Equally important, this project

responds to scholars such as Kanta Kochhar-Lindgren, who has recently called upon

American Studies scholars to more consistently recognize and incorporate into their work

the perspective of disability studies.22 This perspective is vital, as attitudes and policies

regarding disability have long contributed to the construction of American identities,

21 For examples of such scholarship, see: Susan Bordo, The Male Body: A New Look at
Men in Public and in Private (New York: Farrar, Straus and Giroux, 1999); Butler, Gender
Trouble; Richard Dyer, White (New York: Routledge, 1997); Barbara Ehrenreich, The Hearts of
Men: American Dreams and the Flight from Commitment (Garden City, NY: Anchor
Press/Doubleday, 1983); Susan Faludi, Stiffed: The Betrayal of the American Man (New York:
W. Morrow and Co., 1999); John F. Kasson, Houdini, Tarzan, and the Perfect Man: The White
Male Body and the Challenge of Modernity in America. New York: Hill and Wang, 2001); Eric
Lott, “Racial Cross-Dressing and the Construction of American Whiteness,” in The Cultural
Studies Reader, Second Edition, ed. Simon During (New York: Routledge, 1999).
22 Kanta Kochhar-Lindgren, “What Happens If You Put American Disability Studies at
the Center?” American Quarterly, vol. 61, no. 2 (June 2009): 395-404.
 15

often by defining worth and national identity in terms of utility to the nation state.23 In

the cultural study of ADHD, understanding disability as a socially constructed and

permeable identity category offers an important contrast to the trend within cognitive

research to physiologize social behaviors. As I point out in detail below, the

pharmaceutical management of cognitive differences through drugs like Ritalin tends to

reify the status of social and cultural differences as physiological in nature, thereby

obviating social and environmental interventions more commonly favored by those

within the disability rights movement. Such an approach reminds us that knowledges are

contingent, reinforcing George Lipsitz’s admonition to American studies scholars to

derive the vocabulary of scholarship from the object of study itself, rather than from

adherence to and imposition of an a priori theory of method.24

Taking this to heart, my method responds to a series of subfields organized since

the mid 20th Century: the biotechnological system of psychopharmacology and its

products – pills and pill-takers. In investigating these technoscientific objects, I am

influenced by science and technology studies. In addition to these, however, there are

other kinds of popular objects and texts such as books, films, and graphic novels, in

which I read the cultural impact and context of psychopharmacological objects of study.

In chapters four and five, these legible objects include film, television, graphic novels,

comic strips, children’s literature, popular science magazines, hip hop music, museum

displays, internet forums, and advertising. Although this represents a diverse swath of

texts with associated subfields, in fact, Cultural Studies demands such breadth in order to

23 Douglas Baynton, “Disability and the Justification of Inequality in American History.”

in The New Disability History: American Perspectives, eds. Paul K. Longmore and Lauri
Umansky (New York: New York University Press, 2001), 33-57; Claire H. Liachowitz, Disability
as a Social Construct: Legislative Roots (Philadelphia: University of Pennsylvania Press, 1988).
24 George Lipsitz, “Listening to Learn and Learning to Listen: Popular Culture, Cultural
Theory and American Studies.” in Locating American Studies: The Evolution of a Discipline, ed.
Lucy Maddox (Baltimore: John Hopkins University Press, 1999).
 16

grapple with the diffuse and technologized nature of contemporary American popular

culture. In addressing precisely this issue, media scholar Henry Jenkins identifies pop

culture as a “transmedial storytelling ecology,” in which media franchises and “cultural

poachers” work together to produce texts that exceed traditional media boundaries.25

Such cultural texts depend upon and reflect discrete technologies and institutional

histories, in which cultural actors producing these texts interact with the material

technologies involved in the creative process, as well as with technologized communities

involved in marketing and distribution. These relationships between cultural forms and

surrounding technologies underscore the need to examine networks of cultural production

that are inseparable from technology and technologized sciences.26 While there are
cultural studies models that anticipate it,27 my own method has been significantly

influenced by science and technology studies methods, just as my science and technology

studies methods are influenced and supplemented by my American Cultural Studies

method. This crosspollination of methods reflects the reality that science and culture are

more intimately and inextricably associated than is commonly acknowledged, given the

popular perceptions of the “two cultures” of science and the humanities.28

25 Henry Jenkins, Convergence Culture: Where Old and New Media Collide (New York:
New York University Press, 2006).
26 Examples of recent Cultural Studies along these lines include Kevin Heffernan,
Ghouls, Gimmicks, and Gold: Horror Films and the American Movie Business, 1953-1968
(Durham, NC: Duke University Press, 2004), and the work collected by Vicki Mayer, et al, in
Production Studies: Cultural Studies of Media Industries (New York: Routledge, 2009).
27 For example, the “circuit of culture” proposed in Paul du Gay, et al, Doing Cultural
Studies. The Story of the Sony Walkman. (London: Sage Publications, Open University, 1997).
28 C. P. Snow, The Two Cultures and the Scientific Revolution (New York: Cambridge
University Press, 1959).
 17

American Culture and Technosciences of the Mind/Body

The study of technology has long been a field of inquiry in American Studies, but

is now newly and differently central to the field. For instance, a recent American Studies

anthology includes “Mediating Technologies” as one of the ten main “analytics” of the

field,29 while 2007 saw the publication of an American Quarterly issue focused entirely

on Re-Wiring the “Nation”: The Place of Technology in American Studies.30 I echo the

call Carloyn de la Peña makes in this volume, to position the study of technology and

technological systems as central to the field of American studies. Such a line of inquiry

is valuable to the American studies scholar because technology significantly shapes the

conscious experience(s) of our selves within American culture. Technologies accomplish

this by enabling the aggregation of capital and power into complex systems that have the

ability to extend an individual’s agency over his or her self and environment, while

simultaneously delimiting the range of possible social experiences available. Among the

core insights of technology studies is the insight into how subjects are not dictated by

deterministic forces of technologies; rather, consumers of technology actively engage in

the technological process, modifying or even subverting the intended use-value of the

technologies they consume. As a result, investigations of the uses of technology by

individuals in the course of their everyday lives are productive in identifying expressions

of collaboration with, and resistance to, hegemonic social interests.

Moreover, the attention of American studies scholars promises to enrich the field

of science and technology studies, as the far-reaching ramifications of technological

systems demand broad contextualization in cultural history. Further, the current

emphasis within American studies on the cultural production of difference through social

29 Janice A. Radway, et al., American Studies: An Anthology. (Malden, MA: Blackwell,

2009).
30 Carolyn de la Peña and Siva Vaidyanathan, eds., Rewiring the “Nation”: The Place of
Technology in American Studies. (Baltimore, MD: Johns Hopkins University Press, 2007).
 18

constructions of gender, sexuality, race, class, nationality and disability makes scholars in

the field especially suited to address the multiplicity of intersections between

technological systems and individual subjectivities. Discussions of technology have long

failed to address these intersectional issues, leaving unmarked categories that present a

false sense of technological “neutrality,” while functionally structuring technology as

essentially “white” and “male.”31 Conducting such a historical and cultural

contextualization of technology, with particular attention to the construction of American

subjectivities, affords insights that are less apparent through more discipline-bound

approaches to the topic. Most important among these is that, in addition to whatever

object or utility a particular technology ostensibly produces, culture itself is the product

of technology, as individual’s multiple engagements with systems of power authorize,

restrict, modify, challenge, and ultimately re-create the conditions of the social world.

Addressing these issues is essential to understanding technologies, because the cultural

components of a particular technological system are as fundamental to its success or

failure as its material components.

In The Machine in the Garden, Leo Marx called attention to the cultural

components of technologies and the essential function they perform. As he points out,

the perpetuation of the pastoral ideal of the “middle landscape” was inextricable from the

spread of industry and technology; paradoxically, the articulation of this cultural myth

enabled the technological conquest of natural space.32 More recent American studies

work carries this theme forward, pointing out the mutually constitutive relationship

between material technologies and the social roles and meanings assigned to them. For

31 For further discussion of the aggressive whiteness of technology, see: Joel Dinerstein,
“Technology and Its Discontents: On the Verge of the Posthuman.” in Rewiring the “Nation” and
Michael Adas, Dominance by Design: Technological Imperatives and America's Civilizing
Mission (Cambridge, MA: Belknap Press, 2006).
32 Leo Marx, The Machine in the Garden: Technology and the Pastoral Ideal in America
(New York: Oxford University Press, 2000).
 19

example, David Nye, in American Technological Sublime (1994), argues that the feelings

of awe and national pride inspired by large infrastructure projects offered as much utility

for 19th Century Americans as did the bridges, canals and skyscrapers themselves.33

Similarly, Jeffrey Meikle, in American Plastic (1995), addresses both the material reality

of plastic’s development and introduction to the marketplace, as well as the shifting and

sometimes contradictory meanings that accrue to the concept of “plastic” in social life.34

This relationship becomes apparent in my own research, as the technology of Ritalin and

the diagnostic category of ADHD are inseparable from cultural constructions of

normative attensity.

While Leo Marx and a handful of other scholars stand out as important American

anticipations of post-humanist technology studies since 1990,35 much of the important

scholarship in the field has emerged from science studies, itself a still-developing and

interdisciplinary field. The study of science within the Humanities generally did not

concretize as a relatively discrete field of inquiry until the late 60s and early 70s, among

sociologists who referred to themselves collectively as the Strong Programme, eventually

setting the new standard for the sociology of scientific knowledge (SSK).36 These

scholars took inspiration from the work of physicist and philosopher of science Thomas

Kuhn, who argued that scientific knowledge did not develop in a more rational and

33 David Nye, American Technological Sublime (Cambridge, MA: MIT Press, 1994).

34 Jeffrey L. Meikle, American Plastic: A Cultural History (New Brunswick, NJ:

Rutgers University Press, 1995).
35 Most notably, Lewis Mumford, Technics and Civilization (New York: Routledge and
Kegan Paul, 1934), and the group of scholars associated with the founding of the Society for the
History of Technology (SHOT) in 1958, including Thomas P. Hughes, Networks of Power:
Electrification in Western Society, 1880-1930 (Baltimore: Johns Hopkins University Press, 1983)
and Edward Constant II, The Origins of the Turbojet Revolution (Baltimore: Johns Hopkins
University Press, 1980).
36 For an account of the formation of the Strong Programme, see David Bloor,
Knowledge and Social Imagery (London: Routledge, 1976).
 20

systematic manner than other forms of knowledge, but was instead prone to the same fits

and starts and social influences as other fields of knowledge production.37 Based on this

conviction, Strong Programme sociologists rejected “asymmetrical” scholarship38 that

failed to grapple with scientific claims; instead, these scholars and embraced the

challenge of approaching scientific knowledge as a social construction.39 The resulting

new method consists of three stages of analysis: first, identify moments in which

scientific knowledge is understood as flexible or open to interpretation; second, identify

the social mechanisms through which this interpretive flexibility is constrained in order to

produce incontrovertible facts; and third, contextualize those social mechanisms within a

larger cultural framework.40 This dissertation employs this approach, in the light of later
developments.

37 Thomas Kuhn, The Structure of Scientific Revolutions (Chicago: University of

Chicago Press, 1996).
38 As Bloor recounts, Strong Programme scholars characterized SSK scholarship up to
that point as primarily concerned with explaining the failures of science through sociological
methods. This left the knowledge produced by science’s successes largely unexamined, allowing
the internal logic and practice of science to serve as its own self-evident explanation. In so doing,
the successes and failures of science were presented in entirely different and supposedly mutually
exclusive fields of knowledge. This asymmetry casts science as an inevitably self-perfecting
method, while casting all other realms of experience as potential obstacles to the scientific
process. In contrast, the Strong Programme approached SSK “symmetrically,” proposing that
scientific successes were the product of social factors as much as were its failures.
39 In this, SSK scholars were elaborating methods developed by sociology of knowledge
scholars Peter Berger and Bernard Luckmann in The Social Construction of Reality: A Treatise in
the Sociology of Knowledge (Garden City, NY: Doubleday, 1966).
40 In addition, early Strong Programme work of note also employed ethnographic
methods to study the scientific process among scientists and in the laboratory. Examples include
Harry Collins, “The TEA Set: Tacit Knowledge and Scientific Networks” Science Studies, 4:
165-86 (1974), Bruno Latour and Steve Woolgar, Laboratory Life: The Social Construction of
Scientific Facts (Beverly Hills: Sage Publications, 1979), and Karin Knorr-Cetina, The
Manufacture of Knowledge An Essay on the Constructivist and Contextual Nature of Science
(New York: Pergamon, 1981). Other scholars applied Strong Programme methods to the history
of science, such as Donald MacKenzie, Statistics in Britain, 1865-1930: The Social Construction
of Scientific Knowledge (Edinburgh: Edinburgh University Press, 1981) and Steven Shapin and
Simon Schaeffer, Leviathan and the Air-Pump: Hobbes, Boyle and the Experimental Life
(Princeton: Princeton University Press, 1985).
 21

By the mid-1980s, SSK scholars, in collaboration with other scholars, including

those from the Society for History of Technology, translated their method to the study of

technology, as outlined by Wiebe Bijker and Trevor Pinch in The Social Construction of

Technological Systems (1987).41 Even as Pinch and Bijker clarified their method,

however, they were already looking to meld their project with SSK writ large,

envisioning the composite field of Science and Technology Studies (STS).42 Because

SSK methods proved fruitful in the study of technology, Bijker and Pinch argue that

insights from these studies will be of interest to other SSK scholars. Moreover, as the

authors point out, the distinction between science and technology is hazy at best, if not

entirely arbitrary. On this point, French sociologist Bruno Latour has commented that

technology and science are ultimately indistinguishable, precisely because this

sociological method reveals the same basic process at work in both the construction of

scientific facts and the construction of technological artifacts.43 Further, technology and
science (and, for that matter, society) are mutually implicated. For these reasons, in my

own work, I borrow Latour’s hybrid-word “technoscience” to refer to this field as a

whole. As this suggests, Latour’s model of STS emphasizes the interrelationships

between technologies and larger systems. Characteristic of such technological systems is

their heterogeneous nature, being composed of physical artifacts, theories and concepts,

individual people in various roles, organizations, legal institutions, and natural resources.

41 Early examples of this method are exemplified by Donald MacKenzie and Judy
Wajcman, eds., The Social Shaping of Technology: How the Refrigerator Got its Hum
(Philadelphia: Open University Press, 1985) and Wiebe Bijker’s own work on the invention of
the bicycle and certain forms of plastic, as recounted in Of Bicycles, Bakelites, and Bulbs:
Toward a Theory of Sociotechnical Change (Cambridge, MA: MIT Press, 1995).
42 STS may also stand for “science, technology and society.” This title has been
attached to a number of interdisciplinary research programs and academic departments, some of
which preceded and developed independently of SSK. While historical and methodological
differences certainly exist between these different groups, their goals, methods, and subjects of
inquiry remain similar enough to consider them basically interchangeable within the umbrella
term STS.
43 Bruno Latour, Science in Action (Cambridge: Harvard University Press, 1987).
 22

To deal with such systems, SSK scholars – Latour, Michel Callon and John Law,

most notably – developed an approach called actant-network theory (ANT). 44 In

explaining how such heterogeneous systems operate as a whole, ANT considers both

human and non-human elements within the system as active participants – or actants – in

a network of associations, each with its own sense of agency.45 In addition to specifying

as its topic of inquiry the complex and dynamic network of human and non-human

actants that work in concert to form technological systems, ANT further specifies that

moments of controversy are especially instructive events.46 In the midst of

technoscientific controversy, the variability of interpretation of relevant facts becomes

apparent in the arguments put forth by actants who advocate for truth claims that favor

their own particular interests. Latour suggests mapping these various actants and their

interests in the controversy, in order to make visible the far-reaching and often unlikely

alliances forged between different actants in the pursuit of the network’s presumed goal.

This method can be used to describe either the process of publishing research results in

scientific journals, a scientist applying for a research grant from a university or

44 A notable precedent to ANT is the field of cybernetics, spearheaded in the post-WWII

US context by scholars such as mathematicians Norbert Weiner and John von Neumann,
information theorist Claude Shannon, anthropologist Gregory Bateson, sociologist Paul
Lazarsfeld and neuropsychologist Warren McCulloch, among others. Drawing from a wide range
of fields, cybernetics grew out of the military effort to create weapons systems that seamlessly
integrated machine, computer and human elements. By positing human beings and machines as
functionally analogous, both cybernetics and ANT disrupt a central tenet of liberal humanism:
namely, the belief in human beings’ separation from and dominance over the natural world.
Latour identifies this as a rejection of the notion of modernism, along with its accompanying
notions of primitive and postmodernism. In rejecting the modernist project, associated with the
liberal humanism that has its roots in the Enlightenment, Latour calls himself a non-modernist,
insisting that We Have Never Been Modern – as his 1993 book is titled. Latour’s non-modernism
bears a strong affinity to posthumanism, a field that has embraced the image of the cyborg as an
embodiment of the critique of liberal humanism.
45 Latour, Science in Action.

46 This echoes the rhetorical turn in Humanities scholarship also in the 1980s and 90s.
Herbert W. Simons, “The Rhetoric of Inquiry as an Intellectual Movement,” in The Rhetorical
Turn: Invention and Persuasion in the Conduct of Inquiry, ed. Herbert W. Simons (Chicago:
University of Chicago Press, 1990), 1-34.
 23

foundation, or a lab technician consulting a mass spectrometer for corroborating data, all

of which may well be constitutive elements of a technoscientific system, composed of

human and non-human actors. In this dissertation, I employ this method to consider the

wide range of actants involved in the ADHD controversy, including not only human

communities but also techno-pharmaceutical industries, professional associations,

educational institutions, as well as objects of visual and textual culture.

Interdisciplinarity and a Multiperspectival Approach

The multiplicity of forces involved in the cultural construction of ADHD

contributes to its resonance and persistence; the same multiplicity makes discussion of

ADHD challenging, because it is virtually impossible to represent so many bodies of

knowledge. Instead, any particular discussion tends to approach the subject from one

position or another. For example, an article that approaches ADHD as an educational

problem will discuss it in the context of available interventions to educators, or possibly

(less often) in the historical context of teaching interventions with problem students.

These conversations tend to not directly address the psychopharmaceutical research on

ADHD – or the degree that they do it is only to cite it as unproblematized evidence

towards one educational intervention or another. Conversely, discussions of the efficacy

of one drug over another tend to ignore social interventions all together. This tendency

has been an obstacle to understanding what ADHD is, and the role it has played in US

culture and society since the early 1980s.

The inability to address ADHD from multiple perspectives is symptomatic of a

deep structural truth within the modernist project of knowledge production, in which the

ability to “produce” knowledge, and the knowledge that is subsequently produced, are

stratified and slotted into a number of different fields, made distinct from each other not

only by content, but by institutional apparatuses, cultures and vocabularies that surround

them. This facilitates the establishment of experts in different fields – whose authority is
 24

maintained not only by the accumulation of knowledge pertinent to a single field, but by

the complimentary disavowal of knowledge or expertise in other subjects. This

complexity is furthered by a system of professionalization, in which the perpetuation of

knowledge is delimited to a circumscribed group of individuals – certified professionals –

who maintain a monopoly of authority on a topic – which often includes active

obfuscation of that knowledge to those outside the profession.

There are, of course, practical benefits to the compartmentalization of knowledge.

A group of specialists in different fields, acting in concert, clearly represent a greater base

of knowledge than any single generalist could ever hope to wield. The utility of

compartmentalization is challenged, however, when individuals cede intellectual

engagement with fields of knowledge outside of their own, as if different experts employ

entirely different structures of logic and rationality that presumably cannot be engaged

from outside of their respective fields. At its worst, this epistemological

compartmentalization leads to the perpetuation of errors and oversights that result, in

part, from the insularity of “expert knowledge” free from the critical perspective of non-

experts.

In the case of ADHD, the compartmentalization of knowledge obscures our

understanding of both the origin and nature of this technoscientific cultural object as it

emerged at the intersection of multiple fields. At the same time, however, obfuscation is

also partly responsible for the construction of ADHD in its current form, and plays a key

role in its continued existence. That is to say, ADHD is not a phenomenon that simply

exceeds the bounds of any one field of knowledge – it is a phenomenon that is constituted

from and enabled by both the multiplicity and limitations of a compartmentalized

epistemological regime. Ironically, the inconclusivity of knowledge regarding ADHD in

any one field is circularly employed in the consolidation of the diagnosis in the public

sphere, as it affords the occasion to cite (but not engage with) expert knowledge in
 25

different fields as if the borders dividing domains of expertise constituted the boundary

conditions, or limits, of the discussion at hand.

By contrast, the cultural history of ADHD undertaken by this dissertation

necessitates and arises out of a consideration of the topic as a cultural object, constructed

through several different intersecting bodies of knowledge simultaneously and

concurrently. Only then can a clear-eyed view of the disorder as a historical and cultural

artifact be achieved. That the result is ambivalent, contradictory and complex is not the

result of this project’s interdisciplinary method; instead the method responds to the

object. Indeed, many popular cultural texts address ADHD with a sense of complex and

critical ambivalence, but such texts are also often dismissed because they do not come

from “expert” sources. I suggest, however, that the inexpert perspective is often precisely

the strength of these sources, not their limit, when considered from either a cultural

studies or an actor-network theory perspective. This project will draw, therefore, upon

many popular sources in the course of writing a cultural history of ADHD. Ultimately, of

course, a multiperspectival approach to ADHD is difficult to achieve in writing, because

the linear nature of narrative imposes priority of one subject before another, even when

endeavoring to engage with multiple bases of knowledge. Narrative linearity has the

unfortunate effect of implicitly establishing ADHD as, first and foremost, one kind of

object and one kind of problem (e.g., educational; medical; social; environmental, etc.),

with a smattering of considerations of other supplementary issues thrown in for good

measure.

To both address and avoid this problem, I have collated a series of rhetorical

positions in the form of belief statements regarding ADHD (Fig. 1). This collection of

rhetorical positions reflects both a range of opinion – from skepticism to credulity – and a

range of institutional, moral, and medical discourses. By visually documenting these

rhetorical positions in a non-linear, genealogical chart, I hope to avoid the false

prioritization of any particular field of knowledge or group of rhetors; more importantly, I

 26

hope to demonstrate how those adopting any single rhetorical stance in fact marshal

evidence from multiple fields of knowledge to represent themselves on the (imaginary)

public stage of “history.”

Among the most significant observations my approach affords is the fact that the

range of opinion and the range of knowledge bases as regards ADHD are not directly or

consistently correlated. That is to say, there are both skeptical and credulous medical

professionals, skeptical and credulous educators, skeptical and credulous popular and

self-help journalists and popular culture artists and actors, as well as skeptical and

credulous subjects diagnosed with ADHD. This stands in contrast to the non-dialogic

position of the most often-represented rhetorical positions themselves. For instance,

rhetors from the most credulous camps of psychiatry will maintain that there is no

controversy of opinion within psychiatry regarding ADHD. But a mapping out of the

issue reveals that there has never been one single medical perspective on, or definition of,

ADHD. Instead, to whatever degree any single medical perspective exists, it leads

different medical professionals to differing conclusions. My aim in offering the chart in

Fig.1 is to disrupt an uncritical over-reliance on medical or inductively “empirical”

scientific discourses as a source of authoritative knowledge, somehow not subject to the

same social influences that affect other bodies of knowledge. The goal here is not a

rejection of science or rationality; rather, I call for a more balanced, and ultimately more

accurate, understanding of a crucial cultural formation in the contemporary social world.

In Fig. 1, I present this range of belief statements in this chapter in the form of a

flow chart, or decision tree, then, that is intended to reflect the charts mental health

professionals use in differential diagnosis. The term “differential diagnosis,” in medicine

and psychiatry, refers specifically for the process of reaching a diagnostic conclusion by

the systematic elimination of all other possible diagnoses through a series of binary

distinctions that branch into exclusive and contrasting conclusions. The DSM-III and
 27

DSM-IV include, in their appendices, flowcharts for differential diagnosis of mental

disorders.

My use of this format is also somewhat satirical, as it will not yield the clarity of a

positive or negative diagnosis, as decision trees are intended to do. Instead, it will

amplify the complexity and ambivalence of this topic. The goal of this visual satire is not

simply mischief, but a demonstration of how irrationality persists in modern society, not

only despite the institutionalization of rational structures, but through those very

structures. In fact, the use of a differential diagnosis chart suggests that rhetorical

positions themselves are signs or symptoms of an underlying condition. But the condition

revealed by this endlessly branching decision tree would not be a behavioral disorder like

ADHD, but instead, a view of the multiperspectival consciousness created rather than

discovered by the discursive branching constructions of ADHD.

Most of these rhetorical positions on the flow chart are, in fact, logically

incompatible with one another, and are therefore mutually exclusive, as would be

expected in a differential diagnosis chart. What emerges from this rhetorical approach to
ADHD, however, is an image of ADHD as culturally bound and historically contingent –

which some might interpret, ironically, as an argument regarding the ontological reality

of ADHD. However, throughout this project, I in fact maintain that to identify something

as socially constructed is not equivalent to calling into question its material reality or the

consequences of its existence,47 even while recognizing that all disease categories are, to

a greater or lesser extent, socially constructed entities.48

For example, the following chart is arranged by a series of differential distinctions

that are apparently mutually exclusive; however, while each of these branching moments

47 Evelyn Fox Keller and Helen E. Longino, eds. Feminism and Science (New York:
Oxford University Press, 1996).
48 Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity (New
York, London: W.W. Norton & Co., 1997).
 28

results in two apparently different belief structures, the conversation I hope to engender is

concerned with the branching moment itself, rather than either of the two products of a

decision. My goal is to not weigh in on the truth of any claim, but to expose the process

of establishing truth and opinion, and the cultural process that structures decisions in

these terms. I also hope that the resulting chart communicates visually the simultaneity

that is so difficult to represent narratively in a project of this kind. My intention is to

depict how beliefs are related to each other, rather than to present a narrative that, by its

very nature, seems to prioritize one belief over another. To this end, I provide this chart

as a means of navigating a complicated and contingent subject through the remainder of

this chapter and the ones that follow.

Figure 1: A differential diagnostic chart of ADHD beliefs.
29
 30

The “Reality” of Mental Illness

Upon familiarizing new acquaintances with my area of research, the question I am

most commonly asked is whether or not I believe that ADHD is “real” or not. The

frequency with which I am asked this question, as well as the wide range of social

positions from which it is articulated, are indicative of the contested position ADHD

occupies. Outside of archaic diagnoses like neurasthenia, relatively few medical

diagnoses are met with such open skepticism from such a broad range of the general

public. Were I to say that I studied tuberculosis, or even other mental disorders like

schizophrenia, the question might be about prevalence rates or the latest developments in

treatment, but it wouldn’t be the existential question about whether or not those

conditions were “real.”

Considering that there is a desire among most people to reach a definitive

conclusion regarding the validity of the ADHD diagnosis, or at least widespread

confusion about its validity, it would be natural to expect that a cultural history of this

diagnosis might take as its goal such a definitive conclusion. However, both the

complexity of the issues involved, and the foundational theoretical assumptions of this

dissertation, preclude definitive judgment. Chief among these theoretical assumptions is

the socially constructed nature of disease in general, as has been clearly demonstrated

through several decades of scholarship in both medical anthropology and the history of

medicine. Within these fields, mental health is also categorized as both social and

cultural. In a related vein, Foucault has argued that the disciplinary technologies that

police health and disease are particularly persuasive sites for the negotiation of bio-power

between a state and a governed population.49 Finally, just as deviant behaviors

49 Foucault’s critique along these lines first and most famously started in Madness and
Civilization: A History of Insanity in the Age of Reason (New York: Pantheon, 1965), and later
developed in a series of lectures delivered at the Collège de France from 1973-4, recently
published under the title Psychiatric Power: Lectures at the Collège de France from 1973-1974
(New York: Picador, 2003).
 31

associated with mental illness are social constructions, so too are categories of normal

behavior also social constructions, mediated through cultural vectors of difference,

including race, gender, sexuality, class and ability.

However, by identifying illness/health, madness/sanity, and other markers of

identity as cultural constructions, I do not mean to suggest that they are not "real" or are

in any way unconnected from the material world. As Judith Butler has argued, identity

categories are negotiated within the physical bounds of our bodies, and structure our

experiences in meaningful ways, both positively and negatively.50 Moreover, social

actors perform, resist, and co-create the discourses they inhabit. Identity constructions

share the unique ontological status of social phenomena, which are historical, contingent,

and ever shifting, and in this manner very unlike what is conventionally pictured, defined,

or imagined as "objective" forms of material reality.51 This situation calls for a

theoretical approach that can account for these complexities, thereby necessitating the

rejection of a dogmatically reductionist, universalist, secular humanist discourse of

modernity. Accordingly, I employ a non-modernist and posthumanist perspective;52 I

50 Judith Butler, Bodies That Matter: On the Discursive Limits of “Sex” (New York:
Routledge, 1993).
51 For an extended account of the ontological similarities and differences between social
and material realities, see John R. Searle, The Construction of Social Reality (New York: Free
Press, 1995).
52 Donna J. Haraway, N. Katherine Hayles and Bruno Latour are all representative of the
posthumanist perspective I embrace. This is not necessarily a rejection of every achievement of
liberal humanism or the Enlightenment; for example, I do not dispute the importance of the
concept of “human rights” in legislative and juridical contexts. I also embrace Joel Dinerstein’s
critique of scholarship that, in the name of posthumanism, fetishizes technology at the expense of
critical engagement with race, gender or class. I explicitly reject, however, the nominally “post-
humanist” perspective represented, for example, by Robert Pepperell’s The Post-Human
Condition (Exeter, UK: Intellect Books, 1995) and publications like the e-journal H+
(www.hplusmagazine.com), which anticipates a millenarian, rapture-like moment when
humanity, through the incorporation of our bodies into technological systems, transcends our
current evolutionary stage to become, quite literally, post-human. Adherents to such beliefs, who
I distinguish as trans-humanists, may challenge some elements of liberal humanism (e.g., the
irreducibility of human autonomy), but powerfully re-inscribe several of the most problematic
elements of the humanist tradition that emerged from the Enlightenment – a self-serving
teleology, an overinvestment in an inexhaustible human capacity for mastery through technology,
 32

respect the valuable knowledge produced and shared by the scientific establishment while

challenging its popular monopoly on the authorization of knowledge, in an effort to

construct “symmetrical” accounts of science and culture;53 I am interested in the further

development of emergence as a counter-discourse to reductionism;54 and am suspicious

of universalism as an ideological cover for the entrenched systems of power,

characterized by whiteness, masculinity and Western superiority.

From this perspective, I argue that ADHD is neither real nor hoax, neither cultural

nor genetic, in any kind of reductive or predictable way. Rather, ADHD is best

understood as a cultural and technoscientific practice. More specifically, ADHD is the

systematized application of two recently developed technologies. The first of these is, of

course, Ritalin; the second technology involved is the diagnostic category of ADHD

itself. Considered as a technology, finally, the diagnosis of ADHD is representative,

more broadly, of a tautological model of cognition that simultaneously justifies, and is

justified by, the administration of psychoactive drugs.

Why Write a Cultural History of ADHD?

I have been drawn to this subject by a number of personal and academic reasons.

Indirectly, this study works towards making sense of my own experience growing up in a

and a fetishization of the transformative capacity of a technological future at the expense of

attention to social realities in the present.
53 Sociologists in the Strong Programme of the 1970s reacted against what they called
“asymmetrical” histories of science, in which science is constituted by all of its successes, while
all failures are attributed to contamination from other fields of human experience, creating the
impression that science has an exclusive relationship with the Truth. The Strong Programme
called for scholarly approaches to science that challenged scientific claims with the same critical
rigor that would be applied to any other historical, political, or cultural claim. For an account of
the Strong Programme’s foundation and agenda, see David Bloor, Knowledge and Social
Imagery, 2nd edition. Chicago: University of Chicago Press, 1991.
54 For a brief summary of the significance of emergence as a concept within science
studies, see Ernst Mayr, “How Biology Differs from the Physical Sciences.” in Evolution at a
Crossroads: The New Biology and the New Philosophy of Science. David J. Depew & Bruce H.
Weber, eds. (Cambridge, MA: MIT Press, 1985) pp. 41-63.
 33

culture in which the instrumentation of consciousness is normalized to the point of being

mundane, of my own encounters with psychopharmacology and diagnostic psychiatry,

and of the medical and psychiatric abuse to which I have repeatedly been witness in the

course of my life and work. Academically, this topic is an important site for the analysis

of how scientific knowledge spreads throughout culture, and how that knowledge is used,

rejected, and/or negotiated by multiple (consuming) publics. Irrespective of my own

experience, others will recognize the importance of such an analysis simply by virtue of

the remarkable proliferation of psychoactive technologies in US society since 1980. In

spite of the misgivings expressed in popular culture, the instrumentation of consciousness

has achieved a kind of intellectual dominance in medicine, in education, and in the

commercial/consumer imagination of many Americans. Ultimately, I suggest, the

pharmaceutical industry has employed a model of instrumentalized consciousness to gain

wealth and monopolize authority in the medicalization of millions of Americans lives.

The vast majority of psychiatric consumers understand very little about the products they

consume, necessitating a blind trust in the medical-industrial complex. This situation is

generally tolerated, or considered necessary, because of the perception that matters of

science and medicine rely on technical, esoteric knowledge, unavailable to and beyond

the grasp of the lay person. While there is clearly a degree of truth to this, the simple

proliferation of more “scientific” knowledge will not unyoke consumers from growing

dependence on the pharmaceutical industry. The social problem which this project is
addresses is not the fact that the public fails to comprehend the substance of scientific

and psychopharmaceutical research, but rather, that the public fails to perceive the limits

of science and psychiatry. In the arguments of both the adherents and critics of

psychopharmacology, the most consistent and crippling error is a general over-estimation

of the capacity of our mental health system to enact the kind of precision control over

consciousness it purports to have. In reality, the control over consciousness that anyone

possesses is provisional, conditional, inconsistent and predictable only in the broadest

 34

sense.55 My intention is not necessarily to decry the use of psychopharmaceutical drugs

altogether; rather, I am motivated by the conviction that, for whatever reason and to

whatever degree an individual chooses to participate in cognitive augmentation, every

individual should have the right to make such personal and profound decisions based on

realistic expectations and verifiable claims – not the hyperbole of advertising copy and

utopian faith in the mythical perfectibility of “American” technology.

To be sure, the pharmaceutical industry has largely succeeded in maximizing

what control exists in the form of several profitable products, and a number of them have

contributed significantly to many Americans’ quality of life. At the same time, however,

this has had profound – and not entirely positive – effects on health, ecology and social

inequalities. The long term effects of many pharmaceutical drugs are not known, and

will only become apparent as the first generation of Americans raised under the

psychopharmaceutical regime reaches maturity, having unwittingly served as the

experimental group in what amounts to a massive, longitudinal clinical trial conducted in

the marketplace. In the meantime, US waterways are increasingly polluted with high

concentrations of prescription drugs, leached into the groundwater via human urine.56
This situation is the result of a failure to consider the throughputs of managing our own

internal systems with industrial chemicals. Of equal concern is the chemical “life

science” industries’ considerable influence on the social construction of “normative”

social behavior. These expectations, along with their corresponding categories of

cognitive disability, profoundly structure the conscious experience of millions of people,

55 A recent of books detailing the shortcomings and failures of many pharmaceutical

drugs to accomplish the least of their expectations is journalist Robert Whitaker’s Anatomy of an
Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in
America (New York: Crown Publishers, 2010).
56 Environmental Protection Agency, “Occurrence and Fate of Pharmaceuticals and
Personal Care Products in Groundwater”
http://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/1063/rep
ort/0 (accessed 4/24/2013)
 35

and, once in place, tend to replicate the conditions of their own existence. When one

considers the profit that is generated by the construction of new youth identities such as

ADHD, it is clear that not only has consciousness been instrumentalized, but that the

social phenomenon of identity formation has itself been even more intensively

monetized.

Finally, by over-estimating the success of instrumental control, political actors

undervalue social engagement and communicative action. Within disability studies, this

tendency is identified as the problem of the “surgical solution”; that is, the able-ist

medical and legislative establishments have long over-invested in expensive (and

generally ineffective) methods of changing the bodies of people with physical

differences, rather than investing in increased accessibility in the public sphere.

Similarly, the instrumentation of consciousness has allowed and encouraged us to change

the neurochemistry of “deviant” individuals, rather than change our social environment

and learning institutions in ways that make them more accommodating to individuals

with physical and cognitive differences.

The instrumentation of consciousness has certainly proven itself to be a successful

marketing tool. The delusion of control over our selves and others that this model of

consciousness perpetuates is itself a very popular commodity. But this view of

consciousness says perhaps more about the cultural conditions of the globalized

consumer marketplace than it does about the experience of being human. In this
phenomenon, we see the influence of an irrational faith in both technology and “free”

markets, as well as an unfortunate willingness to cede authority over our minds and

bodies to total institutions. In turn, these tendencies have their root in the basic

misapprehension of the limits of human capacity. This conceit has long been recognized

as the central failing of the modernist project of liberal humanism as it emerged from the

Euro-American Enlightenment. This perspective holds (white, male) human rationality

as the irreducible zenith of all creation, thereby justifying the exploitation of

 36

environmental resources and extending a regime of control ever further into our physical

and social reality. Ironically, the instrumentation of human consciousness represents the

continued pursuit and deepening of human control, by employing technologies that, by

their very nature, challenge the basic assumptions of liberal humanism by reducing

human rationality itself to a series of “normal” or “deviant” chemical reactions. In the

name of humanism, we have become posthuman.

Chapter Overviews

Chapter 1:

The Instrumentalization of Consciousness and the

Emergence of ADHD: Cybernetics, Pharmacology, and

Social Control

The turn to diagnostic psychiatry in the late-1970s and early-80s – out of which

ADHD arises – is part of a more general shift in modern, humanist conceptions of what it

means to be a conscious being. In this chapter, I identify this transformation as the

instrumentation of human consciousness. Building on the history of cybernetics and

borrowing a term from engineering, “instrumentation” refers to the development and

application of instruments for the purpose of observation, measurement and control of a

system. Certainly, each of these three functions – observation, measurement, and control

– have played a consistent role in philosophical and scientific definitions of

consciousness since the Enlightenment. Indeed, the instrumentation of consciousness is in

many (but not all) ways an extension of the modernist project, and a way of integrating

multiple and contradictory models of consciousness promoted by different aspects of

modern technoscientific theory, criticism, and institutional practices. However, not until

the twentieth century have technologies been developed that allow for the consistent and

effective observation, measurement, and control of complex human systems including

consciousness. Primary among these 20th century technologies is psychopharmacology.

 37

Along with a handful of other psychiatric instruments, the acceptance and

promotion of psychoactive pharmaceutical drugs by a few key social institutions –

medicine, education, commercial media, and psychoactive chemical research – has, to a

greater degree than ever before, instrumentalized subjective conscious experience. This

incorporation of technology into the most intimate realm of organic human mind/bodies

marks a specific iteration of cyborg experience as a technocultural formation that is

usually associated with digital technoscience and semio-capitalism.57 The insertion of

psychopharmacology into consciousness, however, constitutes an intrinsically related

paradigm shift predicated upon a radically materialist view of the mind itself. Chapter

one argues that technocultural and Science and Technology Studies scholarship must

address the confluence of postmodern chemical technologies within “post-human”

cyborg consciousness associated since the 1980s with digital systems – as well as with

anti-colonialist and postmodern (including feminist) political movements. The popular

and professional responses to ADHD since 1980 mirror the varying responses to the

chemical and pharmaceutical instrumentation of consciousness more generally

understood as the continuation of developments in medicine, education, and U.S. mass

media since the end of World War II.

Chapter 2:

Paying Attention to Individual Differences in American

Students: A Survey of the Journal of Education, 1959-1971

The “problem student,” frequently (and increasingly between 1960-1980)

identified as an inattentive student, existed as an object of discourse among educators

prior to the consolidation of the ADHD diagnosis in 1980. In this chapter, I track the

57 The classic enunciation of this consciousness remains Donna Haraway’s 1988 “A

Manifesto for Cyborgs,” rpt. Simians, Cyborgs, and Women: The Reinvention of Nature. (New
York: Routledge, 1991.)
 38

discourse of attention deficit in the decades leading up to 80s through a survey of Boston

University’s Journal of Education from 1959 to 1971, considering every article that is

specifically oriented to the issue of (in)attention in problem students. Through this

discourse, we can trace a debate about education policy and practice centered on the

physiologization of learning and obstacles to learning. As such, the responses to this

debate call into being different subject positions in regards to the relationship between

consciousness and physiology, with profound consequences for the students made to

occupy those subject positions – and for treatment professionals who imagine that ADHD

emerged suddenly in the early 1980s.

In The Journal of Education, the terms of this debate are framed by the liberal-

democratic ideology of universal compulsory education. Among educators, one side of

the debate is in support of a child-centered approach to instruction, as inspired by the

work of John Dewey. The countervailing voices are informed by contemporary social

developments – industrial models of rationalization, the use of the IQ test, the eugenics

movement, mental health policy and, ultimately, the pharmaceutical industry.

Chemical means of enhancing attensity existed early in the 20th century, but

weren’t initially discussed seriously as a means of dealing with problem students who

didn’t display clinical problems. By the 1950s, this population of problem students is

increasingly identified as “sub-clinical.” By institutional momentum and drift, by 1980,

what is initially identified as sub-clinical becomes a clinical category, and chemical

intervention subsequently becomes more feasible. Many of the articles in this archive –

and an increasing number over the course of the sampled period – report on

contemporary cognitive research, or put their discussion of teaching practices into context

by referencing cognitive research. This reflects both the increase after 1950 in this kind

of research in general, and an increased interest in this kind of research among educators.

By tracking this discussion of attention as a problem for professional educators, this

 39

chapter also facilitates a discussion about how scientific knowledge is constructed,

disseminated, and institutionalized among a wider population.

Chapter 3:

Making History: ADHD On Trial

The sharpest of critical perspectives on ADHD considers the diagnosis to be not

only false, but a fraud perpetrated in the interest of corporate profits and/or social control.

This contention found its most concrete expression in a series of five separate lawsuits

filed over the span of a few months in 2000. The suits – filed in Texas, California, New

Jersey, Florida and Puerto Rico – differed in small (and strategic) ways, but they were

each a part of a coordinated legal campaign to bring a class-action lawsuit, collectively

accusing the manufacturers of Ritalin, the American Psychiatric Association and a non-

profit patient advocacy group of conspiring to “manufacture a disease” with overly broad

diagnostic criteria, in order to promote and profit from the increased sale of Ritalin. The

plaintiffs did not succeed in these efforts, however, and the trials ultimately served the
interests of the defendants; the legal confrontation became, instead, an occasion to

challenge the critics of ADHD. Though these lawsuits were unsuccessful, the event of

their filings created an archive that reveals the variety of belief structures vis-a-vis

ADHD, the inherent contradictions therein, and the social processes through which the

legitimacy and authority of different bodies of knowledge are established and challenged.
Additionally, consideration of this archive provides an opportunity to critically address

the popular history of ADHD, as it has been presented by ADHD researchers and

advocates. Analysis of this popular history further reveals the rhetorical function of

history, particularly as it relates to popular conception of scientific knowledge in late-20th

century technoculture.
 40

Chapter 4:

ADHD in Popular Culture Since 1980

In this chapter, I look at how explanatory narratives of ADHD have emerged in

US popular culture since the 1980s. These narratives, in turn, contribute to the

persistence, evolution, or obviation of different ways of understanding ADHD. I

consider four tropes most commonly used to deal with ADHD, using examples from a

range of media, mostly since the 1990s: 1.) Some of these texts present ADHD and the

use of Ritalin as a form of brainwashing; 2.) Others present ADHD as the medicalization

of normal childhood; 3.) Others, as a mark of genius or as a superpower; 4.) And others

suggest that ADHD is a product, a symptom, or a form of expression of late-20th century

technoculture. In this chapter, I consider how film, television, graphic novels, comic

strips, children’s literature, popular science magazines, hip hop music, museum displays,

internet forums, and advertising have differently contributed to the consolidation and

critique of ADHD before turning to an examination of ADHD medications themselves

and popular cultural representations of “smart drugs.”

Chapter 5:

Emerging Identities: Smart Drugs, Cyborg Subjectivity,

and Self-Improvement

Perennially, headlines in the popular press tout the imminent development and

availability of a new wave of pharmaceutical drugs – designed to boost mental function

and cognitive capacity – to be available without prescription. While it is true that

pharmaceutical companies are constantly producing new drugs, and recent research into

conditions such as Alzheimer’s disease have produced promising new leads into further

understanding particular cognitive functions, stories about hypothetical Smart Drugs – in

literature, film, and popular science journalism – proliferate independently of any

particular scientific developments. This popular narrative trope of the utopic Smart Drug
 41

is the focus of this chapter, as the previous chapter featured popular narratives about

Ritalin and individuals diagnosed with ADHD. As the Smart Drug narrative is typically

mobilized, it directly participates in the extension of the post-industrial model of

subjectivity and consciousness: the cyborg. As this chapter explains, even though we are

told that scientists are on the verge of this ultimate technological advance in chemically

controlled intelligence, this kind of cognitive enhancement remains, elusively, just one

breakthrough away – inevitable, and yet perpetually imminent, just like “The Future”

itself.

Upon closer observation, these hypothetical Smart Drugs of an imminent future

are, in fact, functionally indistinguishable from the amphetamines and amphetamine

derivatives already so widely used today. The cyborg subjectivity so eagerly anticipated

by the Smart Drug narrative, then, is a reality now, not a reality which will come to be

sometime in the future. I argue that what keeps this transformation of subjectivity from

being recognized as such is not a technological development or imminent laboratory

discovery, but the social institutions that govern the distribution of controlled substances,
in concert with wider social beliefs about disability and the integrity of the liberal

humanist subject. In other words, Ritalin is not considered more widely to be a Smart

Drug because of our legal and philosophical dispositions toward disability, drug use, and

the liberal humanist subject.

!
 42

CHAPTER 1

THE INSTRUMENTALIZATION OF CONSCIOUSNESS AND THE

EMERGENCE OF ADHD: CYBERNETICS, PHARMACOLOGY, AND

SOCIAL CONTROL

In both scholarship and popular culture, cybernetic organisms – or cyborgs – are

often used metonymically as a way of representing the accelerating cultural and

technological transformations that have taken place since WWII, not only in the US, but

throughout the world. This rhetorical deployment of the cyborg invites the intended

audience to conceptualize the relationship between human beings, human technologies,

and the material world in ways that challenge several of the ideological underpinnings

that have influenced the development of social systems and institutions for the past two

centuries.1 Cyborgs, in this context, are typically represented as either human beings
who have incorporated robotic or digital technology into their bodies, or as robots or

computers that display traits typically thought of as exclusive to humanity (e.g.,

bipedalism, intelligence, etc.). The more sophisticated texts, both in scholarship and in

popular culture, ask their audiences to understand these alternate modalities of cyborg

existence (human-as-machine or machine-as-human) as poles on a spectrum, and

ultimately question the significance of the distinction altogether.2 Both of these versions

of cyborgs, though, are identified by the perceptible presence of digital and robotic

technologies. This association is reasonable enough, insofar as the cyborg is invoked as a

1 Post-humanity, per se, as a challenge to liberal humanism, is discussed further in

chapter five, “Emerging Identities.”
2 This is the case both in science fiction, such as Ridley Scott’s 1982 film Blade Runner
(inspired by the work of Philip K. Dick), as well as in the work of cognitive neuroscientists and
computer programmers in the field of artificial intelligence.
 43

marker of the cultural transformations since WWII. Digital and robotic technologies

have rendered some of the most dramatic and ubiquitous transformation of human

experience in modern history. Consequently, the advent of these technologies is

frequently invoked as the demarcation between the-world-as-it-was and the world-as-it-

is-now.

Technologies apart from digital and robotic ones have also contributed to the

emerging post-human condition; however, consideration of these other technologies is

largely neglected within the cyborg discourse, both scholarly and popular. This chapter

addresses this gap by situating the rise of pharmaceutical systems within the history of

cybernetics and technologies of control, which together constitute the rise of cyborg

subjectivity since WWII. Specifically, this chapter contextualizes the

psychopharmaceutical system comprised of stimulant drugs and the diagnosis of ADHD

as an instantiation of cyborg subjectivity. Situating chemical technologies within this

context reveals the long history of technoscientific efforts to gain control over human

consciousness, in order to standard and optimize cognitive function on an industrial level.

Recognition of ADHD as a cyborg experience is an emerging theme within the

debate that comprises the popular discourse surrounding ADHD in the US, starting in the

1980s. Those themes will be discussed in chapters four and five of this dissertation. This

chapter prepares that discussion by linking the instrumentalization of consciousness

(which ultimately gives rise to the conditions under which the diagnosis of ADHD is

developed) to late-19th and early- to mid-20th century discourses of control. This chapter

explains specifically how the concept of an “attention deficit” emerged alongside and

within the 20th Century revolution in cybernetic and chemical systems, and its roots, in

earlier medical, military, educational, psychiatric, and psychopharmacological discourses.

 44

Cybernetics and the Rationalization of Human Behaviors

Norbert Wiener is often identified as the “father of cybernetics” – a field of

research dedicated to facilitating the interactions between human beings and

technological systems.3 Consequently, his work (along with that of his collaborators,

such as Claude Shannon, Warren Weaver, and others) is frequently cited as the

generative moment of the digitally-mediated post-human condition.4 However, Wiener

himself identified the revolutionary break that sets the stage for the cybernetic revolution

not as the advent of digital technology, but as the scientific community’s rejection of

Newtonian physics and subsequent acceptance of a probabilistic view of the universe,

culminating around 1920.5 This means that physicists began to speak less of the laws
that govern the way things happen in a causally determined way, and more about what

will most likely happen, within a range of calculable probability, affected to various

degrees by any number of contingencies and circumstances that render conclusions

probable rather than provable. While this shift in the rhetoric and practice of scientists

did not change much in terms of the operation of basic physics (what goes up, after all, is

still extremely likely to come back down), the probabilistic view of the universe provided

physicists, for the first time, a practical means of accounting for phenomena that failed to

comport with Newtonian predictions, such as subatomic physics. Wiener, in turn, used

the probabilistic method of post-Newtonian physics in his research into communication

3 Wiener describes cybernetics as entailing “the electrical engineering theory of the

transmission of messages...the study of language...the study of messages as a means of
controlling machinery and other such automata, certain reflections upon psychology and the
nervous system, and a tentative new theory of scientific method.” Norbert Wiener, The Human
Use of Human Beings: Cybernetics and Society (Boston: Houghton Miflin, 1954), 15.
4 N. Katherine Hayles, How We Became Posthuman: Virtual Bodies in Cybernetics,
Literature, and Informatics (Chicago: University of Chicago Press, 1999).
5 Wiener, The Human Use of Human Beings, 9.
 45

between human beings and machines, ultimately leading to the development of the new

science of cybernetics.

In his book, The Human Use of Human Beings: Cybernetics and Society (1950),

Wiener situates the development of his ideas in his experience of WWII. As part of the

effort to seize and maintain the strategic advantage of air superiority over and against the

threat of fascism, Wiener was tasked with automating several processes in anti-aircraft

artillery systems.6 These systems situate human beings operating in conjunction with a

range of mechanical and digital technologies that assist in targeting through the

computation of the many pieces of data (e.g., velocity, force, distance, turbulence)

pertinent to hitting such fast-moving targets as airplanes. While mechanical and digital

elements within this system greatly increased the speed of the calculations, they could not

respond to unpredictable and arbitrary changes in a target’s course (e.g., evasive action)

without the necessary corrections provided by the human elements within the system

(e.g., the gunner). However, even the possible range of evasive actions were constrained

by physical laws (e.g., inertia), the mechanical limitations of aircraft, and the military

training and protocols under which pilots were obliged to operate – all of which could be

expressed and understood as a range of probabilities. Thus, additional processes (both

mechanical and digital) could be introduced into the system to further assist the human

beings operating the artillery. By endeavoring to improve the efficiency of cooperation

between the machine and the human elements of these systems, Wiener demonstrated the

utility of engaging with human beings and machines as interchangeable and equivalent

within a framework of probabilistic reasoning.

As far-reaching as these ideas would prove to be, they were initially inspired by

concrete military goals. This historical moment is certainly instructive, as a great deal of

6 Ibid., 61.
 46

the technology in our current environment finds its origin in the war effort, from

televisions (which are only a slight modification away from RADAR units) to penicillin

(first discovered in 1929, but not produced in quantity until WWII was well underway).7

But for Wiener, the most significant development of WWII was the open interface of the

probable rather than the provable that arose from cybernetic theory, both a product and an

instrument of communication and control technology. It is here, where probability meets

communicative interfaces between humans and computers, that Wiener’s work

illuminates our current information economy and mass media.

Wiener’s cybernetic theory analyzes communication in terms of information –

that is, the patterns of organization found in the material world, rather than the objects in

which that organizational pattern is embodied. Whereas organization is commonly

perceived as a quality that may or may not be displayed by physical objects, cybernetics

would encourage us to think of objects themselves as simple but relatively fluid or

probable manifestations of organization, through which regular patterns are

communicated. (For example, the very solidity of an object is the result of how tightly

organized are its constituent molecules, rather than a quality of the molecules

themselves.) The utility and revolutionary nature of this approach is that it allows all

material in the universe – whether living or inanimate, on the microscopic or macroscopic

level – to be addressed in common, interchangeable terms; it’s all information, organized

into more or less complicated patterns, and existing in relation to information processing

systems. Information processing systems (which are, themselves, only emergent

accumulations of patterns of information) change information from one form to another

as information passes through them. There are many different manifestations of

7 Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity (New
York, London: W.W. Norton & Co., 1997), 456-7.
 47

information processing systems, with different properties. Most notable among these are

those systems that replicate themselves and manage to persist through time. Such

systems are unique in their ability to resist the thermodynamic law of entropy – the term

by which physicists identify the certainty that, over time, patterns of organization within

closed systems will break down into formless chaos. These self-replicating and counter-

entropic systems, as they are defined by Wiener, are what we think of as life. Living

systems exhibit behaviors that other systems do not: they send, receive and respond to

messages from the environment, and, in so doing, effect control over their environment

and other organisms. In spite of the ability to communicate and control, however, even

living organisms can be understood in terms of the information inherent in their

organization. For Wiener, understanding human beings as information processing

systems is the basis of understanding their interaction with inorganic, non-living

information processing systems.

Like Wiener, communications theorist James R. Beniger has been invested in

explaining the character of our present condition in cybernetic terms – that is, terms of

communication and control. However, in his exhaustive book, The Control Revolution:

Technological and Economic Origins of the Information Society (1986), Beniger locates

the ascendance of the probabilistic theory of self-organizing communications systems in

an earlier historical moment than does Wiener.8 Rather than drawing his terms from the

early 20th century probabilistic turn in academic physics, Beniger looks to the Industrial

Revolution for the beginning of the same discourse. He argues that even before

mechanical and digital technologies came to embody the emerging theories of

8 James R. Beniger, The Control Revolution: Technological and Economic Origins of the
Information Society (Cambridge, Mass.: Harvard University Press, 1986).
 48

communication and control, these ideas were realized by the growing bureaucracies that

accompanied the rise of industrialization in order to coordinate the exponentially

increased efficiency of production, distribution and transportation at the end of the 19th

century.

Although this argument grounds cybernetic discourse in an institutional and

economic history that predates Wiener, Beniger adheres to the heuristic utility cybernetic

theory, and uses it to account for the whole of human evolution in terms of the

communication of information. In this longer history, which integrates systems theory

with life sciences, Beniger sees Wiener and the development of cybernetic theory itself as

an expression of the evolution of human culture’s ability to process information, a

development necessitated by the increasing technological and industrial ability of

Western societies to process life-sustaining materials. Beniger, then, considers not just

computers and human beings to be information processing systems, but also larger

organizations consisting of multiple organisms – namely, economies. In fact, Beniger

identifies the cultural shift that signals the emergence of the current episteme not by the

rejection of Newtonian physics for a probabilistic view of the universe, nor by the

interaction of human beings and intelligent machines, per se, but by the relative

prevalence of information-processing jobs in the economy. Directing this analysis

toward social institutions allows Beniger to argue that bureaucratic developments – such

as the scientific management of the workplace, or the establishment of international time

zones – are pre-digital information processing technologies, and are as foundational to

our experience of the modern world as are computer microprocessors.

In the vocabulary of cybernetics, information-processing systems – whether

bureaucratic, digital, or pharmaceutical – are controlled by programming. Just as

computer programs define goals and operating procedures for computers to follow, any

concrete organization of information that affects a system’s decision-making process or

 49

actions can be thought of as a program. Upon first glance, this seems a remarkably

limited way to think about human activity, as most people would resent the suggestion

that their individual actions are being controlled by some outside force. However, a

program is any pattern of information, including sociocultural patterns, that affects

decision-making to a purposive end. Further, in cyber-modernity, the complexity of

human activity and decision-making affecting human organisms at any given moment

must be explained by multiple interlocking levels of programming across, among, and at

the junctures of biological, sociocultural, and technoscientific systems.

To demonstrate this point, Beniger offers the example of rush hour traffic. If one

were to look down on a busy intersection from a high vantage point, one would (ideally)

see a pattern of remarkable organization and relative efficiency (even though it may seem

to be anything but efficient for an individual commuter on the street). The movement of

cars through the intersection is being controlled by many different programs, of which

Beniger identifies four different levels. Most obvious are the mechanical programs that

control and coordinate the traffic lights, street lamps, and pedestrian crossing signs.

Clearly these machines guide and purposively influence the decisions and actions of the

commuters. But even before those programs were written and installed on the computers,

city planners and traffic engineers organized the layout of streets, the placement of signs

and lights, location of on-ramps and off-ramps, etc. This level of organizational

programming is built into the very structure of the physical environment, and establishes

the parameters of possible actions the commuters can take on their way to and from work

well before any of them get into their cars. In fact, a traffic engineer – or even an

intuitive commuter with the proper perspective – would most likely be able to observe the

street layout alone, without the presence of any cars, and be able to predict with

reasonable accuracy the probable efficiency with which traffic would flow through an

area during rush hour.

 50

And yet, the relationship between these levels of programming and the resulting

activity of commuters is processual and probable, not directly causal. For this reason,

commuters do not feel that they are being controlled by any outside force as they drive

home. To clarify this point, Beniger identifies two more levels of programming. The first

is cultural programming, which is acquired socially and stored physically in the cognitive

structures of the brain.9 To continue with the automotive example, cultural programing

would entail a knowledge of traffic laws, the skills needed to operate a vehicle, and even

social norms, such as driving etiquette.

The final level of programming Beniger addresses is genetic programming,

chemically encoded in the DNA of an organism’s every cell. This genetic code

“programs” a probabilistic range of phenotypical expressions of a number of physical

attributes that may factor into an individual driver’s response to the systems of control

pertinent to operating a vehicle. Such factors would entail an individual’s quality of

vision and hearing, reaction times, and (arguably) even one’s level of patience or ability

to sustain attention.10
This quaternary model of programming (mechanical, organizational, cultural and

genetic) is useful as it identifies ways in which social situations can be purposively

engineered, and yet leaves room for the decisions of individuals to be guided by multiple

9 Whether or not thoughts, belief structures, or cultural norms can be deterministically

identified with physical structures in the brain is a matter of both clinical and philosophical
debate. Beniger’s argument necessitates a materialist and reductionist approach to consciousness,
in order to maintain the physicality of each level of programming, thereby remaining consistent
with the dialectic materialism that guides his history of post-Fordist capitalism.
10 Again, the degree to which cognitive functions – attention in particular – can or should
be linked to genetic programming is a matter of both clinical and philosophical debate.
Furthermore, the debate is one that entails a wide range of subtlety, and few clear-cut
delineations. Although Beniger presents his analysis of control systems in a starkly materialist
and reductionist modality, the utility of his analytical apparatus is amenable to a range of
positions within that debate.
 51

other programs. Cultural and genetic programs may or may not work to the same end as

the organizational and mechanical programming; as a result, Beniger’s model suggests,

different people are likely to adhere to, or privilege, different levels of programming with

varying degrees of fidelity. Moreover, by concerning itself only with programs contained

in physical forms, Beniger’s model necessarily avoids the common and problematic

tendency to individualize and anthropomorphize forms of social organization. In other

words, there is no need to talk about what the city streets “demand” of any individual

commuter, and no need to metaphorically equip the system with ephemeral body parts or

mystified determinants, such as Adam Smith’s famous “invisible hand” of the

marketplace.

Just as Beniger avoids ascribing vitalist concepts such as ‘will’ to forms of social

organization that exist between beings, he also eschews such concepts when considering

individual human beings. Beniger’s investment in the explanatory power of cybernetic

theory leads him to a position of epiphenomenalism – the belief that consciousness itself

is merely an inconsequential by-product of the various material processes of the brain.

Epiphenomenalism has developed throughout the 19th and 20th centuries, as thinkers have
grappled with the fragmentation and quantification of physical and mental properties

once taken for granted as qualities of a unitary, indivisible self. Such a revolution in

thought is not so much an account of reality as it is a response to a large number of

economic, scientific and cultural developments working in concert.11 An early and

illustrative example of such developments is Wilhelm Wundt’s establishment of the first

psychological laboratory at the University of Leipzig in 1879. This research laboratory

11 The history of this transition in academic and scientific thought, as well as in popular
culture, is well documented in the works of Jonathan Crary, Techniques of the Observer: On
Vision and Modernity in the Nineteenth Century (Cambridge: MIT Press, 1990) and Suspensions
of Perception: Attention, Spectacle, and Modern Culture (Cambridge: MIT Press, 1999).
 52

facilitated the development of psychometrics, through which aspects of consciousness

could be discreetly identified and measured by a battery of scales and apparatuses.12

Wundt’s psychometrics, then, are early developments in the instrumentalization of

consciousness, which allows for the entirety of one’s mental life to be broken down and

enumerated as a series of measurable biotechnological systems – or, in Beniger’s terms,

cultural and genetic programs – interacting in their prescribed ways within an

environment comprised of many other basically equivalent systems.

It should be noted that Beniger’s primary intention was not to provide a

convincing account of the experience of consciousness; nonetheless, Beniger’s cybernetic

system analysis seems to have little room for the concept of agency. Of course, it is not

surprising that the perspective of a system analyst would de-emphasize human agency.

Beniger’s interest in system analysis is its project of enacting control under changing

conditions. To that end, predictability is a highly desirable quality of all elements in a

system. For example, minimizing the individual differences in the programming of many

various commuters on their way home from work increases the predictability of the

system as a whole, allowing it to be more effectively and purposively controlled. For this

reason, knowledge of traffic law is standardized by means of the drivers’ licensing

system, ensuring that all drivers (ideally) will understand and respond to traffic signals in

the same, predictable manner. This process of rationalization both reduces the number of

signals sent and delimits the possible responses to those signals, simultaneously

discarding unwanted contingencies as well as information deemed irrelevant. Beniger

identifies this process as a primary component of a “control revolution,” which began

transforming significant non-productive sectors of the economy in the early 19th century.

Rationalization along these lines finds its most salient manifestation in the work of

12 Crary, Suspensions of Perception, 29.

 53

Frederick W. Taylor, whose influential text, The Principles of Scientific Management

(1911), was designed to maximize productivity in the industrial workplace. Taylor’s

system promoted fragmenting workers’ tasks into a series of component movements that

can be individually evaluated, using a stopwatch to time those movements to the second.

Subsequently, unnecessary or redundant components of work tasks can be eliminated,

and the remaining components can be reconstituted in the most efficient form possible,

prescribing a standardized method of performing tasks in the workplace, and thereby very

nearly programming workers with machine precision.13

Note, however, that even this degree of streamlining takes place only at the

mechanical and organizational level of programming, as described by Beniger, and does

nothing to reduce individual variation on the cultural or genetic level. So, even in a

perfectly Taylorized system, the individual variations among the system’s human

elements – whether fostered through enculturation or chemically encoded at the most

basic genetic level – would account for the degree of unpredictability inherent in every

system. Further sociocultural standardization, rationalization, and instrumentation is

required, then, to minimize unpredictability to the lowest degree possible. But, as

cybernetic theory argues, control is never complete; it is, at best, a probabilistic endeavor.

Thus, we come to the ironic paradox that, in the recent history of industrialized

societies, human beings – characterized to a significant degree by the counter-entropic

forces of variation and unpredictability – create information processing systems that, in

an effort to maximize life-sustaining material processing capabilities, seek to limit and

control the inherent variation and unpredictability of the human beings who not only

“invent” but also constitute those systems. As this paradox has become an object of

13 Beniger, The Control Revolution; David Harvey, The Condition of Postmodernity: An

Enquiry into the Origins of Cultural Change (Cambridge: Blackwell, 1990); Frederick W. Taylor,
The Principles of Scientific Management (New York: Harper & Brothers, 1911).
 54

social debate, cybernetics has been often criticized for promoting the relentless

automation of human society in order to realize a fascistic vision of control and

regularity. Wiener, however, was aware of this paradox, and recognized the political

implications of the unqualified application of cybernetic models of rationalization and

control.14 In The Human Use of Human Beings, he warns against the overzealous

rationalization of human society:

Worshippers of efficiency would like to have each man

move in a social orbit meted out to him from his childhood, and
perform a function to which he is bound as the serf was bound to
the clod…If man were to adopt this community as a pattern, he
would live in a fascist state, in which ideally each individual is
conditioned from birth for his proper occupation.15
This warning directly addresses the most common criticism of Wiener’s work, ironically

re-doubling the paradox: even as cybernetic theory is often denigrated as fascistic,

Wiener actually derives his anti-fascist, democratic convictions from the very tenets of

cybernetics and his experience with machine programming.

Wiener develops his democratic vision of cybernetics using several material

examples to demonstrate that in order for a system of control to work well, that system

needs to be able to collect feedback, or information about the response of the

environment to the controlling system’s demands. By collecting feedback, a system can

evaluate its effectiveness and make appropriate adjustments in future commands, thereby

demonstrating responsiveness. To illustrate this, consider an automobile without a

tachometer or a speedometer. The controller of such a car would still be able to estimate

and control the amount of gasoline supplied to the engine, by means of the gas pedal, but

14 In The Human Use of Human Beings (178-181), Wiener responds to such criticisms
directly, reprinting a letter from a Dominican friar who articulates exactly this perception of
Wiener’s first book, Cybernetics.
15 Wiener, 50-51.
 55

would have no efficient way to estimate the actual velocity of the vehicle, which is

affected by a number of additional factors (such as the friction of the driving surface,

wind resistance, momentum, gravity, etc.). By providing the controller with feedback

from the moving parts themselves, instruments such as tachometers and speedometers

allow a driver to adjust the supply of gasoline from moment to moment, responding to the

specific conditions of the road. Without such information, the machine cannot be

operated at full efficiency. Thus, two-way communication is a necessary component to

any kind of control.

Wiener applies this observation to social systems as well as mechanical ones. In a

political system, the democratic process provides feedback to policy makers about the

effectiveness of policy. The more unilateral and totalitarian a state, the less opportunity

there is for its subjects to respond in a substantive way to the dictates of those in power,

making it easier for the unintended consequences of policy decisions (which are as

inevitable as entropy itself) to steer the entire system off course. This leads Wiener to an

explicitly political and democratic conviction:

Administrative officials, whether of a government or a

university or a corporation, should take part in a two-way stream of
communication, and not merely in one descending from the top.16
Wiener does not offer this anti-fascist dictum as a caveat to what many perceive as the

inherent threats of cybernetic theory; rather, he demonstrates that cybernetic models

without due consideration of democratic principles are simply poorly designed, and

therefore prone to inefficiency and error.

Further, Wiener draws our attention to another lesson of cybernetic theory: in

living organisms, as in machines, function is fundamentally related to design. For

example, the tendency of ants to organize themselves into rigid social structures that

16 Ibid., 49.
 56

resemble the ideal organization of fascist states is largely a consequence of their

relatively simple and nearly identical physical structure. In contrast, “Variety and

possibility are inherent in the human sensorium,” hard-wired into our individualized and

constantly changing brains, making variability and contingency an inalienable part of the

human experience.17 Human physiology, then, allows human beings to function most

effectively as relatively autonomous information processing systems that can adapt to

unforeseen contingencies, not as ants or as tools of other human beings. In Wiener’s

eyes, forcing human beings into a fascist, ant-like existence is not simply an untenable

political or ethical position, but a basic misapprehension of human biology:

I am afraid that I am convinced that a community of human

beings is a far more useful thing than a community of ants; and
that if the human being is condemned and restricted to perform the
same functions over and over again, he will not even be a good ant,
not to mention a good human being.18
In this statement, Wiener asserts that the individual variations in human beings –

especially those that are chemically encoded at the genetic level – are both a fundamental

demarcation of humanity, and the ultimate safeguard against the totalizing rationalization

of society that critics of cybernetics fear. Wiener rejects the standardization of individual

genetic variation, not as an ethical position, per se, but because such efforts are ultimately

counter-productive to well-functioning cybernetic systems.

While Wiener derives his convictions from cybernetic theory, as seen above, he

nonetheless elevates the individualism of human beings to the level of a sacrosanct

principle, an article of faith, undeniable and unchangeable. Wiener, then, seems to set a

limit to his theory of system-generating rationalization, a limit that preserves the liberal

humanist notion of the unitary, autonomous, self-directing human subject. If Wiener had

17 Ibid., 52.

18 Ibid., pg. 52
 57

drawn this conviction any less rigorously from the very tenets of cybernetics, this would

seem to be romantic nostalgia for the epoch before the rationalization and fragmentation

of consciousness, a time before the measurable mind posited by Wilhelm Wundt’s

psychometric laboratory. But Wiener’s cybernetics, emerging as it did out of military

imperatives, is essentially pragmatic; he maintains that fragmenting the human subject

and rationalizing and controlling its components is ultimately counter-productive and

inefficient.

Beniger does not directly address genetic programming in The Control

Revolution. He is more interested in the history of organizational and, to some degree,

mechanical programming. However, he does not consider genetic programming to be

sacrosanct, or off limits, as does Wiener. Though he does not discuss it at length,

Beniger identifies ‘genetic programming technology’ as the ultimate iteration of his own

future-reaching timeline of control technology and human evolution, implying that this is

merely the next level of technological intervention in programming human beings.19

Insofar as genetic programming can be thought of as technology, it should be

recognized as a chemical technology, as the information contained within DNA is

encoded within a double helix structure consisting of alternating pairs of four nucleotide

chemicals: cytosine, thymine, adenine, and guanine. Thus, DNA is a chemical

technology that has a unique and profound degree of control over living systems. It is

not, however, the only chemical control technology that can affect an organism’s

behavior. The human organism is not a closed, static system, with genetically-coded

biochemical parameters that are established at conception and consistent throughout its

existence; rather, it is an open and dynamic system. The physical and neurochemical

state of our bodies exists as a complicated balance that changes from moment to moment,

19 Beniger, 63.
 58

based on a wide range of feedback loops and inputs from the environment. Altering any

one of these environmental inputs – or even consciously attending to any one of them –

can lead to dramatic changes in both chemical make-up and resulting behaviors. While

the full complexity of their biochemical make-up is beyond the immediate understanding

of most individuals, there are nonetheless a variety of biotechnologies available to people

to regulate and modify this system. Some of these are as basic to human experience as

diet, while others are as dramatic as surgery, hormone replacement therapy, or the

administration of behavior-modifying drugs.

Since WWII, such extra-genetic chemical interventions have become common

features of everyday life, and are not often thought of as control technologies within a

multifaceted conceptual/materialist evolution in information processing, communication,

and social control. Psychopharmaceutical technologies, such as those administered to

children diagnosed with ADHD, operate at the juncture of the body and the mind, thus

rendering the very distinction immaterial. These chemical biotechnologies situate those

who use them (voluntarily or under coercion) within the self-organizing feedback loop of

several industries and bureaucracies, constituting one of the most somatically

transformative and widespread instantiations of cyborg experience. While it may be

contentious to suggest that pharmaceutical drugs such as Ritalin, widely prescribed to

children for the treatment of ADHD, are yet another manifestation of the control

technologies discussed by Beniger and explicitly warned against by Wiener, the harshest

critics of ADHD would suggest that the only thing keeping these drugs from being

perceived as an Orwellian form of mind control is a thin veil of medical rhetoric. Thus,

considering the development of psychoactive chemical technologies through the

perspective of systems of cybernetic control and programming provides a new

perspective on the history of psychopharmacology, while simultaneously redressing the

oversight of chemical technologies within cybernetic systems theory.

 59

A Brief History of Mind Control – Part I:

The Advent of Chemical Technology, 1842-1952

Scientific management of the workplace – largely inspired by the aforementioned

work of Frederick W. Taylor and often referred to simply as Taylorism – is commonly

characterized as the most overt and proscriptive form of control technology in people’s

lives. It is the most readily recognized form of control technology, because of its

widespread application and general success in improving productivity in a variety of

contexts. But Taylorism is certainly not the control revolution’s most heavy-handed

attempt to control human subjects. While Taylorism explicitly proscribes desired

behaviors from subjects, other 19th Century control technologies aimed to directly and
physically elicit desired behavior from subjects’ bodies by controlling their minds.

For example, in the second half of the 19th century, there was a surge of popular

and professional interest in hypnotism, through which a hypnotist was thought to be able

to impose his or her will onto the body of another human being. The term ‘hypnotism’

was coined in 1842 by James Braid, a Scottish surgeon and scientist who sought to

rationalize and re-present, in a scientific context, the principles common to both Eastern

meditative practice and the popular phenomenon of mesmerism.20 While still used in

some applications today (primarily for pain management, and occasionally in

psychotherapy), the claim that one can control another person’s body through hypnotic

suggestion is now considered the provenance of carnival entertainers, or the final hope of

smokers desperate to quit. However, at the end of the 19th century, hypnosis – and its

possible medical applications in the further rationalization of mind and body – was taken

quite seriously. In the 1890s, hypnosis even played a central role in two high profile

European criminal cases – in one instance as a defense against murder, and in another as

20 Crary, Suspensions of Perception, 66.

 60

an alleged mechanism of fraud.21 These sensationalist cases inspired further speculation

and debate among scholars regarding the legal implications of mind control through

hypnosis.22

The efficacy that hypnosis apparently provided, however, was both inconsistent

and unpredictable, varying in effectiveness from subject to subject. This variation

ultimately made hypnosis difficult to reconcile with scientific method. Much more

consistent results were being afforded by a growing number of chemical technologies

coming to the attention of the medical and psychiatric community after 1890. Some of

these chemicals had been known for quite a while, but were just beginning to be used for

the purpose of control. Ether, for example, had been known as an intoxicant for some

time, but in 1842 began to be used as an anesthetic during surgery, controlling a patient’s

response to pain.23 Prior to this, the pain of surgery could only be attenuated by the
speed and the skill of the surgeon, which limited surgery to basic procedures on the

body’s extremities. Anesthetic drugs such as ether, and later chloroform, coupled with

emerging antiseptic procedures (which also involved chemical technologies), brought the

body under greater rational control, allowing for the development of surgical procedures

into the cavities of the body.

21 In 1890 in France, Gabrielle Bompard unsuccessfully argued that she was not
responsible for a murder committed while under hypnotic suggestion, and in 1895 in Munich,
Ceslav Lubic Czynski was found guilty of manipulating a countess out of her fortune through the
power of his hypnotic suggestion. Ruth. Harris, “Murder Under Hypnosis in the Case of Gabrielle
Bompard.” Psychological Medicine 15:3 (August 1985), 477-505; Stefan Andriopoulos,
Possessed: Hypnotic Crimes, Corporate Fiction, and the Invention of Cinema (Chicago:
University of Chicago Press, 2008), 33.
22 Crary, Suspensions of Perception, 70; Jaan Valsiner and René van der Veer, The
Social Mind: Construction of the Idea (Cambridge, UK: Cambridge University Press, 2000), 50.
23 Porter, Greatest Benefit, 366.
 61

At the same time, new chemicals with powerful behavior control properties, were

being synthesized. In 1903, German chemists Josef Freiherr von Mering and Emil

Fischer published their account of the profound sedative effects of the recently

synthesized chemical barbital in human subjects. The following year, the chemists

patented the chemical as Veronal, the first commercially available barbiturate.24

Psychiatric asylums quickly adopted the use of barbiturates for these sedative effects.

Schizophrenic patients who grew uncontrollable had previously been sedated with opiate

drugs or chloral hydrate, but the new barbiturates – barbital, phenobarbital, and a

particularly effective admixture of both that was marketed as Somnifen – were capable of

producing a coma-like state of sedation that could last for days, even weeks on end.25
Using barbiturates for exactly that purpose became an increasingly common practice

throughout the first decades of the 20th century, known as ‘sleep therapy.’26 While this

practice started simply as a coercive means of controlling delusional and unruly patients,

it came to be seen as genuinely therapeutic, due to the unexpected discovery that some

patients woke from their extended, chemically-induced slumbers free from the delusions

that had previously plagued them. Today, sleep therapy has been all but abandoned as a

therapeutic model – not so much discredited as outmoded by other practices – but the

perception of its utility at the beginning of the 20th century helped to inspire the search

for even more effective sedative chemicals.

24 Francisco López-Muñoz, Ronaldo Ucha-Udabe, and Cecilio Alamo. “The History of

Barbiturates a Century After their Clinical Introduction” Neuropsychiatric Disease and Treatment
Dec. 2005 1:4, 329-343.
25 Francisco López-Muñoz, Ronaldo Ucha-Udabe, and Cecilio Alamo, “The History of
Barbiturates a Century after their Clinical Introduction.” Neuropsychiatric Disease and
Treatment 1, no.4 (December 2005): 329-343.
26 David Healy, The Creation of Psychopharmacology (Cambridge, Mass.: Harvard
University Press, 2002), 44.
 62

At their point of origin, however, most chemicals discovered in the late 19th and

early 20th century were not synthesized with psychopharmaceutical applications in

mind.27 Instead, since the lucrative discovery of synthetic dyes in 1856, commercial

textile applications had been the driving economic force behind chemical innovation.28

These industrial commodities were found to have medical applications only through

circuitous happenstance. German researcher Paul Ehrlich, in the course of using a

synthetic dye to stain tissue for inspection under the microscope, discovered that some of

these dyes stained tissue selectively, and some dyes stained bacteria without staining the

tissue around them. This suggested that the dye was interacting with the bacteria in some

way that it was not interacting with the tissue. The selective action of these dyes led

Ehrlich to try one of them – methylene blue, first synthesized in 1876 – as an antibiotic

agent in the treatment of malaria. In 1891, it worked, earning Ehrlich the lasting title as

the creator of chemotherapy.29

While working with methylene blue, Ehrlich also found that methylene blue

selectively stained nerve cells in laboratory frogs. This lead Ehrlich to speculate that,

since the dye had selectively stained the malaria parasite, and was subsequently shown to

affect that parasite in ways that proved therapeutic, perhaps methylene blue would also

have some effect on nervous conditions. This suggestion influenced Italian doctor Pietro

Bodoni to administer the dye to several psychotic patients in 1899, and it was indeed

found to have sedative effects.30 Methylene blue was used as a sedative for a short time,

27 The earliest pharmaceutical research institutes weren’t founded until after the turn of
th
the 20 century; Porter, Greatest Benefit, 449.
28 Healy, Creation of Psychopharmacology, 38.

29 Porter, Greatest Benefit, 448-51; Healy, Creation of Psychopharmacology, 38.

30 Healy, 44.
 63

though it slowly fell out of use because of the concurrent discovery of barbiturates. But

the brief psychopharmaceutical history of this synthetic dye is instructive for two reasons.

First, methylene blue is an important compound in the history of psychopharmacology

because it is the basic compound from which chlorpromazine – better known as the

market brand Thorazine – would later be derived.31 Second, it illustrates the manner in

which many chemical discoveries have been made. For example, Bodoni did not

administer this anti-bacterial, industrial chemical to patients as an extension of a bacterial

theory of madness.32 Bodoni’s method entailed no theory of madness whatsoever;

instead, it was based on a rather loose association of observed phenomena, with neither

an understanding nor a working hypothesis of the mechanism of action animating any of

the elements of the experiment. As such, Bodoni’s decision to administer textile dyes to

mentally ill patients may seem reckless and uncharacteristic of the ostensibly rational

endeavor of science. But, as David Healy points out in his book, The Creation of

Psychopharmacology (Cambridge, Mass.: Harvard University Press, 2002), the sound

theories of psychiatry have more often been developed post hoc, as a means of

explaining, justifying and eventually marketing therapies that have already been found to

work, through a rather clumsy process of hunches, trial and error, and experimentation on

human subjects – often without their explicit consent.

When Thorazine was first used successfully in 1952, it was immediately hailed

not for its sedative effects, as methylene blue had been, but for its therapeutic action on

schizophrenic symptoms, credited as the drug that brought “silence to the asylum.”33

31 Ibid., 46.

32 The infectious theory of schizophrenia was not seriously considered before E. Fuller
Torrey proposed, in the 1970s, that schizophrenia may be caused by toxoplasma gondii, a parasite
commonly associated with housecats.
33 Healy, Creation of Psychopharmacology, 90.
 64

The effects were so dramatic that it inspired an entirely new approach to dealing with

schizophrenia, and a new classification of pharmaceutical drug – the antipsychotics. This

development marks the first time in psychiatry that drugs are administered for effects that

are believed to be directly therapeutic – as opposed to the administration of drugs for

their sedative effects, or as an element within a therapeutic practice, as barbiturates had

been used in sleep therapy. In the course of trying to explain – and later market – the

effectiveness of antipsychotics, a reconceptualization of the nature of schizophrenia

eventually emerged. Once technology was developed that could demonstrate the fact that

antipsychotics like Thorazine worked by reducing the level of dopamine in the brain, it

was hypothesized that schizophrenia was the result of a dopamine surplus, a chemical

imbalance that the administration of Thorazine corrected.34

However, within a decade, the dramatic effects of Thorazine would also inspire

heated debate. Critics pointed out the circularity of the dopamine theory, a logical error

typical of many theories developed as a means of explaining the effects of psychoactive

drugs. A drug’s efficacy in relieving symptoms does not necessarily provide any

information about the original cause of the symptom in question, no more than the

efficacy of ibuprofen in reducing a fever suggests that the fever was the result of an

insufficiency of ibuprofen. To skeptics, the dopamine theory of schizophrenia looked

like a hypothesis tailor-fitted to justify a preconceived faith in the healing power of

Thorazine. And while some psychiatrists initially pointed to an increase of dopamine

34 Ibid., 198-214; The dopamine theory of schizophrenia was actually hypothesized

before the existence of neuro-receptors was established, but this theory was not yet widely
accepted, largely because it relied on a model of neurotransmission that was itself hypothetical
and unproven. The technological developments of the spectrophotofluorimeter in 1955 and radio
labeling of neurotransmitters in the early 1970s made it possible to demonstrate the physical
effects of dopamine on the brain, but more importantly, they helped to establish the existence of
neuro-receptors and the currently accepted model of synaptic neurotransmission, the theoretical
ground from which the dopamine theory makes any sense at all.
 65

receptors in the brains of schizophrenic patients as evidence for the dopamine theory,

others quickly pointed out that these changes in brain biology could easily be the result of

medication, rather than a pre-existing condition. The harshest critics of Thorazine

derided it as a “chemical straight-jacket,” charging that it reduces schizophrenic

symptoms only by crippling the greater part of an individual’s higher mental functioning,

including one’s “autonomy and self-determination.”35 Thorazine negatively affects

motivation, making people more amenable to following orders. For this reason, the drug

has been administered – even to people without schizophrenia – for the express purpose

of behavioral control, in prisons and other coercive institutions.36 In such non-

therapeutic contexts, Thorazine’s functionality as a control technology is apparent.

A Brief History of Mind Control – Part II:

The Military Use of Human Beings, 1942-1974

Psychoactive chemicals, and their specific use as agents of control, have

generated interest outside of just the psychiatric and antipsychiatry communities. The

history of mind control research that comes out of WWII illustrates both how totalizing

the desire to control individual behavior can be, as well as the physical limits of such

fantasies of control. For example, among the many atrocious medical experiments that

took place in Dachau – the most infamous of Nazi prison camps – were attempts “to

impose one’s will on another person as in hypnosis” through the administration of high

doses of mescaline, a psychotropic drug derived from the peyote cactus.37 These

35 Peter R. Breggin, Brain Disabling Treatments in Psychiatry: Drugs, Electroshock,

and the Role of the FDA (New York: Springer Publishing Company, 1997), 3-4.
36 Ibid., 22.

37 Lee, Martin A. and Shlain, Bruce, Acid Dreams: The Complete Social History of LSD:
The CIA, the Sixties, and Beyond (New York: Grove Press, 1985), 5.
 66

experiments failed to yield the desired results, and the Nazis concluded, prior to the war’s

end, that using mescaline to control the will of another person was impossible.

Such experiments have been publicly vilified and deemed unethical, along with a

host of other Nazi wartime activity, in the Nuremberg Trials that followed WWII.

However, the resulting Nuremberg Code, which helped established postwar ethical

standards for medical research, did not explicitly identify mind control as an unethical

endeavor.38 Instead, the Nuremberg Code focuses on clearly attaining the consent of all

participants in experimental research, and decries the coercive nature of experimentation

on prisoners of war.39 The idea of mind control was overshadowed by, and fully
subsumed into a body of dubious research known as the ‘aviation experiments,’ in which

Nazi scientists used concentration camp prisoners as subjects in testing the limits of the

body’s ability to sustain tremendous amounts of pressure, gravitational force, and other

adverse circumstances. The gruesome brutality of many of these experiments (e.g.,

crushing people to death in pressure chambers, injecting people with gasoline, etc.)

served better to illustrate the cruelty of Nazi technoscience than did the comparatively

tame peyote experiments. In fact, the Nuremburg Code’s glaring omission of any

reference to mind control suggests that the issue was perceived as a laughable goal, akin

to the occult interests of Hitler, requiring no specific sanction due to the self-evidence of

its implausibility.40

38 Ibid., 6n.

39 Informed consent, as it is practiced currently, didn’t become fully realized until

decades later, in the 1970s, when the practice of medical experimentation on prison populations
finally came to light (discussed further, below).
40 In Suspensions of Perception, Jonathan Crary suggests that all issues similar to mind
control have been discredited in this manner for their proximity to the rise and fall of hypnosis at
the end of the 19th century, which is unfortunate, as it obscures objective assessments of other
behavior control technologies that are much more effective than hypnosis, such as state
propaganda through the mass media (another control technology effectively employed by the
Nazi party); Crary, 231.
 67

But the CIA didn’t find the notion of mind control laughable, and even took

inspiration from Nazi research uncovered at the conclusion of WWII, hoping to succeed

where the Nazis failed. To understand the CIA’s interest in mind control technology, one

must consider the circumstances of the Cold War era. Anticommunist rhetoric often

expressed the fear that foreign ideologies had the power to corrupt American minds from

within.41 Postwar events in the USSR apparently legitimated these fears, as Stalin

seemed to hold incredible power over his political opponents, forcing them to confess to

improbable crimes before execution in public show trials – such as the trial of Hungarian

political dissident Cardinal József Mindszenty in 1949. In keeping with cold war

anxieties, such influence was presumed by the U.S. government to be the result of a

technological innovation in mind control. The secretive nature of the Communist Party

in America during the 1950s further obscured to the observer the true mechanisms of the

party’s politics, making their renowned solidarity and organizational skills seem

necessarily attributable to some kind of suspect, supernatural cohesion — perhaps the

result of mind control technology.42

In the years directly following the US entrance into the Korean War in 1950,

thousands of US prisoners of war were coerced into publicly confessing to war crimes

enacted upon the orders of their commanding officers, or publicly renouncing their US

citizenship altogether. US intelligence officers trained in psychological warfare

recognized this strategy as one meant to demoralize and weaken the resolve of the US

41 This was true both in the rhetoric of prominent politicians, such as Senator Joseph
McCarthy, as well as in conspiracy-minded conservative movements that took on the anti-
communist crusade, such as the John Birch Society.
42 A more detailed discussion of Communist Party policies that may have inadvertently
contributed to their own demonization is presented in Ellen Schrecker’s excellent history of the
McCarthy era, Many are the Crimes: McCarthyism in America (Princeton, NJ: Princeton
University Press, 1998).
 68

public’s support of the war effort. In response, the CIA hatched its own covert

propaganda plot to counter these efforts. This was achieved by inventing a counter-

narrative that explained the apparent mind-control capabilities of Communist leaders in

Russia and China. According to this counter-narrative, this ability was the result of a

diabolical new technology called brainwashing. This term was coined by Edward

Hunter, an Office of Strategic Services and CIA operative, who, while acting as a

journalist, published a series of articles throughout the early 1950s that leaked this bit of

propaganda into the public discourse.

Hunter’s fictional explanation of recent events was eagerly embraced.43 Within

five years, other writers, including prominent psychologists Joost A.M. Meerloo and

William Sargant, had publicly speculated about the looming threat of brainwashing.

Though their sensationally-titled books – Rape of the Mind (1956) and Battle for the

Mind (1957), respectively – were based on little evidence, and were influenced heavily

by science fiction writers such as George Orwell and Aldous Huxley (whom they

liberally quote when describing “brainwashing”), Meerloo’s and Sargant’s social status

as psychologists added the authority of Science to their speculations, contributing to the

persistence of brainwashing as an ideological construct.44 Even FBI director J. Edgar

Hoover described what he called the “communist through-control machine” in his 1958

book, Masters of Deceit.45 The most significant and bitterly ironic blowback from

43 Timothy Melley, “Brainwashed! Conspiracy Theory and Ideology in the Postwar

United States.” New German Critique 103, vol. 35.1 (Spring 2008): 145-164.
44 William Sargent, Battle for the Mind: A Physiology of Conversion and Brainwashing
(London: Heinemann, 1957); Joost A.M. Meerlo, The Rape of the Mind: The Psychology of
Thought Control, Menticide, and Brainwashing (World Publishing Company, 1956.) Full text
online: http://www.lermanet.com/scientology/mc-ch1.html.
45 Edgar J. Hoover Masters of Deceit: The Story of Communism in America and How to
Fight It (New York: Pocket Books, 1959),175.
 69

Hunter’s brainwashing hoax, however, is the fact that CIA director Allan Dulles, in an

effort to address the perception of a growing “brainwashing gap” between the US and its

Communist adversaries, increased funding allocations for a number of covert projects

dedicated to achieving mind control technology.46 The result was the MK-ULTRA

project – infamous since its sensational exposure by New York Times investigative

journalist Seymour Hersh, as part of the “Family Jewels” revelations in 1974.47 As

Hersh’s article revealed, the MK-ULTRA project entailed a range of human

experimentation that built upon the CIA’s already extant interests in “truth serums” as

interrogation tools, while dramatically expanding the scope of research and re-orienting it

to the goal of:

controlling an individual to the point where he will do our

bidding against his will and even against such fundamental laws of
nature as self-preservation.48
Brainwashing proved to be such a desirable explanation for the spread of Communism

that the CIA essentially fell for its own propaganda.49

Over the course of the next several decades, the CIA funded and administered a

number of secretive experiments in order to establish a chemical means of mind control.

In direct violation of the Nuremberg Code, these experiments were frequently performed

on subjects who were unable to either resist or consent, or who were entirely unaware of

46 I employ the term ‘blowback’ in this context as it is used by Kembrew McLeod in

Pranksters: Making Mischief in the Modern World (New York: NYU Press, 2014).
47 Hersh, Seymour. “Huge CIA Operation reported in U.S. against Anti-War Forces,
other Dissidents in Nixon Years” New York Times, December 31, 1974, pg. 1.
48 As stated in internal CIA memoranda. See Rebecca Lemov, “Brainwashing’s Avatar:
The Curious Case of Dr. Ewan Cameron”, Grey Room 45 (Fall 2011), 67-8.
49 The further history of the MK-ULTRA project (see Lee & Shlain, Acid Dreams)
makes clear that the CIA operated throughout this period in multiple layers of secrecy, which
created the conditions in which the organization kept many secrets from itself, illustrating, in
cybernetic terms, the pitfalls of insufficient system feedback.
 70

their participation in scientific experiments.50 The range of chemicals that were

investigated is comparable to the range of euphemisms employed by the CIA in speaking

of their intentions, from the relatively innocent-sounding notion of a “truth serum,” to the

more sinister concept of “brainwashing.” Among the most egregious of these CIA-

funded experiments were those of Dr. Ewan Cameron, who used sedative and

psychotropic drugs in combination with massive doses of electroshock therapy to

systematically “depattern” the brains of his subjects – a process that took months to

complete. Then, while his patients were fully sedated under the continuous

administration of alternating doses of Thorazine and LSD, Cameron would attempt to

“reprogram” them through a process he called “psychic driving,” which involved

somnambulistic exposure to tape-recorded suggestions, endlessly repeated over

loudspeakers in what was called the “sleep room.”51 While this method employs a
number of different techniques in consort, the CIA concluded it was the prolonged

exposure to psychoactive chemicals that made subjects most receptive to behavioral

control.

However, just as the Dachau experiments finally convinced Nazi scientists that

mind control was nothing more than an impossible fantasy, the CIA’s psychoactive drug

experiments failed to produce any results consistent or predictable enough for practical

application. Cameron’s “psychic driving” project only succeeded in driving a significant

number of his subjects insane. While his techniques of depatterning were proven

50 For example, Frank Olson, the C.I.A. operative who was secretly dosed with LSD by
his supervisor, and who fell out a New York hotel window to his death.
51 Significantly, Cameron’s method was inspired by a scientistic and fraudulent self-help
product he had once seen advertised, called the Cerebrophone, which claimed to be a
“revolutionary way to learn...while you sleep!” Dominic Streatfeild, Brainwash: The Secret
History of Mind Control (New York: Picador, 2006), 217; Lemov, “Brainwashing’s Avatar,” 64;
Lee & Shlain, Acid Dreams.
 71

effective, he was unable to reprogram or restore any cognitive functions he had

eradicated from the minds of his subjects. Many were institutionalized for the remainder

of their lives.52 Upon the public revelation of the CIA’s covert funding of Cameron’s

research, a group of surviving subjects successfully sued the US government for millions

of dollars, collectively.53 The CIA subsequently abandoned this aggressive approach to

mind control research and psychoactive drug experimentation – not because it was

deemed unsafe or unethical, but because it was found to be too unpredictable, and

thereby, ineffective as a control technology.

A Brief History of Mind Control – Part III:

The Humanist Subject and The Fifth Freedom, 1963-1980

The ineffectiveness of these Cold War experiments resonates with Wiener’s

conviction that overzealous control of individual human beings is ultimately a

misapprehension of human physiology. Though people may be guided and influenced in

their decision making processes, the human organism apparently resists outside control

by such totalizing techniques. Rather, somewhat ironically, behavior can be more easily

predicted when human organisms are granted autonomy – or at least the illusion of it.

Control, then, to the degree that it is possible, is most effective not when exerted directly

over human organisms, but rather, when exerted over the environment in which the

organisms find themselves. When left to their own initiative, human organisms seem to

behave in more predictable, “rational” ways.

But Wiener was hardly the first to note this. Nor was the ineffectiveness of

totalizing control technologies first discovered by the CIA, through failed LSD and

52 Lemov, “Brainwashing’s Avatar.”

53 In addition, this lawsuit directly inspired the formalization of current standards and
practices of informed consent in the US and Canada. Lee & Shlain, Acid Dreams, 23.
 72

“psychic driving” experiments. Rather, such concepts of order through freedom and

unfettered “rational choice” are foundational concepts in United States political and

economic history. For example, the predictability and rationality of autonomous human

subjects left to their own initiative is a necessary component Adam Smith’s 1776

articulation of the free market system in his influential text, The Wealth of Nations.54 An

even more instructive defense of the autonomy and self-determination of human subjects

is the Bill of Rights, conceived of by Thomas Jefferson and James Madison in 1789. In

protecting the civil liberties of US citizens, the Bill of Rights – and in particular the First

Amendment – establishes the limits of state power exactly at the boundary of self-

determination and self-expression, to which people are entitled by virtue of being human.

In this document, human beings are taken for granted as unitary and indivisible entities

whose integrity is self-evident and unqualified.55

In cybernetic terms, then, liberty – that is, the right to self-determination – might

be thought of as the right to program one’s self. This definition, as it turns out, largely

comports with the understanding of liberty evident in the US Constitution. Several

examples of what Beniger might label as cultural programming technologies (that is,

systems of ethical and behavioral proscription, such as religion or political affiliation) are

54 The fact that Smith’s proto-capitalist convictions helped to establish the industrial
capitalist system that fueled the Modern Era in which the autonomous subject was effectively
fragmented and subjected to invasive forms of control is more than ironic; it is exactly what Marx
would identify as characteristic of the inherently contradictory nature of capitalism, an illustrative
example of a system bearing within itself the seed of its own undoing.
55 While this serves a similar function as does Wiener’s circumscription of the
application of control technology over human beings, Jefferson’s and Madison’s conception of
the unitary, autonomous subject is a romantic, pre-Modern notion of the Self. And, interestingly,
it is already a nostalgic concept of the Self, for at the time of the Bill of Rights’ authorship, the
soon-to-be-united states were already actively contributing to the fragmentation of the integrity of
the human subject by the celebration of the perfect exchangeability of all objects, including
human chattel. This is also described more negatively in Michael Warner’s “Textuality and
Legitimacy in the Printed Constitution,” Proceedings of the American Antiquarian Society 97
(1987): 59-84.
 73

explicitly identified in the First Amendment of the Bill of Rights as falling under the

authority of the self. While the First Amendment does not directly address anything

analogous to the notion of genetic programming, one could logically surmise that genetic

programming would fall under similar protection as these other technologies of the self;

one’s genetic code is, after all, even more intimately related to general perceptions of the

self than is religion or any other instance of cultural programming.

Less clear, however, is the status of extra-genetic biochemical programming

technologies in relation to the protections afforded by the Bill of Rights. Because these

kinds of chemical technology did not develop until the mid-19th century, there was no
practical concept of chemical control when the constitution was authored at the end of the

18th century. Any attempt to establish a legal right in reference to the application of such

control technologies, then, would necessarily be a matter of Constitutional interpretation.

Because interpretation of the Constitution falls under the jurisdiction of the judicial

branch of government, settling this issue in this manner would necessitate a lengthy legal

process which is dispositionally antagonistic to the establishment of novel rights, based

as it is on a system of precedent. Only through a Constitutional Amendment could the

Constitution directly address the questions posed by the developments in chemical

technology through which an individual could possibly program his or her own

consciousness. In 1963, psychologists Timothy Leary and Richard Alpert suggested just

such an amendment, to protect what they called the ‘Fifth Freedom.’ In an issue of the

Harvard Review, the authors made their case, asserting that “the Fifth Freedom – the

freedom to expand your own consciousness – cannot be denied without due cause.”56

There was no mistaking that Leary and Alpert were talking about chemical programming

– with chemicals such as LSD – as the primary means through which an individual could

56 Timothy Leary, The Politics of Ecstasy (Berkeley, CA: Ronin Publishing, 1980), 69.
 74

effectively take control of his or her own consciousness. Leary and Alpert called this an

‘internal freedom,’ likening it to the freedom of thought associated with the free press.

Leary and Alpert’s campaign to establish the Fifth Freedom as a right under the

Constitution was not successful. This was particularly unfortunate for Leary, because in

1967, just four years after first calling for an Amendment to this effect, he found himself

in federal court facing several charges of drug trafficking. In keeping with his

pronounced convictions, Leary defended his right to use psychedelic drugs as a religious

sacrament, under the protections of the First Amendment.57 His case was based on a

precedent set by the California Supreme Court in People v. Woody, 40 Cal. 69, 394 P.2d

813 (1964), a decision which sanctioned the use of peyote within the Native American

Church. Though this defense was characterized by the prosecutor a "colossal hoax" and

"just hogwash,"58 Leary’s logic in linking the state of his own neurochemistry to his First
Amendment rights was an attempt to resolve contradictions between the liberal humanist

episteme that structured the Constitution and the realities of the emerging post-human

condition.

In spite of the fact that Leary’s defense is consistent with Wiener’s cybernetically-

informed understanding of liberal democracy, he lost his case and was sentenced to 30

57 Though Leary’s charges were all related to marijuana, Leary himself classified
marijuana as a psychedelic drug in his testimony, deliberately linking it to his already well-
publicized advocacy of LSD. This strategy is risky, because the trafficking of LSD would be an
even greater offense, and thus could easily make him appear to be guilty of a crime even more
serious than the one he was charged with. However, linking marijuana to LSD, Leary sought to
characterize marijuana as a biotechnology of the self, rather than as a simple intoxicant, thereby
strengthening his argument for protection under the Bill of Rights. It should also be noted that
this idealistic defense was one of a strategic battery of defenses offered by Leary. Leary’s
religious exemption defense garnered publicity for Leary and his case, but it backfired on him in
the courtroom. The more practical and less novel defense strategies which he simultaneously
deployed proved successful in the long run, through a series of appeals.
58 Leary v. United States, 383 F. 2d 851, (5 CA, 1967).
 75

years in prison.59 But it would be a wrong reading of the legal judgment to conclude that

the basic logic of his argument was dismissed by the court; rather, concerns other than

Leary’s First Amendment rights simply weighed more heavily on the court’s conscience.

The court concluded that “action[s]…in accord with one’s religious convictions [are] not

totally free from legislative restrictions,” especially actions that “posed some substantial

threat to public safety, peace or order.”60 The court went on to clarify:

We do not inquire into the truth or verity of appellant's

religious beliefs – to do so would be violative of the Free Exercise
Clause of the First Amendment...But appellant's religious creed
and the sincerity of his beliefs are not at issue here.61
By dismissing Leary’s defense exclusively on grounds of public safety, the court tacitly

acknowledged that controlling one’s own neurochemistry is comparable to choosing

one’s own religion, and therefore subject to protection under the First Amendment.

However, by the late 1960s, psychedelic drugs like LSD – once hailed by medical and

military technoscientists as the latest psychiatric miracle drug – were perceived to be

extremely dangerous, madness-inducing chemicals.62 These “public safety” concerns

outweighed the rights of the individual. The court sidestepped Leary’s challenge to

adjudicate his case in terms of Constitutional rights and his proposed Fifth Freedom.

59 This conviction was later overturned on an appeal, though Leary’s successful appeal
was based on a different and much more pragmatic legal strategy that did not attempt to establish
the right to control one’s own consciousness.
60 Leary v. United States, 383 F. 2d 851, (5 CA, 1967).

61 Leary v. United States, 383 F. 2d 851, (5 CA, 1967).

62 This perception, within the legal context, was fostered primarily by the military
classification of LSD as a psychotomimetic chemical weapon, associating it with other chemical
weapons, such as “nerve gas.” For further discussion of this history, see J. Hansen, “Chemical
Transformation: The American Struggle to Understand LSD,” unpublished manuscript; also,
Hearing before the Committee on Science and Astronautics, U.S. House of Representatives,
Eighty-Sixth Congress, First Session, June 16 & 22, 1959: Chemical, Biological, and
Radiological Warfare Agents (Washington, D.C.: United States Government Printing Office,
1959).
 76

Rather than authoring an opinion on personal liberty, the court ruled on a matter of public

health.

Antipsychiatry

Just as Leary was losing his court case, a social and legal movement concerned

with civil liberties and chemical systems of command and control was just beginning to

pick up momentum. Since the 1940s there had been progressive individuals within

psychiatry in favor of de-institutionalization, who lauded the therapeutic power of

interpersonal relationships over the more extreme measures of chemically-induced

comas, electroshock therapy or lobotomy. In 1946, Thomas Main coined the term

“therapeutic communities” to describe this more open and democratic approach to

psychiatry, and many of these communities – such as those established, in the US, under

the recently formed National Institute for Mental Health under the direction of Robert A.

Cohen – were soon established, helping to deal with the remarkable influx of post-WWII

mental trauma patients.63

During the 1950s, this dissent was treated as an ideological difference of opinion

and practice within psychiatry. But by the beginning of the 1960s, the positions within

psychiatry were becoming increasingly polarized, finally coming to be seen in the starkly

contrasting terms suggested by the title of David Cooper’s 1967 Psychiatry and

Antipsychiatry. The furthest extension of the antipsychiatric positions was exemplified

by psychiatrists such as Thomas Szasz, R.D. Laing, David Cooper and, later, Peter

Breggin. The title of Szasz’s influential book, The Myth of Mental Illness (1961),

epitomizes the radical social constructionist view of mental illness adopted by

63 Healy, Creation of Psychopharmacology, 131; Porter, Greatest Benefit, 521-2;

Farreras et al., eds., Mind, Brain, Body, and Behavior: The Foundations of Neuroscience and
Behavioral Research at the National Institutes of Health (Washington, D.C.: IOS Press, 2004),
72; interview with David S. Janowsky, by Burt Angrist, December 10, 1997, http://bit.ly/RbTiXP.
 77

antipsychiatrists.64 As an extension of the conviction that mental illness is both a

product and a tool of power relationships, rather than a matter of physical pathology,

antipsychiatrists maintain that the invasive, coercive practices of psychiatry are the true

causes of mental illness, rather than legitimate treatments.65 During this same period,

popular books of both fiction and non-fiction, such as Ken Kesey’s novel One Flew Over

the Cuckoo’s Nest (1962) and Erving Goffman’s Asylums: Essays on the Social Situation

of Mental Patients and Other Inmates (1961), helped introduce a wider audience to this

professional dissent and dissatisfaction with the state of psychiatry. Electroshock was

publicly vilified as a particularly barbaric practice, the description of which was

sensational enough to earn sympathy for the antipsychiatric cause. The space of the

psychiatric hospital itself was described as an alienating prison, in which patients were

often held against their will once they had been labeled as mentally ill. And chemical

technologies like Thorazine were derided as nothing more than mechanisms of behavior

control, chemical straightjackets with damaging and often permanent side effects.

As the 1960s progressed, antipsychiatry activists were inspired by the successes

of the civil rights movement, and the legal and rhetorical strategies of civil rights leaders

provided a model for social action. Using these strategies, the antipsychiatrists gained

much attention and a number of legal victories for their cause. A series of lawsuits,

starting in 1964 and culminating in the landmark case of Lesard v. Schmidt in 1972,

64 Szasz title so epitomizes this perspective that variations of it are often used
pejoratively by those critical of radical constructionism.
65 Social constructionists (e.g., Szasz, Cooper, and Laing) reached these conclusions as
an extension of the strongest interpretations of constructionist theories; however, many critics of
psychiatry who followed this initial wave of antipsychiatrists – including many within the
psychiatric survivors movement – reach the same conclusions about psychiatric treatments, while
not embracing the strongest of social constructionist positions. For this reason, critics of
psychiatric practice who accept at least some mental disorders as somatic disturbances now
distance themselves from Szasz and The Myth of Mental Illness, in spite of their concurrence with
many of Szasz practical conclusions.
 78

changed the standards for involuntary hospitalization, after which someone could be

committed only if “there is an extreme likelihood that if the person is not confined he will

do immediate harm to himself or others.”66

In 1974, schizophrenic patients brought a series of successful law suits against

Smith Kline & French, the pharmaceutical company that produces Thorazine.67 In the

course of taking psychiatrically prescribed Thorazine, the plaintiffs had all developed

tardive dyskinesia, a disabling condition that causes persistent, involuntary facial ticks.

This serious condition is a sign of permanent brain damage, often making effective

interpersonal communication quite difficult, thereby perpetuating the alienation already

associated with a diagnosis of mental illness. Tardive dyskinesia is one of the many

effects of antipsychotic medication cited by antipsychiatrists like Breggin as proof of the

drugs’ toxicity.

In addition to the legal victories being won, a number of organizations were

started in the 1970s, such as the Mental Patients Liberation Front and the Network

Against Psychiatric Assault, both in Boston. These organizations, with the contributing

efforts of pioneering patient-activists like Judi Chamberlin and Leonard Roy Frank, were

the beginning of what would in later decades grow into the psychiatric survivors’

movement. These groups of former-patients provided support for individuals who had

suffered the abuses of coercive psychiatric practices – primarily forced administration of

Electroconvulsive Therapy (ECT, or more widely referred to as ‘electroshock’) and the

forced administration of antipsychotic medications.68 Additionally, these groups

66 E. Fuller Torrey, Out of the Shadows: Confronting America’s Mental Illness Crisis
(New York: John Wiley and Sons, 1997), 144.
67 Healy, Creation of Psychopharmacology, 248.

68 Chamberlin, Judi. “Rehabilitating Ourselves: The Psychiatric Survivors Movement”

International Journal of Mental Health 24:1 Spring, 1995. 39-46
 79

organized protests of the American Psychiatric Association (APA) and lobbied state

lawmakers.69 The efforts of these consumer advocacy groups, coupled with the wave of

legal decisions in favor of the rights of mental patients, resulted in a wave of reform to

the mental health laws of multiple states, ensuring due process in cases of commitment

and generally reiterating the rights of individuals confined in psychiatric hospitals.70

Many of these legal reforms and court cases framed their decisions as a matter of civil

liberties, nearly articulating Leary’s argument for the establishment of a Fifth Freedom.

For example, in the 1973 case of Kaimowitz v. Department of Mental Health, the Court,

in its decision, argued that:

A person’s mental processes, the communication of ideas,

and the generation of ideas, come within the ambit of the First
Amendment. To the extent that the Frist Amendment protects the
dissemination of ideas and the expression of thoughts, it equally
must protect the individual’s right to generate ideas71
In reaching this conclusion, the same court cited precedent from an earlier case, Stanley

v. Georgia (1969), in which the Court asserted, “Our whole constitutional heritage rebels

at the thought of giving government the power to control men’s minds.”72

But perhaps the greatest victory for the antipsychiatrists came in 1980, in two

separate cases that firmly established a patient’s right to refuse medication. In one of the

cases, class action lawsuit Okin v. Rogers (1979), the judge even referred to the practice

69 Leah Harris, “Protest at the APA: Women Psychiatric Survivors Speak Out,” Off Our
Backs 33, no.7-8 (July-August 2003), 52-53.
70 Neal Milner, “The Right to Refuse Treatment: Four Case Studies of Legal
Mobilization.” Law & Society Review 21:3 (1987), 447-486; “Robert Okin, et al Defendants –
Appellants v. Ruby Rogers, et al Plaintiffs – Appellees” Mental Disability Law Reporter 2:1
(1977) pp. 43-50.
71 “Robert Okin, et al Defendants – Appellants v. Ruby Rogers, et al Plaintiffs –
Appellees” Mental Disability Law Reporter 2:1 (1977), 43-50.
72 “Robert Okin, et al Defendants – Appellants v. Ruby Rogers, et al Plaintiffs –
Appellees” Mental Disability Law Reporter 2:1 (1977), 43-50.
 80

of forcefully medicating individuals against their will – irrespective of their diagnostic

status – as “involuntary mind control.”73 These rulings are not directly equivalent to the

kind of ruling Leary sought, establishing the right to actively control one’s own

consciousness; however, in the delimited context of hospital settings, these rulings did

establish the legal right to not have one’s consciousness controlled by others.

By the end of the 1970s, the antipsychiatry movement was changing. While

activism around the issues of forced medication and electroshock continued throughout

the 1980s, it was increasingly taken on by patient-activists in the psychiatric survivors

movement.74 The dissenting psychiatrists (including Szasz, Cooper, Laing, as well as

new additions like Dr. Peter Breggin) continued to produce critical work, but differences

between them became increasingly apparent, while their tone increasingly strident and

conspiracy-oriented, eventually overshadowing the original force of their critiques.75

The legal mobilization inspired by antipsychiatrists also waned in the 1980s, in part

because it had achieved many of its goals.

But the legal victories inspired by the antipsychiatry movement, as is often the

case, had unintended consequences. Some psychiatrists, such as E. Fuller Torrey, author

Out of the Shadows: Confronting America’s Mental Health Crisis (1997), oppose the

right-to-refuse-medication ruling, on the grounds that the diagnosis of schizophrenia

entails a lack of insight into one’s mental condition. Thus, the refusal of medication is

not an expression of a patient’s self-determination, but an expression of schizophrenic

73 Torrey, Out of the Shadows, 145.

74 Key activists in this movement include Judi Chamberlin, who wrote On Our Own:
Patient Controlled Alternatives to the Mental Health System in 1978, Ted Chabasinski, a survivor
of electroconvulsive therapy who led a campaign to ban its use in California.
75 For example, beginning in 1976, in a number of different publications, Szasz publicly
denounced Laing and Cooper as Communists. See Theodore Itten and Ron Roberts, “Laing and
Szasz: Anti-Psychiatry, Capitalism and Therapy,” unpublished manuscript, http://bit.ly/1eJUf3Y.
 81

delusion, wherein the afflicted individual cannot perceive the benefits of medication.

Torrey’s paternalistic position necessarily dismisses the complaints of individuals who do

not experience antipsychotic medications as therapeutic, or for whom the drugs’ side-

effects outweigh the tangible benefits. Irrespective of the epistemological status of the

subjective experience of individuals diagnosed with schizophrenia, however, the fact

remains that many patients choose to not take their prescribed antipsychotic medication.

Those among them who, when not medicated, cannot maintain a job or pay rent often end

up living on the street. The fact that hospitals can no longer admit them to psychiatric

care without their cooperation (unless they can be proven to be dangerous) arguably

contributes to this problem of homelessness. This problem was compounded by a large

number of state hospitals closing down throughout the 1980s. These shut-downs were, for

the most part, economically inspired and precipitated by Reagan-era changes in federal

funding; state governments, however, utilized the rhetoric of deinstitutionalization to

justify the removal of mental health services to many who genuinely needed and wanted

them. Even more bitterly ironic is the fact that in the first decades of the 21st century,
profoundly schizophrenic or otherwise mentally ill individuals who, in the 1960s would

have been confined to psychiatric institutions, and in the 1980s would have been living

on the street, are increasingly confined in already-overcrowded prisons.76 So a

movement that aimed to liberate a population in the prison-like environment of

psychiatric hospitals culminates half a century later with the same population

increasingly confined in actual prisons, with even less adequate medical care.

Many of the antipsychiatry activists of the 1960s were caregivers concerned with

the wellness of a marginalized group being systematically subjected to coercive control.

76 “Mentally Ill Persons in Corrections,” National Institute of Corrections.

http://nicic.gov/mentalillness.
 82

In spite of adopting the provocative title of “antipsychiatry,” the founding members of

this group were themselves psychiatrists who adhered to alternative diagnostic and

therapeutic philosophies of mental health and illness.77 In the course of expressing this

dissent, the antipsychiatrists popularized a grim vision of psychiatric hospitals that drew

as much upon the dark history of coercive psychiatric institutions78 as it did upon

contemporary practice. This anti-PR campaign, coupled with canny legal activism,

pressured many hospitals to limit or abandon the use of more extreme physical

interventions, such as electroshock therapy.79 In this way, the movement was generally

successful in its efforts to reform the most coercive elements of these institutions. But as

critics have noted, it also contributed to new problems for many schizophrenic

individuals, simply shifting the site of their struggles from psychiatric institutions to the

street or to prison.

The Diagnostic Turn, 1980-1997

The reforms brought about in response to the antipsychiatry movement of the

1960s and 70s significantly affected the lives of individuals engaged as subjects within

systems of psychiatric care. From the perspective of activists, these reforms curbed the

abuses of “involuntary mind control,” and expressed popular resistance to abuses of

77 Szasz, Cooper, and Laing have each expressed regret that the term they helped to
popularize potentially mischaracterizes their position as psychiatrists dedicated to their practice.
Thomas Szasz, Anti-psychiatry: Quackery Squared (Syracuse, NY: Syracuse University Press,
2009),1-7.
78 A prime example in this well-known and dark history would be Bethlem Royal
Hospital in London, whose coercive and exhibitory practices, from the 17th century to the early-
19th century, helped coin the term “bedlam” as a description for uncontrollable madness.
79 For decades after this, ECT increasingly fell out of favor, in part from the work of the
antipsychiatry movement, as well as continued anti-ECT activism in the psychiatric survivors
movement, which picked up momentum in the 1980s. In the first decades of the 21st century,
however, its use has been regaining popularity.
 83

power made possible by the instrumentalization of consciousness. However, the most

dramatic transformation of psychiatry in the late-20th century was not inspired by the

agitation of antipsychiatry activists. Instead, a range of institutional influences within

psychiatry itself contributed to an epistemic break in psychiatry in the 1980s, often

referred to as the diagnostic turn. This was a turn away from Freudianism, and a turn

towards an allopathic model of disease, which presumed all mental disorders to be

discrete entities, rooted in somatic brain disturbances. This shift brought psychiatry more

in line with larger trends in the medical industry as a whole, made psychiatry more

amenable to the billing practices of insurance companies, and created literally hundreds

of new clinical indications, proving to be the most significant change to the field of

psychiatry since the introduction of Thorazine in 1952. Moreover, this change in

psychiatric practice was a significant advance in the instrumentalization of

consciousness.

The diagnostic turn can be conveniently marked by the publication of the third

edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980.

This text, published by the American Psychiatric Association (APA), has been the

primary reference tool of psychiatrists in the US (and, increasingly, the world80) since
the publication of its first edition in 1952. However, with the new edition in 1980, the

APA effectively rejected the fundamental principles of psychiatry as it was being

practiced and replaced them with a new model of mental illness.

The psychiatric model which directly preceded the diagnostic turn was heavily

influenced by the work of Sigmund Freud, Carl Jung, and Jacques Lacan, and

emphasized psychoanalysis as a therapeutic tool of choice (though psychoanalysis was

80 Watters, Ethan. Crazy Like Us: The Globalization of the American Psyche. (New
York: Free Press, 2010).
 84

occasionally augmented or facilitated by psychoactive drugs such as LSD81 and

Ritalin82). This model is often referred to as dynamic psychiatry, because it established

that neuroses existed along a spectrum, in a dynamic relationship with normal mental

functioning. Thus, the developmental processes of early childhood (e.g., breastfeeding,

toilet training, awakening sexuality) resulted in normal behaviors when allowed to

resolve in accordance with social expectations, but the same processes were also the

source of pathology when their resolution was interrupted by some traumatic event. This

explanation rendered mental disturbances relatable to the experience of “normal” mental

states, and therefore, understandable. The effect was to normalize pathology, and

simultaneously to bring the normal closer to the pathological.

Dynamic psychiatry was embraced by its middle- and upper-class consumers, in

part, because of its narrative orientation. Dynamic psychiatry demanded that clients enter

into relationships with analysts, and exchange in a dialogue of self-discovery, which

allowed individuals dissatisfied with the social conditions of their lives to make sense out

of their own biographies. Further, in keeping with Freud’s works of social criticism (e.g.,

The Future of an Illusion [1927]), dynamic psychiatry provided a position from which to

critique a number of social institutions, such as Judeo-Christian religious traditions, that

had heretofore proscribed appropriate behaviors (what Beniger would describe as cultural

programs). As the terms of dynamic psychiatry became increasingly familiar, it came to

function as a kind of lingua franca among artists, intellectuals, and cultural producers,

facilitating communication and understanding across social barriers. Consequently, its

terms and concepts became a part of popular culture in the US (e.g., the films of Alfred

81 Jay Stevens, Storming Heaven: LSD and the American Dream (New York: Grove
Press, 1987).
82 Estelle P. Epstein et al., “Chemotherapy and the Hyperkinetic Child,” Journal of
Education 151:2 (Dec. 1968), 54.
 85

Hitchcock, such as Spellbound [1945] and Psycho [1960]), furthering the utility of

dynamic psychiatry as a tool of popular and political discourse.83 Ultimately, it

encouraged people who were dissatisfied with many different social aspects of their lives

to present these things as problems to dynamic psychiatrists.

In the US, dynamic psychiatrists defended their professional legitimacy by

identifying themselves as physicians, which distinguished them from other professionals

who could use the basic tenets of Freudian analysis as easily as they could, such as social

workers, clinical psychologists, and a growing number of pop-psychology self-help

authors.84 At the same time, this close association with physicians created an increasing
tension within psychiatry as the demands of the medical profession changed.85 As

medicine became more scientifically oriented, and placed a greater emphasis on

quantification, dynamic psychiatry was increasingly pressured to adhere to these new

standards. However, the entities that dynamic psychiatry dealt with – ego, id, superego,

neuroses and complexes – did not lend themselves easily to this kind of quantification.

Further changes exacerbated the tensions within dynamic psychiatry around mid-

20th century. Notably, the increasing use of third party payers for psychiatric care placed

demands of accountability on psychiatrists. The dynamic spectrum of neuroses was not

nearly as conducive to insurance company billing as were the discrete disease categories

of allopathic medicine, which implied a known etiology and course of treatment upon

diagnosis. Dynamic psychiatrists would often not even reach a diagnosis until after

83 For example, the film The Manchurian Candidate (1962) is as much about Freudian
psychoanalysis as it is about Communism or mind control.
84 Indeed, this is only an extension of the long history of psychiatric discourse
constructing itself as an analog to medical and scientific discourse, as Michel Foucault made the
topic of a series of lectures in 1973. Michel Foucault, Psychiatric Power,153.
85 Horwitz, Creating Mental Illness, Paul Starr, The Social Transformation of American
Medicine (New York: Basic Books, 1982).
 86

weeks of analysis, and every patient/consumer required a different, unique course of

treatment, based on their personal history.86

All of this led to a paradigm shift within psychiatry. Sociologist Allan V.

Horwitz, in his account of the diagnostic turn in psychiatry (Creating Mental Illness

[2002]), explicitly cites Thomas S. Kuhn’s use of the term “paradigm shift” as an

accurate characterization of this transition.87 As Kuhn’s revisionist account of scientific

“progress” describes, developments in scientific thought happen quickly, in sporadic,

intermittent bursts, rather than slowly and consistently, over long periods of time.

Moreover, paradigm shifts, as outline by Kuhn, tend to displace the paradigms they

follow, rejecting one body of knowledge in favor of another. In suggesting this, Kuhn is

himself rejecting previous models of scientific knowledge production, which were

characterized by the incremental contribution to the slow accretion of an ever-expanding

body of undisputed knowledge. The events that comprise the diagnostic turn comport

with Kuhn’s argument: in the space of a decade, concluding with the publication of DSM-

III in 1980, the APA threw out all of the dynamic concepts that had been espoused in the

first two editions of the manual and replaced them with a diagnostic model of psychiatry

that was organized around symptoms and discrete disease categories.

The editorial staff of the DSM-III were inspired by the work of a group of

psychiatrists from Washington University in St. Louis, led by Eli Robins and Samuel

Guze, who had been developing a diagnostic model of psychiatry throughout the

1970s.88 This group modeled their work on that of 19th century psychiatrist Emil

86 The difficulties of commoditizing psychoanalytic therapy had already been an issue

within psychiatry, leading Lacan – who ideologically opposed the standardization of the length of
therapy sessions – to distance himself from the position of organizations such as the APA.
87 Kuhn, The Structure of Scientific Revolutions.

88 Allan V. Horwitz, Creating Mental Illness (Chicago: University of Chicago Press,

2002), 39.
 87

Kraepelin (1856-1926), who classified mental illness according to a strict adherence to

empirical observation. This method led Kraepelin to categorize all mental disturbances

into only two broad categories: affective psychoses (what we would call depression) and

dementia praecox (what we would call schizophrenia). Using similar methods, the neo-

Kraepelians produced a set of discrete criteria that effectively identified only fourteen

categories of mental illness.89 This greatly reduced the number of complaints considered

to be the scope of dynamic psychiatry, limiting it primarily to profound psychosis.

This approach supplied several elements that were appealing to the editorial staff

of the DSM-III, and the membership of APA more generally. It consisted of discrete

diagnostic categories, which were clearly identified by empirical symptoms. Moreover,

these diagnostic categories were all presumed to be somatic disturbances, which implied

that they would be subject to quantifiable, physical interventions. All of these qualities

brought the diagnostic model closer in line with medical practice more generally, and

insurance billing practices, more specifically.

However, when the DSM-III editorial staff was faced with making this neo-

Kraepelian model operational, it encountered a dilemma. The dynamic model had so

greatly expanded the range of complaints that fell under the purview of psychiatry, and

had been so effective in popularizing the therapeutic benefits of psychiatric interventions

at any-and-all points along the dynamic spectrum of neuroses, that the majority of

psychiatric patient/consumers fell outside of the limited criteria of the neo-Kraepelian

model. Therefore, in order to avoid undermining the client-base of APA members, the

DSM-III editorial staff applied the diagnostic model to the whole range of complaints that

psychiatrists had come to treat under the dynamic model, rather than restricting its

application to the comparatively sparse fourteen diagnostic categories proposed by the

89 Ibid., 65.
 88

neo-Kraepelians. As a result, the number of diagnostic categories created by the DSM-III

was in the hundreds.90 More precisely, there was little change to the numbers of mental

diseases – that is, mental disturbances which are demonstrably based in physical

pathology – but a dramatic increase in the number of mental disorders – disturbances in

mental functioning that have not been demonstrably linked to physical pathology.

Though the diagnostic turn was a response to institutional pressures, and not a

direct response to antipsychiatry, it is nonetheless an unqualified rejection of the social

constructionist view of mental illness. By identifying a particular constellation of

behaviors as a behavioral disorder, the somatic nature of the disturbance is already

presumed, obviating the necessity of addressing social or power relations. In so doing,

the diagnostic turn marks the nearest realization of Wilhelm Wundt’s psychometric

vision of 1879, in which the psyche as a whole is understood as a collection of discrete

functions, individually quantifiable, knowable, and therefore subject to intentional

manipulation.

Diagnostic Pharmacy
The diagnostic turn also changed the relationship between psychiatry and the

pharmaceutical industry in ways that served the interests of both systems. The pharmacy

industry as a whole had suffered a significant setback in the early 1960s, as a result of the

Thalidomide affair. In the 1950s and 60s, a newly synthesized drug, marketed as

Thalidomide, had been widely administered to thousands of pregnant women as a means

of treating the symptoms associated with morning sickness. As became increasingly

clear by the beginning of the 1960s, children born to mothers who had used Thalidomide

presented an abnormally high rate of congenital birth defects. While the real burden of

90 Horwitz, Creating Mental Illness.

 89

this pharmaceutical misadventure was borne by the families directly affected by

Thalidomide, there were negative effects for the industry, as well. To start, Grünenthal

GmbH, the German pharmaceutical company that manufactured Thalidomide (and,

previously, penicillin), faced a series of class action lawsuits and was forced to pay out

large sums of money in legal settlements to those directly affected by Thalidomide in

several countries. There was also a significant amount of bad publicity brought to bear

on the industry as a result. But perhaps most significantly, pharmaceutical companies

faced a new set of legal restrictions put in place after the Thalidomide affair.

In the US, Thalidomide had not received approval from the FDA and was

therefore not widely available, which helped to minimize the effects of Thalidomide in

the US. In spite of the FDA’s prudent denial of the Thalidomide, however, many

pregnant women in the US managed to navigate the rather sizeable gaps in FDA

regulations governing experimental drugs – which is the FDA’s terminology for drugs

currently in the process of applying for approval. After the Thalidomide affair, these

regulations were addressed and strengthened through the Kefauver-Harris Amendment to

the Food, Drug and Cosmetics Act, in 1962. Among the layers of oversight this

amendment added was a preliminary bureaucratic procedure to the drug development

process, which required drug developers to submit an approval form even before new

chemical compounds could be synthesized or obtained for initial testing. This approval

form asked drug developers to specify the medical indication for which the chemical

compound was to be tested – meaning that the FDA would only approve basic research

into new chemical compounds if they were indicated as potentially therapeutic in the

treatment of specific illnesses or conditions. This gave the FDA more control over

experimental substances, while simultaneously imposing an additional test of efficacy

into the structure of the approval process. It also structures the regulatory disposition of
 90

the FDA in favor of an allopathic model of medicine.91 The Kefauver-Harris

amendment also wrote into law the use of the large-scale clinical trial as the gold

standard of proving safety and efficacy. In this, the Kefauver-Harris amendment can be

seen as one more step in a continuing trend towards standardization and the adoption of

industrial science within the medical industry. This step was taken explicitly for the

increased control it afforded to regulatory bodies over potentially dangerous chemicals.

By mandating the scale and structure of acceptable research, the same legislation

effectively restricted research to industries and institutions with the necessary

infrastructure and resources, and thus, granted those institutions and industries increased

control of production. This regulatory change effectively shut down several extant basic

research programs into the effects of experimental drugs – including Timothy Leary’s

psychedelic research at Harvard.92

To whatever degree the Kefauver-Harris Amendment constrained the

pharmaceutical industry’s freedom and ability to research and produce new drugs,

however, the diagnostic turn compensated for it. The DSM-III provided hundreds of new

diagnostic categories for which pharmaceutical companies could develop new drugs,

while conforming to the allopathic proscriptions of the FDA. Further, new diagnostic

categories provide more opportunities for drugs to be re-purposed for new indications.

This is a particularly lucrative practice, because US patent law recognizes a novel

application of an established chemical technology as a new, patentable product. By

repurposing existing drugs to new indications, or by making admixtures of existing drugs,

91 That is, a model in which the primary function of medicine is to combat and destroy
discrete pathological entities, as opposed to other models, such as a public health model, in which
the primary function of medicine is to promote wellness and prevent illness at the population
level.
92 Stevens, Storming Heaven.
 91

pharmaceutical companies can effectively extend their patents on chemical beyond the

sunset clause built into US patent law – a provision designed to insure that medical

knowledge produced by private companies would eventually find its way into the public

domain.

Direct-to-Consumer Marketing

The diagnostic turn, as materially instantiated in the DSM-III, enables several

systems (e.g., the insurance industry, psychiatry, the pharmaceutical industry) to operate

in a single network. The scope of this network of systems expanded further in 1997,

when the FDA changed its regulatory stance on Direct-to-Consumer (DTC) marketing.

This change created new feedback loops within the network, allowing for more direct

communication between pharmaceutical companies and patient/consumers, thereby

increasing the efficiency of the network. Prior to 1997, pharmaceutical companies were,

for the most part, restricted to marketing their products to psychiatrists, which situated

psychiatrists as a kind of buffer zone between pharmaceutical companies and

patients/consumers. The change in FDA policy, however, made it possible for

pharmaceutical companies to advertise their products directly to patient/consumers on all

media outlets.

While marketing had already been an important part of the pharmaceutical

industry prior to this, DTC marketing allowed for an entirely new approach to advertising

on a much broader level. Instead of relying on traditional means of marketing to

psychiatrists (e.g., hosting conferences, circulating papers, and distributing free samples,

free literature and free office supplies branded with the corporate logo – all techniques

that continue to be employed), pharmaceutical companies could now launch multimedia

campaigns designed to convince consumers to lead the prescription process themselves

by seeking brand name drugs from psychiatrists.

 92

Critics of psychiatry, since the 1990s, have identified this network of systems as

being dangerously incentivized to produce new behavioral disorders expressly for the

purpose of selling drugs.93 The criticism, in the furthest expression, is that labeling

behaviors as behavioral disorders is merely a means of marketing drugs, and may serve

no social good beyond generating wealth for the pharmaceutical industry. For example,

in the book Shyness: How Normal Behavior Became a Sickness (2007), psychiatric

historian Christopher Lane recounts the history of the diagnostic turn as an occasion to

look in detail at the development of social anxiety disorder, from the deliberations of the

editorial staff of the DSM-III to the marketing of Paxil – which put SmithKline (now

Glaxo SmithKline), the pharmaceutical company that produces Paxil, in the position of

needing to advertise social anxiety disorder itself, so that subsequent advertising for Paxil

would be comprehensible.94 This was accomplished through print advertisements – such

as a series of posters in New York subway stations – as well as through the placement

and promotion of ostensibly objective and disinterested research in trade publications and

popular journalism, not unlike the propaganda campaign Edward Hunter performed with

the concept of brainwashing in the 1950s. In this sense, the diagnostic category of social

anxiety disorder was as much a SmithKline product as was Paxil.

Among the behavioral disorders that arose from the diagnostic turn is Attention

Deficit/ Hyperactivity Disorder. Specified in the DSM-III as a “disorder of childhood,”

diagnosis of ADHD was primarily based on the clinical observation of some combination

of three behavioral tendencies: inattention, hyperactivity, and impulsivity.95 Beyond

93 Conrad, The Medicalization of Society; Whitaker, Anatomy of an Epidemic; Szasz,

The Medicalization of Everyday Life.
94 Lane, Shyness.

95 DSM-IV-TR (2000) offers nine symptoms of inattention (i.e., "often does not seem to
listen when spoken to directly"), six symptoms of hyperactivity (i.e., "often fidgets with hands or
 93

these behaviors, no physical marker of ADHD was identified. As such, it is

representative of one of the many new “disorders” that essentially re-presents research

that fell under the pre-diagnostic jurisdiction of dynamic psychiatry into the new,

allopathic model. Consequently, ADHD has been subject to the criticism that it, too, is

an invented disorder, created primarily to drive profits for pharmaceutical companies. In

fact, for reasons I will discuss below, popular skepticism of ADHD was among the first

critical responses to the diagnostic turn as a development in the instrumentalization of

consciousness. Several popular texts, such as The Myth of the A.D.D. Child (1995) by

Thomas Armstrong (directly alluding to Thomas Szasz), have made this claim.96
This skepticism is most dramatically exemplified by a series of class action

lawsuits, filed in 2000, known collectively as the Ritalin lawsuits (as I discuss further in

chapter three). These suits named several actants in this network of systems, including

Novartis Pharmaceuticals and the American Psychiatric Association (APA), as

defendants, alleging that they "planned, conspired, and colluded to create, develop and

promote the diagnosis of [ADD] in a highly successful effort to increase the market for

its product Ritalin."97 The plaintiffs’ attorneys further claimed that Novartis failed to

inform consumers about both the lack of long-term efficacy and the significant health

risks of Ritalin. As in the Thorazine cases of the 1970s, plaintiffs sought damages for

feet or squirms in seat"), and three symptoms of impulsivity (i.e., "often has difficulty awaiting
turn").
96 Thomas Armstrong, The Myth of the A.D.D. Child: 50 Ways to Improve Your Child’s
Behavior and Attention Span Without Drugs, Labels, or Coercion (New York: Penguin, 1995).
97 http://www.bio-medical.com/adhd_0002.htm
 94

physical injury incurred from taking Ritalin.98 The lawyers for the lawsuits even secured

Peter Breggin as an expert witness and medical consultant. 99

Reducing ADHD to this analysis, however, is an oversimplification that fails to

take into account several additional systems and factors unique to ADHD. The forces

motivating the creation of the idea of an attention deficit are larger, more diffuse, and

much older than diagnostic psychiatry or even the pharmaceutical industry.

School/Children

Unlike most of the diagnoses in the DSM, ADHD is one of a small group of

disorders explicitly identified as “disorders of childhood,” meaning that the diagnosis was

to apply exclusively to children.100 Further, as the DSM-III itself acknowledges, ADHD

behaviors are most often identified in the context of school. Both of these things

contribute to the anxiety that the diagnosis aroused in the 1980s, because of the social

meanings attached to the concept of childhood. The condition of childhood is a special

exemption from the liberal humanist ideal of individualism. (Critics of humanism would

say it reveals the limits of individualism.) Since children are not considered entirely

rational or autonomous subjects, they are perceived as both a vulnerable and protected

class of subjects. Because of the vulnerable and protected position of children, schools –

grade schools, especially – operate as custodial institutions at the same time as they

operate as educational institutions. While students are not subject to the same level of

coercion as are residents in psychiatric hospitals, they exist within the school systems,

98 This is still a controversial issue, but likely includes permanent cardiac damage.

99 Thomas B. Johnson and Andrea Canter, “Ritalin on Trial: Class Action Lawsuit Filed
Against Drug Company, Psychiatrists and ChADD,” National Association of School Psychiatrists
Communiqué, Volume 29, No. 4. http://www.nasponline.org
100 Adult ADHD, as a category distinct from ADHD, did not develop until later.
 95

nonetheless, in a stark disparity of power distribution. The vulnerability of this

population within the disciplinary institution of the school contributed to public concern

over potential abuses of control technologies. At the same time, the fact that the

diagnosis of ADHD was being applied to children in the context of the public schools

also contributed to the rapidity with which ADHD was adopted – even more quickly than

other behavioral disorders created in the same gesture. The ease with which the various

systems involved in ADHD merged with education systems is due to the fact that there

already existed a discourse of control into which this technology could be adopted, and a

population of students to which it could be readily applied.

At the end of the 19th century in the US, education was also being standardized on
a factory model.101 Common school reformers, starting with Horace Mann, took it upon

themselves to standardize education across the US. In the 1880s and 90s, this effort was

ideological, drawing its inspiration from Thomas Jefferson’s vision of universal

compulsory publically funded education as a mechanism for sorting “geniuses” from

ordinary men, and an indispensable element of republican “virtue.” Equalitarian

principles dictated that people of every social class had an equal ability and an equal right

to learn, and Jefferson saw it as the responsibility of a democratic government to make

sure that economic conditions not distort that reality, especially since, as more middle

class educators argued, a voting public, after all, needed to be a literate public.

Industrial interests also contributed to Horace Mann’s common school reform

movement. Schools tended to flourish in industrial areas, as the capital accumulated by

business – and collected by the community in property taxes – helped in the construction

of new buildings and the hiring of teachers. This situation helped the factory owners as

well, because the unskilled wage labor of factory work demanded a different kind of

101 The following chapter on the education system will look at this in more detail.
 96

education than the traditional apprenticeships of artisans and craftsmen. Rather, a

generalized education from an institution, itself not unlike a factory, was more suited to

the preparation of future workers.102

By the turn of the century, these combined interests had brought universal

compulsory education to almost every community in the US. Ironically, the very success

of the common school reform movement at the end of the 19th century had set the stage

for the educational problems of the 20th century. As education became both more

universal and more compulsory, educators increasingly had to ask themselves not ‘how

do we educate children,’ but rather ‘how do we educate all children?’ The democratic

vision of universal, compulsory education, then, was both the strength and the weakness

of the developing educational system.

Just as Crary and Beniger suggest, that the increased productivity of industrial

capital necessitated the installation of new means of control, so did the increasing scope

of universal education require a highly systematized approach. The model that took hold

and was emulated by efficiency-minded administrators across the country was one in

which a population of students was broken down into several sub-populations, each of

which was taught uniformly on a routine, rotating basis. The simplest and most efficient

way to establish these sub-populations is by age. After all, everyone has a birth date; in

most circumstances the birth date is immediately knowable and rarely disputed; a birth

date requires no special measurement or procedure to obtain; and it can be recorded as a

discrete number, easily comparable to other birthdates.

As historians such as Michael Katz (1987) have observed, teaching by cohort,

then, developed out of administrative principles of organization and standardization,

102 Bowles and Gintis, Schooling in Capitalist America, 162.

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rather than out of any educational utility.103 In fact, organizing a student population by

cohort introduced a significant educational problem, since it assumed that all students of

the same age are at the same, standard level of ability. This assumption is problematic

for at least two reasons. First of all, it implies that education is a physical process – like

the growth of one’s feet – and not a social process dependent on the multivalent factors of

an individual’s particular history. Second, it fails to account for the inherent variability

of human subjects. By standardizing levels of educational development in a population

of students defined only by an arbitrary criterion like age, the school simultaneously

creates a sub-population that is non-standard. In other words, standardization proliferates

and implants the nonstandard, precisely as “attention” requires “distraction.” That some

students will not perform at the same reading level, for example, as the rest of their

cohort is both statistically certain and predictable.

Thus, from the beginning of standardized education, schools have had to

determine what to do with the students who don’t fit into the industrial era organizational

system of the school. At the beginning of the 20th century, the influence of the
concurrent eugenics movement led many schools to label such nonstandard children as

“morons,” “imbeciles,” or “idiots,” in descending order of mental and physical

inferiority. Eugenicists promoted the notion that intelligence – one’s very capacity to

learn – was an inborn trait (closely associated with race); it followed, then, that

attempting to help these students catch up would only be a waste of time and resources –

the opposite of streamlined efficiency. Instead, students who found themselves in this

sub-population – often as the result of scoring poorly on a standardized IQ test – were

encouraged to attend separate high schools, and were taught vocational skills.

103 Michael B. Katz, Reconstructing American Education (Cambridge: Harvard

University Press, 1987).
 98

Though the rhetoric of the eugenics movement faded in time, the presence of a

sub-population of students that don’t fit the organizational structure of the American high

schools – in keeping with the inherent unpredictability of any system – did not go away.

But the vocabulary by which these students are identified did change, along with other

socioeconomic, institutional, and cultural transformations. Specifically, as psychiatrists

became increasingly incorporated into the administrative structure of high schools

throughout the 1950s and 1960s, they brought to bear their psychometric tools on this

new research population. It is here, in the work of school psychiatrists, that we see the

contradictions that emerged as students began to be classified in terms of attention and

distraction. As the synaptic theory of neurotransmission became accepted by mainstream

psychiatry during the Cold War (initially inspired by the marketing of Thorazine),

American medical researchers grew increasingly confident that every aspect of mental

life could ultimately be attributed to (and manipulated by) particular neurochemicals. By

the time the DSM-III included ADHD as a diagnostic category in 1980, there was already

a population of school psychiatrists and research psychiatrists in the field of education

anticipating that attention (and distraction) could help clarify, understand, treat and

process students that didn’t do well in school, yet didn’t seem to suffer from organic

brain damage or severe mental retardation.

Attention/Distraction

While ADHD was formalized as a recognized diagnosis with the publication of

the DSM-III in 1980, there was a growing body of clinical research into attention as a

cognitive function in the 1960s and 70s. Research that conceivably pre-figures ADHD

went under many different names, including hyperactivity and minimal brain damage

(MBD). (This research is addressed more fully in chapter 2.) While this clinical research

directly preceded the consolidation of ADHD as a diagnosis, this work, too, was preceded
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by a much longer discourse of attention, which is itself connected to technologies of

control and systems that integrate human beings as well as machines into their operations.

In his book, Suspensions of Perception (1999), Jonathan Crary traces a history of

our current notion of “attention” back to the mid-19th century, arguing that it emerged

from the fragmentation of the human subject by other social processes, most notably the

nascent science of psychiatry and the demands of industrial capitalism. As people began

to interact with new technologies – whether the psychometric devices of Wilhelm Wundt,

machines in industrial factories, or a number of new entertainment technologies such as

the stereograph and kinetoscope – they were asked to devote an unprecedented amount of

sustained attention to a remarkably constrained and standardized range of stimuli. Thus,

corporate researchers and investors had a newfound vested interest in promoting the very

idea of attention; as a result, Crary argues, the word came into common use in a number

of different applications.

Previously, influential cultural critics like Walter Benjamin, Siegfried Kracauer

and Theodor Adorno had argued, in apparent contradiction to Crary’s thesis, that modern

society is characterized by a state of distraction, and that members of Western society

were losing the ability to pay sustained attention. In fact, rather than wholly opposing the

older critique of a society of distraction, or spectacle, Crary asserts that the concepts of

attention and distraction emerged together, at the same historical epoch, in response to

the same scientific and economic developments. He writes:

Modern distraction was not a disruption of stable or

“natural” kinds of sustained, value-laden perception that had
existed for centuries but was an effect, and in many cases a
constituent element, of the many attempts to produce attentiveness
in human subjects. If distraction emerges as a problem in the late
19th century, it is inseparable from the parallel construction of an
attentive observer in various domains.104

104 Crary, Suspensions of Perception, 49.

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The “construction of an attentive observer” was, in other words, a necessary component

of the rationalization, systematizing, and bureaucratization that comprise what Beniger

calls the control revolution.

This is apparent in in the late-19th century factory, the site where fragmentation,

attention, and distraction initially converged. Just as, through Taylorist approaches to

workplace management, the performance of labor in mechanized factories was being

standardized, so too was the duration that workers were expected to be able to perform,

as well as the range of stimuli to which they would be expected to respond. It is the

process of standardization – in this case, of attention – that both required and materialized

the non-standard: distraction.105

From the perspective of cybernetic systems, in fact, attention might best be

thought of not as a quality of an individual’s consciousness, but as a measure of a

subject’s degree of compliance to the demands of a particular instantiation of control

programming – that is, the degree to which an individual successfully constrains the flow

of information from the environment to the standardized range demanded by the control

technologies to which he or she is subject. As a means of measuring, addressing, and

ultimately disciplining this degree of compliance, the concept of attention, as it is

increasingly employed since the mid-19th century, function as a control technology, itself.

ADHD, then, is itself a technology that arises from the organization of two other

technologies: the late-19th century technology of attention/distraction and the late-20th

century technology of behavioral disorders. Together, they create the conditions under

105 Michel Foucault observes the same phenomenon in his lectures on the lounge durée
history of psychiatry. Foucault observes this in his archeology of a related concept: discipline.
As an illustration, he even uses the example of attention in education: “...you see the appearance
of something like the feeble-minded or mentally defective when there is school discipline. the
individual who cannot be reached by school discipline can only exist in relation to this discipline;
someone who does not learn to read and write can only appear as a problem, as a limit, when the
school adopts the disciplinary schema.” Foucault, Psychiatric Power, 53
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which previously existing chemical technologies – in this case, the amphetamine-

derivative methylphenidate, marketed under the brand name Ritalin – can be employed.

This organization of technologies is in turn adopted because of its utility not just to

psychiatry and the pharmaceutical industry, but public education in the US, as well. The

eager reception of this technology within education is related to school administrator’s

embrace of industrial models of organization and control.

Ritalin

The efficacy of amphetamines is used to legitimize the diagnosis of ADHD, even

as the diagnosis legitimizes the use of amphetamines to those who take them or

administer them to their children. Just as the efficacy of Thorazine prompted a re-

definition of schizophrenia, so did the effectiveness of Ritalin contribute to a re-

conceptualization of the nature of behavioral disorders, adopting a similar rhetoric of

“chemical imbalances.” And, just as the dopamine theory of schizophrenia was

developed as a means of explaining the apparent efficacy of Thorazine, ADHD was

hypothesized post hoc as a means of explaining and marketing the efficacy of

amphetamines in controlling the behavior of unruly children. In the case of Thorazine,

however, schizophrenia already existed as a recognized disease category. The discovered

efficacy of the new drug then inspired a post hoc theory that explained the efficacy, and

in so doing, re-defined schizophrenia. In the case of ADHD, as a consequence of an

ideological re-organization within psychiatry, a subclinical manifestation of a behavioral

disturbance was hypothetically re-positioned as a somatic brain disturbance; this enabled

the renewed marketing and distribution of an established drug, the highly predictable

results of which are subsequently employed to justify the somatization of the disorder.

The attention-promoting effects of amphetamines had been established in 1937,

when Charles Bradley administered Benzedrine to children who had suffered brain
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damage from encephalitis infections. Bradley hypothesized it would relieve their

headaches, but discovered that the children’s performance in mathematics improved as

well. Since then, the attention-promoting and –sustaining qualities of amphetamines and

amphetamine-derivatives have been widely exploited and marketed. For example, in

Sweden in 1938, amphetamines were sold over the counter under the commercial slogan,

“Two pills beat a month’s vacation.”106

The US military used amphetamines regularly throughout WWII. As used in the

military – especially among pilots tasked with flying the long hours of trans-Pacific

bombing runs, in which sustained attention was crucial – amphetamines were clearly

used as a control technology, an exercise in biopower to rationalize the somatic variation

of the human elements with a cybernetic system. In spite of this, however, the vigilance

amphetamines inspired in individuals who took them was typically characterized as a

bodily experience, rather than a cognitive experience. They were “pep pills,” and in that

sense analogous to more familiar organic chemical technologies, like coffee, tea, and

sugar. Pep pills kept soldiers awake and alert, but they were not perceived to be altering

cognition to an instrumental end.107 It was a technological extension of human power,

but a step removed from the instrumentalization of consciousness, as would be achieved

several decades later.

This demonstrates that the process of medicalization of mental states, and the

enforced standardization of mental states, is the true control technology at play; the

chemical technology (e.g., Ritalin) merely facilitates the project of rationalization and

standardization in powerful new ways. Eventually, cultural products – film, fiction,

106 Palfai and Jankiewicz, Drugs and Human Behavior, 290.

107 Except in cases of amphetamine-induced dementia, as is portrayed in the fiction of

both William Burroughs and Phillip K. Dick.
 103

graphic novels – would connect these developments in psychiatry and education to an

emerging cyborg subjectivity, a subjectivity increasingly more fully articulated by the

early 21st Century (see chapters 4 and 5). In the short term, however, the diagnostic

indication of ADHD allowed Ciba-Geigy (now Novartis) to repurpose Ritalin – already

understood for its ability to promote attention – as a treatment for a behavioral disorder.

This point is illustrative of pharmaceutical history. The rise of a biotechnological

practice – in this case, administering stimulant drugs to a statistical subpopulation of

grade school students – is not the direct result of a technological or scientific

development – as traditional historians of science or technofuturists would have us

believe is the case in every instance. Rather, developments in institutional policies and

the rhetorical dispositions of organizations – the politics of knowledge production – made

possible new uses for well-established chemical technologies.

The Ritalin lawsuits of 2000 fell apart, failing to establish ADHD as the invention

of a conspiracy to defraud the public. The claim of conspiracy that they brought to the

court proved to be too broad, lacking in the particularities needed in a court of law.

Based as it is on a liberal humanist model of the autonomous, rational individual, US law

requires individual specificity in such matters to proceed. (I address this further in

chapter 3.) Ironically, to understand ADHD in terms of this broader history, the plaintiffs

of the Ritalin lawsuits made a claim that was too narrow. ADHD wasn’t invented simply

to sell parents Ritalin; rather, the established effects of amphetamines were employed to

provide a justification for the existence of a disease category that in turn justifies a

cultural process of standardization of internal chemical states, while simultaneously

exonerating educational institutions from the responsibility to account for shortcomings

in their own systems. The diagnostic category of ADHD is a social construction that

exists in the interstices of public education, Taylorism, and psychopharmacology.

ADHD is neither a “new” somatic condition that has developed in response to the
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changing media environment, nor is it an age old condition that we have just come to

recognize and treat (both of which are popular explanations for the dramatic increase in

ADHD diagnoses throughout the 1980s and 90s). It’s a behavior control practice that has

become institutionalized at the nexus of several competing and complimentary interests

at a particular moment in history.

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CHAPTER 2

PAYING ATTENTION TO INDIVIDUAL DIFFERENCES IN

AMERICAN STUDENTS: A SURVEY OF THE JOURNAL OF

EDUCATION, 1959-1971

The “problem student,” frequently (and increasingly between 1960-1980)

identified as an inattentive student, existed as an object of discourse among educators

prior to the consolidation of the ADHD diagnosis in 1980. In this chapter, I track the
discourse of attention deficit in the decades leading up to 80s through a survey of Boston

University’s Journal of Education from 1959 to 1971, considering every article that is

specifically oriented to the issue of (in)attention in problem students.1 Through this

discourse, we can trace a debate about education policy and practice centered on the

physiologization of learning and obstacles to learning. As such, the responses to this

debate call into being different subject positions in regards to the relationship between

consciousness and physiology, with profound consequences for the students made to

occupy those subject positions – and for treatment professionals who imagine that ADHD

emerged suddenly in the early 1980s.

In The Journal of Education, the terms of this debate are framed by the liberal-

democratic ideology of universal compulsory education. Among educators, one side of

the debate is in support of a child-centered approach to instruction, as inspired by the

work of John Dewey. The countervailing voices are informed by contemporary social

1 The Journal of Education is published out of Boston University School of Education,

which boasts that it is the oldest continuously published education journal in the country. The
history that justifies this claim starts in 1875, upon the consolidation of five other education
journals from Massachusetts, Maine, Rhode Island, and Connecticut. Initially title the New
England Journal of Education, its name was changed to the Journal of Education in 1886. In
1951, it was purchased by Boston University, and in 2009, it became a peer-reviewed publication.
 106

developments – industrial models of rationalization, the use of the IQ test, the eugenics

movement, mental health policy and, ultimately, the pharmaceutical industry. But as

Stephen J. Gould makes evident in The Mismeasure of Man (1981), whenever a

taxonomic system like the IQ test is applied to a population, there are necessarily

marginal cases which will not fit clearly into one or another category.2 The statistical

certainties of these taxonomic outliers, coupled with racist, classist, sexist and able-ist

assumptions built into many school environments, ensures that some students, in spite of

expectations of their success, will not do well in the classes to which they are assigned.

As a result, there is an ongoing discussion in educational journals about what to do with

“problem students.” Often, and increasingly over the last half of the twentieth century,

educators and administrators characterize these students as “inattentive” – to the point

where “attention” itself has become a topic of discussion among educators.

Chemical means of enhancing attensity existed early in the 20th century, but
weren’t initially discussed seriously as a means of dealing with problem students who

didn’t display clinical problems. By the 1950s, this population of problem students is

increasingly identified as “sub-clinical.” By institutional momentum and drift, by 1980,

what is initially identified as sub-clinical becomes a clinical category, and chemical

intervention subsequently becomes more feasible. Many of the articles in this archive –

and an increasing number over the course of the sampled period – report on

contemporary cognitive research, or put their discussion of teaching practices into context

by referencing cognitive research. This reflects both the increase after 1950 in this kind

of research in general, and an increased interest in this kind of research among educators.

By tracking this discussion of attention as a problem for professional educators, this

2 Gould, The Mismeasure of Man.

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chapter also facilitates a discussion about how scientific knowledge is constructed,

disseminated, and institutionalized among a wider population.

As Wiebe Bijker points out in Bicycles, Bakelites and Bulbs (1995), a technology

becomes successfully dispersed when it is adopted by a population for whom it fulfills an

already existing need or desire. In considering ADHD as a bio-technology, then, we will

understand more fully this practice's dispersal through culture if we consider the social

network that created and adopted this technological practice. Starting the 1930s,

education in the US begins to shift away from a Dewey-based, child-centered model of

education towards a centralized administrative model of education, inspired by the

inherent economic and managerial challenges of implementing universal, compulsory

education.3 Some of the changes entailed in this shift seem mundane and innocuous,

though their impact was and remains profound. For example, the decision to organize

public schools by age cohort not only contributes more to administrative efficiency than

educational quality, but gives rise to statistical anomalies that later contribute to the

perception and diagnosis of ADHD. This managerial trend away from child-centered

education continued through the 1980s, eventually inspiring performance evaluation via

standardized test – a pedagogical tool that, arguably, facilitates administrative function at

the expense of the educational development of diverse students.

The furthest expression of this shift has been the move away from making

accommodations in the educational environment to suit the needs of students, and toward

making adjustments in the conscious experience of students to make them more suited to

the demands of the educational environment. As the Journal of Education archive

3 There is a large body of scholarship detailing the waxing and waning influence of John
Dewey in US education; among the first and most influential works to explicitly link the history
of educational administration with industrial capital concerns is Bowles and Gintis, Schooling in
Capitalist America.
 108

demonstrates, new chemical technologies came to play an important role in both

expanding and narrowing range of possibilities open to educators, allowing for the

completion of a paradigm shift started decades earlier as schools responded to changes in

control technology and industrial practices. For example, in the mid-1960s, educators

discussed manipulating elements of the classroom environment in order to recapture their

students’ attention, occasionally quipping that this was their only option, since they

couldn’t manipulate their students’ brains directly. By the 1980s, however, Ritalin

changed that equation for educators, who soon became the first and most common
reporters of potential cases of ADHD to parents and psychiatrists. What we learn, then,

is that there was an active debate in education about how to appropriately deal with

disruptive and distractible students – a debate that went as far to consider the merits and

drawbacks of managing cognitive functions through chemical technologies – well before

the advent of ADHD. The fact complicates the efforts on the part of ADHD advocates to

characterize – and by so doing, dismiss – public resistance to the instrumentalization of

consciousness as a “backlash” arising in the 1980s.4

Individualized Instruction: John Dewey, Eugenics, and the

Scientific Management of Public Education

In December of 1959, Boston University's Journal of Education dedicated an

entire issue to "Adapting Instruction to the Learning Needs of Children in the

Intermediate Grades." The issue was edited by Donald Durrell, who also wrote the first

article in the collection, which bears the same title. The article concerns itself with the

merits of teaching children according to their individual educational needs, as opposed to

teaching the same material in the same fashion to a large group of children. Durrell notes

4 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook, 15.

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that this differentiated, individualized approach is not commonly practiced: "Uniform

instruction appears to be prevalent in intermediate grades despite consistent research

evidence of the wide differences among children in the same grade."5 Durrell reasons

that educators’ efforts will be more successful if they take into consideration the

differences among students within a single cohort.

As a way of testing that idea, Durrell reports on a controlled experiment

conducted in the spring of 1958 in Dedham, Massachusetts. The study involved 47

intermediate grade classrooms in 8 elementary schools. The 35 participating teachers

attended a 3-day workshop in which they were exposed to a series of teaching strategies

that were designed to encourage differentiated learning in their classrooms. The

strategies included: adjusting to different levels of ability and different rates of learning

among students; identifying and addressing points of weakness in students' skills;

encouraging self-direction, cooperation and social learning among students; and making

learning enriching and pertinent to students’ lives.

After implementing these teaching strategies, test results from students were

compared to similar classes taught by the same teachers the previous year, in which

students had been educated in the more traditional, uniform manner. The results – which

are presented in an exhaustive collection of graphs and statistics – are somewhat mixed.

Some grade levels seemed to benefit from the intervention more than others, boys seemed

to benefit more than girls, and students seemed to improve more in some subjects than in

others. But despite these variations, the results were, overall, a positive, demonstration of

the value of paying attention to students' individual needs in instruction.

5 Donald D. Durrell, "Adapting Instruction to the Learning Needs of Children in the

Intermediate Grades: A Summary," Journal of Education, Boston University, v. 142, no. 2 (Dec.
1959), 2.
 110

Durrell's article does not mark the first time that this observation has been made.

Rather, how to properly attend to the individual and differentiated needs of children has

been a common theme in educational debates since the end of the 19th century. Though

Durrell doesn't make explicit reference to this historical discourse, the approach he

advocates resembles that of influential philosopher and educational theorist John Dewey.

Starting in 1890, with the publication of School and Society, Dewey advocated an

educational environment in which a student learns through experiences and activities that

find their source in the student’s own interests. Dewey's ideal teacher, then, would use

these experiences as teaching tools, guiding the student towards a more profound

understanding of the experience and its relationship to other experiences in the world.

The pace of the education would be set by the abilities and curiosity of the student.6 This
contrasted with other models that moved students through a set curriculum, rated them by

their progress through that curriculum (as was more common earlier in the 19th century),

and organized students by birthdate, which would increasingly become the norm

throughout the 20th century. In a Dewey-based educational environment, by contrast, a

group of students of various ages and abilities could interact by working through lessons

tailored along the way to individual needs and interests. Because Dewey believed that

widespread implementation of child-centered education had the potential to be a powerful

force for social progress, this approach to education was the first pedagogical stance to

become associated with the term progressive education, and the first schools organized

around these principles were called “progressive schools.”7

6 John Dewey, Experience and Education (New York: Collier, 1938; 1963).

7 Diane Ravitch, The Troubled Crusade: American Education, 1945-1980 (New York:
Basic Books, 1983).
 111

At the time Durrell was writing in 1959, the term “progressive education” and the

reputation of John Dewey itself had undergone several transformations, which helps

explain why Durrell presents similar conclusions as the rational outcome of empirical

studies, rather than as an extension of established pedagogical philosophies. The troubled

history of Dewey-inspired child-centered pedagogy is, in part, a product of the challenges

inherent to the approach. As education historian Diane Ravitch explains,

teachers in a progressive school had to be extraordinarily

talented and well educated; they needed both a perceptive
understanding of children and a wide knowledge of the disciplines
in order to recognize when the child was ready to move through an
experience to a new understanding, be it in history or science or
mathematics or the arts.8
Not only do such demands require more of teachers, they also necessarily limit class size.

A progressive teacher would be most successful with a small number of students,

allowing for as much one-on-one instruction as might be needed. A population of

students in a progressive school would require a greater number of teachers, each with a

higher level of experience. In turn, those teachers would require a relatively high degree

of institutional autonomy, as well as a ready supply of educational resources, in order to

tailor individual instruction from moment to moment.

Unfortunately for Dewey’s model of child-centered education, the conditions

most conducive to individualized instruction became increasingly difficult to meet as

classrooms became crowded in the early 20th century US. The success of the common

school reform movement at the end of the 19th century resulted in a surge in student

populations, which in turn set the stage for the educational challenges of the 20th century.

As education drew closer to a stated ideal of being both universal and compulsory (30

states had adopted mandatory education laws by 1900; by 1918, education was

8 Ibid., 47.
 112

compulsory in every state),9 educators and education leaders and researchers had to ask

themselves not “how do we educate children,” but rather “how do we educate all

children?”

This situation was further complicated by a wave of immigration in the late 19th

and early 20th century, populating urban areas with poor Southern and Eastern Europeans.

Not only did this make for more school-aged children to educate, it simultaneously

increased the linguistic and cultural diversity of that population. In addition, by the late

1930s, the economic hardships of The Great Depression compounded these challenges.

As employment became scarce, among the first to lose their jobs were school-aged

children who had been working rather than attending school.10 Many children returned to
school, and others chose to stay in school longer, for want of any alternatives. The

resulting boom in high school attendance, then, came precisely when schools were facing

budget cuts, and the number of new teachers was in decline. In short, a growing

population with more – and more diverse – needs swelled attendance in public schools, at

a time when resources were already depleted by the general economic downturn.

To deal with these challenges, school administrators looked to industrial models

of efficiency and control that were gaining influence in a number of institutions

throughout society in the early 20th century.11 The most overt manifestation of this

9 Zenderland, Measuring Minds, 56-7.

10 Angus and Mirel, The Failed Promise of the American High School, 59.

11 In Schooling in Capitalist America (1976), authors Bowles and Gintis quote an 1852
report of the Lowell School Committee that demonstrates how both early this became an issue,
and how frankly the issue was addressed: “The principle of the division of labor holds good in
schools, as in mechanical industry....What a school system requires is that it be systematic.” (167-
168).
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‘ethos of efficiency’12 was the publication of F. W. Taylor’s The Principles of Scientific

Management in 1911. This influential book described how to maximize productivity

through the rigid standardization of miniscule components of the work process in the

interest of efficiency. Taylor is often cited as a precursor to Henry Ford’s assembly line

model, which began putting these kind of ideas into practice by 1914, and resoundingly

demonstrated their efficacy throughout the first half of the 20th century.13 This Taylorist

or Fordist approach to industry led to an increasing reliance on management and

administration, as the organizational engine for systematizing labor and educational

outcomes.

The ethos of efficiency, then, along with economic constraints, motivated an

extension of administrative power, and further motivated school administrators to

“emulate the process of decision-making used by men on the board of directors of a

modern business corporation.”14 In the words of Journal of Education contributor Gene

Phillips, when summarizing the events of this period, “educational practices became

more immediately associated with those of big business, and the cry for efficiency was

heard ever more clearly.”15 As a result, “the model of the corporate board of directors

with its expert manager became the norm”16 in education administration. In this model,

12 Here, I borrow the phrase used by education historian Carl F. Kaestle in his discussion
of public education in the late nineteenth century, Pillars of the Republic: Common Schools and
American Society, 1780-1860 (New York: Hill and Wang, 1983).
13 David Harvey, The Condition of Postmodernity: An Enquiry into the Origins of
Cultural Change (Cambridge: Blackwell, 1990), 125-140.
14 David B. Tyack, The One Best System: A History of American Urban Education.
Cambridge: Harvard University Press, 1974), 126.
15 Gene D. Phillips. “Toward a Theory of Measurement and Appraisal in Education.”
Journal of Education, 146:1 (Oct 1963): 3
16 Tyack, The One Best System, 128.
 114

administration officials were empowered over teachers to make managerial decision that

affected curriculum, and common sense organizational practices – such as grouping of

children by age cohort – became standard. After all, grouping students according to skill

level required repeated and continuous assessment, which was ultimately subjective and

required additional human resources, time and money, while organization by an

uncontroversial and discrete statistic like a student’s birthdate is easily achieved at an

administrative level, upon initial incorporation into a system. As Phillips states:

since education has been likened unto mass production, the

product must be serviceable and highly functional, but not
expensive. In order to produce this mass product, the learner,
many values have been sacrificed.17
In spite of the obvious advantages to organizing classrooms by age cohort, the

limitations of this organization model were immediately apparent. Any group of students

selected by birthdate alone can be expected to display a range of development and

experience, which will be made more dramatically different by differences in social class

and ethnic/linguistic background. To manage the large and heterogeneous population of

students for whom they found themselves responsible, school administrators relied on the

classification tools available at the time. One such tool that was gaining popularity in the

early 20th century was the IQ test. The IQ test had originally been designed as a teaching
tool, to assess individual progress in relation to an average population of the same age.18

As it was put into practice in US public education, however, it became seen as a measure

of inherent intelligence. This was due in part to its application by immigration officials,

who used it to justify turning away a portion of immigration applicants on the pretext that

17 Phillips, “Toward a Theory of Measurement and Appraisal in Education,” 3.

18 The history of the IQ is more complicated than suggested here, and the relationship
between education institutions and immigration official is more subtle and mutually constitutive
than can be discussed here. For more, see Zenderland, Measuring Minds.
 115

they were ‘mentally unfit’ – a reflection of the influence of the eugenics movement of the

time, which was obsessed with preserving the evolutionary ‘fitness’ of the population.

IQ testing allowed school officials – like immigration officials – to quickly sort the

population in question. Once organized according to intellectual (in)capacity, resources

could be allocated more efficiently and appropriately – a pressing issue when those

resources are scarce.

The classification of students into differentiated sub-populations of varying

‘mental capacity’ subsequently led to systematically differentiated curricula. It was

reasoned that it was unfair to expect students who were, in the words of a Detroit high

school administrator, “congenitally incapable” of learning19 to participate in the same

curriculum as ‘normal’ students; instead, alternate curricula were designed for those who

were identified by IQ tests as “idiots,” “imbeciles,” “morons,” or “dullards.” These

alternate curricula de-emphasized (or completely removed) traditional academic

instruction. Instead, “dull” students were classified for training in labor and industry, in

what came to be known as vocational education. While the use of assessment tools like

the IQ test lent this process an aura of scientific objectivity, in practice, such decisions

were affected by administrators’ attitudes towards race, class, gender and disability. As a

result, IQ assessment and vocational rankings recreated and reinforcing pre-existing

social inequities, effectively making the distinction between vocational classes and

regular classes a de facto kind of segregation. As David Tyack and Elisabeth Hansot

explain:

As vocational education developed in practice, effective

choice was severely constrained, for most advocates of vocational
education and guidance also prided themselves on being social
realists and on knowing what was best for pupils and society. Real
choice was possible for white boys of appropriate talent...Girls, by

19 Angus and Mirel, The Failed Promise of the American High School, 70.
 116

contrast, had few vocational options either in school or the labor

market...The job market had few niches for blacks, and hence the
should only be prepared to do menial tasks better.20
Paradoxically, in the process, school administrators claimed to be working towards the

progressive ideals of John Dewey, by ‘differentiating instruction’ in order to meet the

‘individual needs’ of students. Thus, by the mid-1930s, the process of classifying

students by IQ test scores and differentiating curriculum into college-bound education

and vocational instruction had inherited the title progressive education, in spite of the

obvious contrast between this model and Dewey’s. An instructor using Dewey’s model

of progressive education had the responsibility of fitting the instruction to an individual

student’s needs from moment to moment as they developed. But in this new version of

“progressive education,” the responsibility for assessing and responding to individual

students lay with an administrative body, with which the student had an entirely

institutional, impersonal relationship. Furthermore, a student was assigned to a fixed

curriculum based on a test often administered only once. Such children were, in a sense,

ranked for life, and denied the capacity to grow, because school officials believed they

were physically deficient of such a capacity. These abuses of Dewey’s progressive

philosophy led Dewey himself to denounce what had become of progressive education in

his 1938 book Experience and Education, warning that “an educational philosophy which
professes to be based on the idea of freedom may become as dogmatic as ever was the

traditional education which is reacted against.”21

This shifting of responsibility from the teacher to an administrative system was a

large part of the success of the “progressive education” movement. The early part of the

20th century saw the rise of education professionals and administrators, who exerted more

20 Tyack and Hansot, Learning Together, 185.

21 Dewey, Experience and Education, 64-65

 117

and more power over public schools. Having received degrees from the same schools of

education, most of these administrators held remarkably uniform “progressive” beliefs,

and spread their expert ideology through appointments in public schools and agencies of

education on both the state and federal levels. Historian Arthur Bestor later described

this relationship as an “interlocking directorate of professional educationists.”22 Because

of their attempt to implement progressive ideals through the extension of administrative

power, historian David Tyack has proposed the title “administrative progressives” to

characterize these professional educationists – a title which effectively distinguishes the

actors of this movement from those who embraced the progressive education envisioned

by John Dewey.23
Of course, the administrative progressives were met with some resistance. Critics

saw differentiated curriculum as a means of social engineering, which functioned

primarily to perpetuate existing class distinctions. Public protest emerged as early as

1917, when a group of 10,000 parents and children rioted in New York, opposing

proposed changes in the public school curriculum that would have introduced vocational

training, because the parents, mostly immigrants, “believed that it would condemn youth

to blue-collar occupations and prevent upward mobility.”24

In that instance, the proposed changes to the New York school system were

abandoned, but, in general, the administrative progressives were successful. Even as the

economy came out of The Depression, high schools felt pressure to keep enrollment high,

as a means of keeping young people out of the job market. In a 1938 report, the

22 Arthur Bestor, Educational Wastelands: The Retreat from Learning in our Public
Schools (Urbana: University of Illinois Press, 1953), 75; Ravitch, The Troubled Crusade, 76.
23 Tyack, The One Best System, 126-129.

24 Ibid., 250.
 118

Educational Policies Commission – a professional organization started by the National

Education Association and the American Association for School Administrators – stated

that “every youth and adult added to the school enrollment tends to reduce the

competition for jobs.”25 David Angus and Jeffrey Mirel, in The Failed Promise of the

American High School, argue that as this custodial function of the public schools became

increasingly important, both economically and socially, it superseded intellectual growth

as the primary function of the institution. The administrative progressive agenda was

well-equipped to handle this new responsibility.

In their efforts to maintain high attendance, administrative progressives de-

emphasized academic courses, and added courses that were designed to meet the

immediate and pragmatic needs of children. These courses – often referred to as “life-

adjustment” courses – were thought to benefit all students, not just the “dull pupils”

assigned to vocational training. Under the guise of pragmatism – another value lauded by

Dewey – these courses concerned themselves with the quotidian details of life, such as

“how to be a good consumer,” and “how to behave on a date.”26 Increasingly, this

curriculum taught prescribed behaviors. Texts dictated to students how to dress, offered

maxims such as “always have a clean handkerchief,”27 and even discussed washing

windows in a manner that would make efficiency expert F.W. Taylor proud:

25 Educational Policies Commission, “The Purposes of Education in American

Democracy” (Washington, DC: National Education Association, 1938), 3; Angus, The Failed
Promise of the American High School, 65, 78.
26 Ravitch, The Troubled Crusade, 55.

27 W.E. Buckward, R.L. Chambers, and F.W. Maroney, Your Health and Happiness
(Chicago: Lyons and Carnahan, 1946), 228.
 119

wiping with straight vertical and horizontal overlapping

strokes is quicker and requires much less energy than the circular,
random approach.28
The issue of differentiated instruction and life-adjustment curriculum was debated

throughout the 40’s and 50’s. The most commonly cited articulation of opposition to the

administrative progressive movement is the work of history professor Arthur Bestor. In

Educational Wastelands (1953), Bestor states:

To assert that intellectual capacity decreases as one reaches

down into lower economic levels of the population is to deny,
point-blank, the basic assumptions of democratic
equalitarianism.29
While Bestor’s appeal to democratic ideals is rhetorically powerful, the patriotism

stirred up by an event just four years later would have more direct influence on education.

With the successful Soviet launch of Sputnik 1 in 1957, America was suddenly behind in

the Cold War and the nation clamored for explanations. Overwhelmingly, people looked

to the school system, and began to blame the practices of administrative progressives.

There was a public outcry for more academic rigor in high school curriculum. In 1959, in

a book entitled, Education and Freedom, Navy officer Hyman Rickover linked the need

for academic rigor in high school to the health of America’s national defense, and called

for a return to a comparatively student-centered, liberal arts education – at least for some

students. Rickover worried that the next generation of military leaders was being denied

a proper education because of the pragmatic approach of public schools, preparing

students for pre-ordained careers. His concern was not what to do with the exceptionally

“dull” students, but what was happening to the “bright” students that were lost in an

educational system entirely organized around identifying and training slower students to

28 Mary Catharine Star, Management for Better Living (Lexington, Mass.: D.C. Heath
and Company, 1968), 155.
29 Bestor, Educational Wastelands, 36.
 120

quietly incorporate themselves into mainstream society. As Rickover put it, “talented

children are this nation’s reservoir of brain power. We have neglected them too long.”30

These views were echoed, to a degree, by James B. Conant in The American High School

Today, released that same year. While Conant agreed that talented students were being

insufficiently challenged by high school, he suggested that the solution wasn’t taking the

best students out of the current system, but the further extension of differentiated

curriculum to meet the individual needs of talented students.31

While Sputnik is not explicitly named by Thomas Eames in his 1960

Journal of Education article, “Some Neural and Glandular Bases of Learning,” it is

undoubtedly a response to this debate. As the author states:

Recent developments in international politics have focused

attention on the enormous potential of the superior pupil. It is to
be devoutly hoped that his capacity for making a larger than
average social contribution will continue to be valued and that the
day of dragging him down to a dead level of stultifying mediocrity
is over.32
While this hearkens to the kind of rhetoric employed by Rickover, Eames suggests a very

different solution:

Teachers of superior children should permit them to set

their own pace if it tends to exceed that of their
classmates....Stimulate such a child to use his capacity, enrich his
curriculum, provide special projects within his grade or accelerate
him if his performance warrants before boredom robs him of his
will to achieve. Give him plenty of opportunity to experiment and
try his wings, help him to follow up interests and show him how to
attain such goals as he may set.33

30 Hyman G. Rickover, Education and Freedom (New York: Dutton, 1959), 208.

31 Angus & Mirel, The Failed Promise of the American High School, 108-116.

32 Thomas H. Eames, "Some Neural and Glandular Bases of Learning," Journal of

Education, Boston University, v. 142, no. 4 (April 1960), 19.
33 Ibid.
 121

Though Eames does not cite John Dewey, this statement, like Durrell’s 1959 article in the

same journal, sounds remarkably similar to Dewey’s progressive vision of education –

with the notable exception, however, that Eames suggests using this approach only as a

compensatory measure for “superior” students, rather than advocating this teaching

approach in general.

But Eames’ statement is primarily a gesture; in fact, he dedicates only 4

paragraphs in a 36-page article to discussing the “superior pupil.” The rest is dedicated to

identifying and dealing with “dull pupils,” and unselfconsciously echoes the kind of
social engineering that critics like Arthur Bestor found so distasteful in public education.

For example:

Dull pupils are easily upset emotionally when parents and

teachers expect too much of them....They also experience bitter
disappointments, many having set their hearts on entering some
profession beyond their capacity. These people fit into a simple
society and do very well. Many find satisfactory and useful
situations in rural and industrial life....Dull and mentally defective
persons should be taught up to the limit of their capacity to
learn....Vocational training is desirable and the pupils should be led
to feel that all jobs are honorable and worth while if they make a
social contribution.34
It is revealing that, in this statement, Eames anticipates resistance on the part of the

student to being labeled a “dull pupil” and subsequently placed into vocational training;

to combat this resistance, such a pupil “should be led to feel that all jobs are honorable.”

Eames’ word choice implies that all jobs are not, in fact, honorable – which raises the

question of why the “dull pupils” are being trained for them at all. This manipulation is

apparently justified because the student in question is believed to lack the cognitive

capacity to learn. In fact, throughout this article Eames employs eugenics terminology

(i.e., feebleminded; idiots; imbeciles; morons) without a trace of irony:

34 Ibid., 20.
 122

Feeblemindedness occurs in variable degrees from mild to

severe. It is usually classified by IQ; those with IQs from 0 to 20
being termed idiots, those with IQs from 20 to 50 imbeciles, and
those with IQs from 50 to 70 as morons.35
Further, Eames repeatedly refers to children having difficulty in school as being

“defective,” demonstrating the rhetorical power of the eugenics movement decades long

after the policies that had originally popularized such language had been, for the most

part, abolished as unconstitutional and publicly vilified as abhorrent.36 This type of

classification survived in the school system because of the role it served educators in the

efficient allocation of limited resources, which was as pressing an issue in 1960 as it had

been earlier in the century. As Eames points out:

a great deal of pedagogic effort is unintentionally thrown

away in an attempt to teach pupils whose undiscovered handicaps,
often of a mild nature in themselves, prevent the child from
learning or interfere with the learning process.37
Eames takes this logic to its furthest conclusion, in some cases advocating the use of

more extreme measures:

Pupils found to be very defective should be

institutionalized. This can be determined and carried out through
the school health authorities.38
Here, Eames articulates an important distinction between his position and the tradition of

the administrative progressives before him: he locates the responsibility of determining

who will receive vocational training – as well as who will be institutionalized – not with a

representative of the administration (such as the school guidance counselor), but with the

35 Ibid., 19.

36 Recent scholarship and reporting has made clear that the eugenic practices
unfortunately continued well past the commonly understood end of the eugenics movement. See
Johanna Schoen, Choice and Coercion: Birth Control, Sterilization, and Abortion in Public
Health and Welfare (Chapel Hill: University of North Carolina Press, 2005).
37 Eames, “Some Neural and Glandular Bases of Learning,” 3.

38 Ibid., pg. 20
 123

school health authorities. Eames does not present the differentiation of curricula as a

Dewey-inspired response to “individual needs,” as it had been justified by the

administrative progressives. Instead, it is a response to individual biology.

Of course, the eugenics movement was also concerned with the biological roots of

intelligence. But what can be seen in Eames’ article is a reflection of the beginning of a

rhetorical shift away from the language of the eugenics movement, and towards a more

neurological vocabulary.39 In this, Eames represents increasing numbers of educators

who were relying on medical and scientific authority, previously located outside of the

school; Eames’ rhetoric represents the incorporation of a network of medical and socio-

biological professionals into the “interlocking directorate” of school administration. This

developing trend was less concerned with identifying congenital intellectual incapacity

on the population level, and instead, concentrated on individual manifestations of

neurological pathology as a means of explaining and dealing with the individual

differences of students.

That this shift is not merely organizational but rhetorical is apparent when

comparing Eames’ article to another article, “Education and Rehabilitation,” by Julian

Myers, that appeared in the Journal of Education in December of 1962 – two years after

Eames. In this article, Myers discusses mental retardation and its implications for

education. Myers points out that “mental retardation” occurs in varying degrees, from

mild, to moderate, to severe. At first glance, this appears to be concerned with

39 Thomas Eames hardly initiated this rhetorical shift by himself. Rather, this article
occupies a convenient moment in history, poised between two rhetorical regimes, thereby
rendering the shift visible as we compare Eames to Durrell and a series of other articles that
appeared in the Journal of Education over the decade of the 1960’s. Neither do I want to imply
that these articles represent entrenched positions of the Journal or of education professionals in
general. The Journal of Education presents a continuing dialogue, rather than a party line. It is
an environment in which the participating members disagree and share contrasting viewpoints. In
that sense, the presence of these articles testifies to the currency of these notions in an intellectual
marketplace.
 124

neurological pathology, bearing little resemblance to the eugenics movement. But when

we look at how Myers distinguishes between the varying degrees of mental retardation,

we see a reliance on the same tool employed by eugenicists: the IQ test. In fact, the

breakdown corresponds almost exactly with that of the eugenicists, in which “morons”

scored between 50 and 70 on their IQ tests, “imbeciles” between 20 and 50, and “idiots”

scored below 20. In the 1962 article, Myers states:

84 per cent of this group [the retarded] have an I.Q. in the range of 50 to 75 and

are considered in the mild category, 13 per cent of the retarded population are moderately
retarded with an I.Q. in the range of 20 to 50, and only 3 per cent of the retarded

population are classified in the severe category with an I.Q. below 20.40

Like Eames, Myers envisions medical authority as a function of the school

system, though Myers collapses this authority into the traditional role of the guidance

counselor, another health professional charged by the administrative progressives with

the task of identifying mental capacity and “guiding” students to their appropriate

curriculum: “the counselor is empowered to provide a variety of services for his clients,

including medical treatment.”41 However, Myers does not displace these concerns

entirely onto a medical/administrative authority, beyond the jurisdiction of the classroom

teacher. Quite the contrary, Myers hopes to make teachers aware of these medical issues,

because:

only 5 percent of the retarded are confined to public or

private institutions, while 95 percent live at home [and] are active
in the community to some extent. Undoubtedly, a large segment of
the latter group, diagnosed or undiagnosed, is in regular classes,

40 Julian S. Myers, "Education and Rehabilitation," Journal of Education, Boston

University, v. 145, no. 2 (Dec. 1962), 9.
41 Ibid., 15.
 125

struggling with a curriculum designed for children of higher

intelligence.42
Myers warns that it is these students, those with “sub-clinical” retardation, that a teacher

needs to look out for. These are the students whose retardation is serious enough to

affect their development, but not serious enough to be acknowledged by a clinical

authority. Students who defy categorization, by virtue of their unique individual neuro-

biology, obstruct the efficiency model of mass education championed by the

administrative progressives.

Eames, in his earlier article, agrees that “school people experience a good deal of

difficulty with the borderline cases."43 While the bulk of Eames’ article outlines gross
endocrine pathology and its potential for disruption of the education process, he speaks of

sub-clinical medical conditions as well. For example:

Cretinism and myxedema are not the only types of thyroid

deficiency. A mild type occurs among young pupils and older
students. It is often overlooked because parents, teachers, and
sometimes doctors, are fooled by the apparent disinclination to
work, the lack of interest, the dislike for school, poor achievement
in studies, and poor attention....the commonest complaint from
teachers was that the children could not complete their
assignments.44
Note that this difficult-to-diagnose thyroid deficiency, though a medical problem, is

identified primarily by behavior, and furthermore, by behaviors that are basically linked

to school. Eames even notes that, outside of the educational environment, these

behaviors may not be present, further confounding diagnosis:

Some intense interest, such as television, sports, or model

railroading, may stimulate the child and make him appear more

42 Ibid., 9.

43 Eames, “Some Neural and Glandular Bases of Learning,” 18.

44 Ibid., 28.
 126

alert when out of school and thereby obscure the real cause of his
slowness.45
Eames’ choice of words (e.g., “the real cause”) indicates that his view of the situation is

decidedly physicalist.

Among the behavioral traits that Eames identifies as betraying the presence of

thyroid dysfunction, most notable is “poor attention.” The biology of poor attention

became an increasingly popular topic of discussion and scientific debate throughout the

decade of the 60’s, as can be observed by its prominent position in several articles in The

Journal of Education. In Eames’ 1960 article, poor attention is mentioned as one

behavior among a group of behaviors associated with other problems; as the decade

progressed, poor attention became the key to explaining administrative and educational

inefficiency itself.

Education and the Cognitive Science of Attention: “The

Concept of Attention in Education” (1968)

In February of 1968, The Journal of Education devoted an entire issue to, as its

title announces, “The Concept of Attention in Education.” While the existence of this

issue of the Journal may demonstrate that professional educators were talking about

attention more explicitly and particularly than in previous years, one should not presume

this publication represents any kind of consensus. Rather, this is another site of

controversy which allows us to map the involvement of various actants and their

interests. Some contributors to this issue of the Journal argue that it is only fair to

consider inattentive children as disabled, in order to relieve them of personal

responsibility. Other contributors point to social conditions that structure attention, such

as class, diet, and experiences with poverty or racism. Several articles review clinical

45 Ibid., 28
 127

research into attention, and conclude that there is very little consensus even within the

scientific community on how to define attention, how to measure it, and how to study it.

For example, David Mostofsky’s article, “Attention Research: The Case of the

Verbal Phantom,” questions whether or not it is even possible to address attention as a

discrete mental function. Mostofsky points out that, despite the large amount of clinical

research into the nature of attention, most researchers have failed to adequately define

what it is they are looking for. Though such research presumes that attention is a

neurochemical process or event, attention is still identified, as we have seen, by

behaviors:

The use of attention – it is claimed – has been inferred from

and at the same time used to explain the funneling of sensory
inputs [i.e., looking], the initiation of specifiable responses [i.e.,
silence], the modification of recorded biopotentials [i.e., reduced
movement], and so forth.46
Furthermore, Mostofsky adds, many researchers who identify attention in this manner are

guilty of “the failure to recognize that attention is not identical to but is rather identified

by these response states.”47 This leads to circular logic, in which researchers “explain”
the disruptive, inattentive behaviors of a child as the result of an “attention deficit.” If

pressed for a definition of “attention deficit,” however, the same researchers can only

respond that it is a failure to display the behaviors associated with attention. So, rather

than explaining anything, such researchers have simply replaced one term for another, a

rhetorical trick that Mostofsky refers to as “verbal magic.”48

46 David I. Mostofsky, "Attention Research: The Case of the Verbal Phantom" Journal of
Education, Boston University, v. 150, no. 3 (Feb. 1968), 6.
47 Ibid., 6.

48 Ibid., 7.
 128

Mostofsky touches upon the research of Hernández-Péon, who attempted to

“demonstrate the observability of attention behavior in the form of altered neural firings

following the introduction of an attention-getting stimulus.”49 Such an approach – which

Mostofsky calls “the neural substrate model” – would seem to be more concrete than the

“verbal magic” of other researchers; however, the results have proven impossible to

duplicate, leading other researchers to conclude that “unequivocally….there is no solid

evidence of attentive states” in the areas of the brain hypothesized by Hernández-Péon.50

Mostofsky concludes that Hernandez-Peon’s approach is basically flawed, as well,

because it “attempts to physiologize attention, i.e. to discuss in physiological terms

something for which no physiological data exist.”51 Recognizing that the inspiration for
such physiologization is linked to the ethos of efficiency and the desire to make

administrative systems run smoother, Mostofsky concludes by quoting E.R. Guthrie:

It would be gratifying from a systematist’s point of view of

attention would behave as a simple entity, reducible in some
manner to a number, and so capable of entering into a formula.52
Mostofsky, however, believes this to be neither possible nor desirable.

Somewhat similarly, Abraham Blum’s and Carolyn Adcock’s article in the same

issue of the Journal, “Attention and Early Learning: A Selected Review,” makes the

issue of attention even murkier, despite the authors’ optimistic conviction that:

Looking at attention as it relates to young children and

early learning may help us carve out a meaningful area with

49 Ibid.

50 Ibid.

51 Ibid.

52 E.R. Guthrie, “Association by Contiguity,” quoted in Mostofsky, “Attention

Research,” 8.
 129

implications for the whole realm of behaviors subsumed under the

general concept.53
In reviewing recent research into attention, what becomes most clear to Blum and

Adcock is the wide range of ways in which to define “attention.” While there is no need

to think of these different approaches as mutually exclusive, their multiplicity doesn’t

make attention any easier to define. As the authors state,

That attention and early learning is only gradually

becoming an active area of investigation is evident in the lack of
any central focus in the following studies.54
Blum and Adcock go on to summarize work that investigates a remarkable array of

terms, causes, research areas, and hypotheses regarding the various forms of attention

deficit. These include: the genetics of attention; attention and infant development;

attention and stimulus complexity; gender difference and attention; attention in children

who tend to favor analytic cognitive patterns vs. attention in children who tend to favor

non-analytic cognitive patterns; attention to details vs. attention to global similarities;

attention in children with reading difficulties; attention to visual stimulus vs. attention to

auditory stimulus; attention and multiple sensory stimulus; distractibility; behavioral

reinforcement and attention; and novelty and attention.

Not only are the sites of investigation myriad, but to further complicate matters,

some of the research results contradict each other. For example, the research on attention

and infant development seems to demonstrate an increasing level of attention, as well as

an increasing attraction to novelty and complexity, throughout the first three months of

development. However, considering research into the notion of “distractibility” – which

seems to be simply the inverse of “attention” – one finds that “the suggestion that

53 Abraham Blum and Carolyn Adcock, “Attention and Early Learning: A Selected
Review,” Journal of Education, Boston University, v. 150, no. 3 (Feb. 1968), 28-29.
54 Ibid., 32.
 130

children become less distractible with age has received little support in actual empirical

evidence.”55

Some of these contradictions may be understood as the result of different

definitions of attention, as suggested by Mostofsky. This point is not lost on Blum and

Adcock, who point out that:

Attention means different things to different people.

[Moreover,] attention and other constructs such as concentration,
arousal, vigilance, and distraction cross-cut one another and are
sometimes used to mean the same thing.56
To demonstrate, Blum and Adcock contrast the 1948 research of Heinz Werner to the

1963 research of Jean Piaget. Werner conceives of attention as an increasingly refined

process of filtering out unnecessary stimuli from pertinent information. Piaget, on the

other hand, characterizes attention as the ability to be less confounded with apparent

logical or sensory contradictions – what might be called, in early-21st century parlance,

multitasking. Blum and Adcock summarize:

What Werner views as the increasing ability to separate out

the relevant is what Piaget sees as the increasing ability to take in
more elements simultaneously and resolve them. Attention thus
becomes a function that can be directed either to an increasing
number of qualities or to increasingly more refined articulation of
qualities.57
It is exactly these kinds of subtle distinctions in framing or focusing research that

profoundly affect the methodology employed. As a result, data from one researcher may

not be comparable to that of another.

In the midst of such contradictions, however, Blum and Adcock observe a few

things that emerge as generally accepted truths about attention. First, attention is a

55 Ibid., 33.

56 Ibid., 36.

57 Ibid., 37.
 131

necessary component of learning. Second, boys pay less attention than girls do. And

third,

Children more readily respond to complexity, to violations

of the familiar, or even the unfamiliar, than to the obvious or
simply solved….By providing a child with something “new,”
something he can work with, manipulate, and/or “figure out,” his
attention will not only be captured but will persist for a rather long
period of time, regardless of his age.58
Lastly, Blum and Adcock observe the role of economic class in attention. The authors

point to research in which “hungry infants did not attend to the extent that those who

were not hungry did,” as well as other research that establishes that “the social situation

affects whether or not a child is distracted.”59 Because abstract thought and activities
requiring vigilance that are especially negatively affected by a lack of attention, these

elements of education are unfairly biased in favor of “the superior and the affluent,

education-oriented children in the school system.”60 Therefore,

A system which makes learning a feat because of abstract

orientation and drill can only expect to succeed where motivation
is high – with a “Middle-Class” in which need achievement is
dominant.61
Though Mostofsky did not specifically address class as a contributing factor to attention,

agrees in his article that “the word attention connotes a process, a state, or a relationship

involving a subject reacting with and to his environment.”62 Mostofsky identifies

internal and external factors of attention, using the term attentive to describe the internal

factors located in the child (as observable through behaviors), and the term attentional to

58 Ibid., 35-36.

59 Ibid., 38.

60 Ibid.

61 Ibid.

62 Mostofsky, “Attention Research,” 13.

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describe external factors located in the educational environment. In this schema,

attentive research focuses on “maturational and developmental variables….

reinforcement histories, and….response repertories” in research subjects, while

attentional research “concerns the manipulation and testing of stimulus properties” in the

learning environment.63 From this point of view, then, Blum and Adcock’s discussion of

class is notable for its attentional focus, counter-weighting the generally attentive

approach of the bulk of the research reviewed.

This relationship model of attention is further developed by Kenneth Crosby and

Burton Blatt, in their contribution to the same issue of the Journal, an article entitled

“Attention and Mental Retardation.” Though this article reviews several studies of

attention and distractibility in retarded and brain-damaged students, specifically, most of

their pedagogical conclusions apply equally to non-brain-damaged students. Indeed, the

authors can identify little difference between these populations in regard to attention.

That they fail to do so is somewhat surprising, given that research purporting to link

distractibility to brain-damage goes back at least as far as 1934, when Eugene Kahn and

Louis Cohen observed inattentive behavior in the brain-damaged survivors of

encephalitis.64 Despite this, Crosby and Blatt, like the other contributors to this issue of
the Journal, observe that biologically-oriented research on attention to be contradictory

and inconclusive, for many of the same reasons cited by Mostofsky, Blum and Adcock.

Crosby and Blatt finally conclude that “there is little evidence that there is any necessary

correlation between brain damage and distractibility.”65

63 Ibid.

64 Barkley, Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and

Treatment, 5-6; also, see Jonathan Hansen, “Rhetorical Disorder: Attention Deficit Disorder, U.S.
Law and the Search for Structural Differences in the Brain” (unpublished manuscript).
65 Crosby and Blatt, “Attention and Mental Retardation,” 76.
 133

In presenting these findings, Crosby and Blatt offer their own observations

regarding attention and distraction. Crucially, the authors point out the asymmetrical

power dynamic at play in the observation of behavioral responses from which

assessments of attention are inferred. “Distraction,” they write,

is not a separate class of attending response, but describes

attending to task-irrelevant stimuli instead of or in addition to task-
relevant ones. Thus, when a teacher describes a child as
distractible, he usually means that the child is attending to
something – or to many things – other than that to which the
teacher would have him attend. When a teacher describes a child
as inattentive, he usually means that the child is not attending to
the task at hand, and perhaps that he is unaware of the stimuli to
which the child is attending.” 66
In this light, an attention deficit can be seen as a failure of educators, or education

researchers, to recognize or acknowledge the authority of others to dictate the relevance

of various stimuli in a given situation. It’s not surprising, then, as Crosby and Blatt point

out, that much of the research into how to improve attention in research subjects has been

driven by military and industrial interests.67 These institutions are not investigating
deficiencies of attention inherent in the population at large; rather, the discrepancies in

attention researched are brought about by the specific demands of these forms of

authority and their associated technologies – such as paying attention for a set amount of

time (an 8 hour workday or longer military shift), responding to a highly delimited set of

stimuli (to identical products in an assembly line or the blinking dots on a radar screen)

and responding within a limited range of proscribed reactions (in the manner articulated

and promoted by F.W. Taylor).68 Industrial and military research into attention is for the

66 Ibid., 68.

67 Ibid., 67.

68 See Jonathan Crary, Suspensions of Perception, especially Chapter 1; Crary argues

that our very concept of attention/distraction arises out of the social and economic changes of the
industrial revolution.
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explicit purpose of inspiring compliance with the hierarchal valuation of stimuli imposed

by figures of authority. The transparency of these interests in promoting attentiveness

lays bare the fact that attention is not simply a mental function, but a relationship between

individual subjects, their environment, and existing structures of authority. The capacity

for attention, then, is not unlike other markers of identity: a social reality that is popularly

understood as a biological capacity. For example, Judith Butler rejects the materiality of

gender altogether, instead characterizing gender as an ongoing performance of attributes

that achieves a “substantive effect” by the consistent social regulation of gender

expectations.69 In fact, when one considers the highly gendered diagnosis rate of ADHD

(those diagnosed are overwhelmingly male70) it suggests that attention is not only similar

to identity categories like gender, it is itself a performative attribute of masculinity, and

more specifically, white bourgeois masculinity.

In fact, Crosby and Blatt employ their relational model of attention to circumvent

the notion of individual attention deficits altogether, focusing instead on attentional

interventions into the learning process. While they don’t entirely dismiss the possibility

of biologically-rooted deficits of attentive behaviors, the contradictory results of the

studies they review demonstrate the difficulty of assessing attentiveness. The authors

pragmatically note that “it is difficult to imagine how the teacher…can manage the

attensity of a pupil’s [subjective] experience,” while, in contrast, “it is possible to

manipulate stimuli [in the educational environment] so as to increase the likelihood of

selective response [i.e. attention] to them.”71

69 Butler, Gender Trouble, 33.

70 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook, 85.

71 Crosby and Blatt, “Attention and Mental Retardation,” 68.

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In developing this point, the authors identify some general strategies for

accomplishing this, such as mixing modalities of material presentation so as to engage

multiple sensory experiences in the learning process. But they are also quick to point out

that there is no simple or standardized way to systematically increase the attentional

capacity of stimuli. Indeed, many strategies for increasing the attentional capacity of

stimuli are determined by the student and his or her history. For example, ‘novelty’ is

commonly acknowledged as an attentional aid, but the novelty of any given stimulus is

predicated on a student’s prior experience (or lack of experience) with that stimulus.
What is novel for one student, may not be for another; while what is novel for a student at

one point in time, will cease to be novel as he or she gains experience. While this

variability would frustrate an administrative progressive hoping to standardize curricula,

Crosby and Blatt see this as an opportunity, rather than a limitation:

surely the crucial point for education is that attention as

stimulus selection is, at least within rather broad limits, a learned
response and therefore susceptible to manipulation by the
teacher.72
Thus, the most appropriate method for sustaining attention in students is for a teacher to

engage with them personally and manipulate the learning environment and teaching

materials as necessary to accommodate the specific needs, interests, and particular history

of each student. Though Crosby and Blatt propose this as a conclusion reached after

reviewing contemporary psychiatric research, it is effectively the same model of

progressive education articulated by John Dewey in 1890.

From Crosby and Blatt’s difficulty in imagining ways in which a teacher might be

able to manage the attensity of a pupil’s experience, one might infer that the authors were

unfamiliar with the efficacy of amphetamines in doing exactly that. Of course, by 1980,

72 Ibid., 78.
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once the diagnosis of Attention Deficit Disorder was added to the DSM-III and Ritalin

became the familiar drug prescribed to school children, managing pupils’ subjective

experiences would not be so difficult to imagine. But, in fact, the attention-producing

effects of amphetamines had been known since Charles Bradley reported on their

administration to brain-damaged children in 1937 – a moment that is often cited as

foundational in the development of the ADD diagnosis. For example, in response to a

2000 lawsuit that accused pharmaceutical company Novartis of profiting from the

fraudulent invention of an allegedly fictional disorder called ADD, a spokesperson for

Novartis defended the corporation (and the diagnosis) by claiming that research into

ADHD started in the 30s – a clear reference to Bradley. However, the fact that Crosby

and Blatt, as recently as 1968, seem wholly unaware of chemical means of managing

attensity suggests that, in fact, the long pedigree of this use of amphetamines in

educational settings is somewhat spurious. Rather, the concept of a biologically rooted

attention deficit, and its management through chemical technology, arises from a

complex interaction of circumstances in the late 1960s, and was not widely accepted until

the late 1970s and early 1980s, when pharmaceutical companies began to actively

promote the notion of chemical treatments of attention.

Even if Crosby and Blatt were aware of the efficacy of amphetamines in

promoting attensity, this likely would not have altered their practical evaluation of the

prudence of manipulating the learning environment over manipulating the learning

individual. In the authors’ view, any other conclusion loses track of the teacher’s primary

responsibility:

Whether or not some fundamental attention deficit not

found in the normal child exists in the retarded is, after all,
irrelevant to the teacher insofar as his task is always to improve the
efficiency of stimulus scanning and selection.73

73 Crosby and Blatt, “Attention and Mental Retardation,” 77.

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In other words, a teacher should always be working to maintain his or her students’

attention, regardless of how those students’ learning problems might be labeled. Such a

label, then, has little practical utility for classroom teachers.

Beyond their doubts about the feasibility of physiologically manipulating

attention, Crosby and Blatt were also skeptical of the motivations behind the impulse to

physiologize attention, which locates the failure of the attentional relationship in the

biology of the individual student, and implicitly beyond the responsibility of educators.

As the authors speculate, “the cynic could state, with some justification, that the
acknowledgement of a special defect has too often been accompanied by an abandonment

of efforts to surmount it.”74 Such a cynic might characterize this physiologization of

attention as the latest, post-eugenics way of establishing that a portion of a student

population is ‘congenitally incapable of learning.’

This concern echoes that of Seymour B. Sarason, expressed in an article entitled

“Some Aspects of the Brain-Behavior Problem,” which appeared in the Journal of

Education in 1964. Sarason, a practicing psychologist and Yale professor, is troubled by

the post-war trend to physiologize behavioral problems. This trend is evidenced by “a

dramatic increase in the number of children who have been diagnosed as…‘minimally

brain-injured’” – Sarason’s term for what has more commonly been referred to as

Minimal Brain Damage, or MBD.75 Sarason is doubtful of the validity of the diagnostic

category, but is even more “concerned about…how these diagnoses are utilized and what

this reflects about conceptions of the potentialities of these children.”76

74 Ibid.

75 Seymour B. Sarason, “Some Aspects of the Brain-Behavior Problem,” Journal of

Education, Boston University, v. 147, no.1 (October, 1964), 55.
76 Ibid.
 138

It should be noted that MBD has been identified by many writers as an early

articulation of Attention Deficit/Hyperactivity Disorder.77 Whether or not MBD is

simply another name for ADHD is, of course, debatable; it is clear, however, that

proponents of the ADHD diagnosis can claim a longer history for the diagnostic category

by linking it to earlier diagnoses like MBD. And, as we shall see, there are in fact many

similarities between MBD and ADHD. Because of these very similarities, Sarason’s

critique of MBD effectively functions as a prescient critique of ADHD.78

Minimal Brain Damage is a sub-clinical disorder, essentially the same as the

borderline cases of mild retardation that concerned Journal contributors Julian Myers and

Thomas Eames. In these cases there is no “clear-cut evidence of neurological damage,”

as there would be in the case of cerebral palsy, for example. In the absence of any

quantifiable clinical symptoms, MBD can only be identified by its putative expression

through a series of behaviors, including “impulsiveness in thought and action…learning

difficulties…problems in attention, and so on.”79 Of course, none of these behaviors are,

in and of themselves, pathological, especially when observed in growing children. So

what causes normal behaviors to be construed as evidence of an underlying neurological

problem? The most common answers provided by psychiatric authority are confluence

and duration. But Sarason identifies the other key factor in this equation to be a child’s

relationship to authority:

when a combination of these characteristics is manifested

by a child who is perceived by someone else (parent, teacher,

77 For example, see Barkley, Attention-Deficit Hyperactivity Disorder or the often-cited

work of Edward Hallowell and John Ratey, Driven to Distraction: Recognizing and Coping with
Attention Deficit Disorder from Childhood Through Adulthood (New York: Touchstone, 1994).
78 If this suggestion seems potentially anachronistic, I would defend it as no more
anachronistic than the claims of ADD proponents linking ADD to MBD in the first place.
79 Sarason, “Some Aspects of the Brain-Behavior Problem,” 55.
 139

pediatrician) as being a ‘problem,’ he is usually referred for a

psychological and/or a neurological examination.80
Upon this examination – and based only on the presentation of these behaviors – the

child, thought to be a “problem” even before diagnosis, may be further identified as

having MBD.

Sarason’s concern is how that diagnosis subsequently affects educators’

perception of the child: “It very frequently happens,” he notes,

that when this diagnosis is made the assumption is also

made that we now can explain the behavior of the child. That is to
say, the behavior of the child is a consequence of the brain-injury.”
81

Like Crosby and Blatt, Sarason finds this assumption to have little utility. But where

Crosby and Blatt dismiss serious consideration of such a notion primarily for practical

reasons, Sarason is more fundamentally critical of the logic underpinning it, stating that

“we have not been justified in ‘explaining’ psychological behavior by the presence of a

brain injury.”82 Sarason concedes that “it is one thing to say that brain-injury affects
behavior;” however, he clarifies that “it is quite another thing to say that the

psychological behavior we observe is a direct affect of brain-injury.”83 This is because

“psychological characteristics never directly reflect a brain-injury but a tremendously

complex…set of interactions between organism and environment.”84 Certainly, the

interactions that form the development of psychological characteristics may take into

account particular impairments, but must also include an individual’s history, home

80 Ibid., emphasis added.

81 Ibid.

82 Ibid., 57.

83 Ibid., 59.

84 Ibid., emphasis in original.

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environment, learning environment, social situation, relationship to authority, and a range

of other factors. It is quite likely, for example, that an identical neurological injury in

two different people could lead to the development of different psychological

characteristics, due to other differences in the two people’s histories and environments.

Therefore, “the presence of a brain-injury does not predetermine the development of

specific psychological characteristics.”85 If we accept then, that “there is no inherent

relationship between brain-injury and psychological characteristics,”86 how could one

possibly diagnose a brain-injury through the presentation of psychological characteristics

and behaviors?

But Sarason does not only want to discredit the assumptions that undergird the

diagnostic category of MBD. More important, he wants to promote this relational model

of understanding behavior, because of the implications that is has for education;

Such a viewpoint shifts our attention to the different ways

in which the environment reacts to the organism and how these
ways differ in the degree to which they exacerbate or minimize one
of the organism’s characteristics.87
By shifting attention to the (learning) environment, educators have an equal

responsibility in the success or failure of each student, and more opportunities to locate

moments of meaningful intervention in the learning process. The alternative viewpoint,

fixated on identifying neurological imperfections in “problem” students, certainly

lightens the workload of classroom teachers, but the benefits enjoyed by students labeled

as MBD are less apparent. Sarason pointedly asks, “Are we not taking the easy way out

when we make the brain-injury the etiological scapegoat?”88

85 Ibid.

86 Ibid.

87 Ibid., 57-58.

88 Ibid., 58.
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That the physiologization of learning difficulties (primarily characterized as

attention problems) misdirects responsibility for learning away from educators is only

part of the problem. Additionally, locating such failures in the neurology of individuals

may have negative consequences on future interactions between those individuals and the

environments in which they find themselves. Sarason speculates:

To the extent that we draw or imply such a [physiological]

conclusion we obscure the complexity of the brain-behavior
relationship at the possible expense of knowledge which would
alter our perception of the potentialities of these children.89
In other words, once officially recognized as ‘congenitally incapable of learning,’ an

individual’s environment is more likely to respond to that individual in such a way as to

inhibit learning beyond what is perceived (perhaps falsely) to be the limits of his or her

capabilities. In this way, Sarason worries that such diagnoses, only dubiously justified in

the first place, become self-fulfilling prophesies that actually work to create failures in

education.

Finally, Sarason sees this self-fulfilling prophecy at work not only in the

individual lives of students, but also in the realm of psychological research. Many

research projects are designed to collect evidence in support of the neurological

hypothesis of attention, but few are designed to critically challenge the assumptions

underlying that hypothesis. In such a climate, researchers may be tempted to design their

research and read their results in such a way as to reaffirm their preconceptions. In

Sarason’s estimation,

One could characterize most of the research which has been

done as an attempt to demonstrate that brain-injury produces
directly certain psychological characteristics. It would be my
guess that hundreds of studies have been done with different types
of tests with the aim of describing a pattern of behavior which
would distinguish brain-injured from non-brain-injured

89 Ibid., 56.
 142

individuals. When such a pattern has been obtained the

interpretation always implies that the pattern directly reflects the
presence of brain injury. Such an interpretation rests on a
fantastically oversimplified conception of brain-behavior
relationships.90
Sarason suggests that, in order to conduct more balanced research, “we will have to

observe the interaction between organism and environment with methodologies and

conceptions which do justice to the complexities of these interactions.”91 Such a program

of research would not fully discount neurological impairments, but “would view brain

injury as but another characteristic of the organism which affects and is affected by the

environment.”92 This kind of research would not serve simply to establish an ‘etiological

scapegoat’ for failures in the learning process; instead, it may establish useful points of

environmental intervention that could accommodate the individual needs of challenged

students.

As we have seen expressed by Sarason in 1964, and echoed throughout the

Journal again in 1968, many educational theorists agree that the physiologization of

attention/distraction is, at best, of dubious utility, and at worst, an impediment to

learning. Often, the neuro-biological approach to education is contrasted with a

progressive, individualized approach; one that is more concerned with the learning

environment; and one that places the teacher in a position to make substantive decisions

about the course of a child’s education – in other words, the approach originally

articulated by John Dewey.

Nevertheless, despite the concerns of these educational theorists, the trend to

physiologize learning difficulties did not slow. On the contrary, this line of neuro-

90 Ibid., 59-60.

91 Ibid., 61.

92 Ibid., 60.
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psychological investigation grew in estimation and spread in its implementation,

eventually blossoming in the formalization of the Attention Deficit Disorder diagnosis.

What accounts for this? To answer that question, we must turn our attention to the

structure of school administrations, mental health delivery systems, and the changing

roles of teachers.

The Interlocking Directorate

In the same 1960 article discussed earlier, Thomas Eames makes some revealing

comments on the role of teachers in the course of addressing the issue of sub-clinical

brain damage,93 in which he articulates the position Sarason so strongly critiqued: the
tendency to physiologize learning difficulties, even in the absence of clinical symptoms

of neurological damage:

During the last several years there has been an increased

interest in slow learning attributed to brain damage....These
injuries occur in all degrees of severity form the sub-clinical to the
severe....It must not be forgotten that milder damage accounts for
many of the cases of apparent normalcy which fail to respond to
the usual teaching techniques....Generally speaking, if there is very
serious brain damage the teacher observes an incoordinate, erratic,
uninhibited, hyperactive, and often socially unacceptable
child....Many brain-damaged children are so defective that it is
unfair to the rest of the pupils to keep them in regular
classes....they distract the class and interfere with its progress.94
Here, Eames explicitly states that “the teacher observes” behaviors that may lead to a

diagnosis of neurological pathology. To be fair, Eames, at other points in the article,

93 While Eames does not explicitly identify “attention” or “distractibility” as signs of

sub-clinical brain damage, he does mention “inhibition” and “hyperactivity.” Even before the
notion of an attention deficit was diagnostically formalized in concert with hyperactivity in the
term AD/HD (Attention Deficit-Hyperactivity Disorder – a basically interchangeable semantic
revision of ADD), the terms “hyperactivity” or “hyperkineticism” were often mentioned in close
association with attentive problems. These disruptive behaviors were typically characterized as
sub-clinical expressions of brain damage.
94 Eames, "Some Neural and Glandular Bases of Learning," 11.
 144

cautions against drawing medical conclusions too easily: "The reader is not to infer that

these neurological conditions are the only causes of reading or arithmetic failure."95 Yet,

in the same article, Eames observes that "teachers often explain the adjustment

difficulties of the brain-injured child in terms of reading disability or speech

difficulties."96 With this statement, Eames stops short of extending diagnostic authority

to teachers, yet states that they may in fact be guilty of what amounts to a misdiagnosis,

by naming problematic behaviors as problematic behaviors (difficulty in reading or

speaking), rather than identifying the neurological anomaly of which those behaviors are

purportedly an expression. This implies that teachers are already implicated in the

diagnostic process. This confusion over the lines of authority is, no doubt, a symptom of

the annexation of medical authority – especially psychological and psychiatric authority –

into the “interlocking directorate” of American universal compulsory education, a

process that gained momentum after WWII.

In February of 1964, the Journal of Education had addressed this topic by

dedicating an entire issue to considering the various roles and functions of the mental

health profession within this interlocking directorate.97 In the introduction to the issue,
editor and contributor Arthur J. Bindman cites two historical factors influencing the

increasing presence of mental health officials in the school. The first is the “rapid growth

in community mental health services in this country” since the mid-1940s.98 This general

growth in the industry was, in part, a by-product of the war, which had fundamentally

95 Ibid., 8.

96 Ibid., 3.

97 “Roles and Functions in School Mental Health” Journal of Education, Boston

University, v. 146, no.3 (February, 1964).
98 Arthur J. Bindman, “Introduction to the Problem” Journal of Education, Boston
University, v. 146, no.3 (February, 1964), 3.
 145

changed the practice of psychology. The large population of young men entering the

armed forces had supplied psychologists with an enormous data set, as every new recruit

was subjected to a battery of personality tests and psychological evaluations. This

allowed psychologists to refine models of personality and increase the predictive capacity

of behavioral assessments. At the other end of the war, the traumatic experience of battle

created a sizeable population of new mental health patients with nervous and anxiety

disorders – or what would most likely be identified under the current diagnostic

psychiatric paradigm as Post-Traumatic Stress Disorder (PTSD). In trying to meet the

needs of these veterans, and in response to a growing criticism of earlier practices of

psychiatric institutionalization, a new, community-based model of psychiatric care was

developed. This model moved patients out of institutions, which tended to isolate

patients and treat their problems individually, and into “therapeutic communities” (a term

coined by Thomas Main in 1946), which concentrated on “re-socialization” and group-

therapy.99 The effectiveness of these methods, along with the higher-than-expected

prevalence of mental health problems identified among those entering and serving in the

armed forces (suggesting a correspondingly high prevalence in the civilian population, as

well), inspired post-war legislation that promised to increase the accessibility of mental

health services to all Americans, and at the same time, to uncouple those services from

traditional hospital settings. The National Mental Health Act of 1946 made available

federal grants for establishing psychiatric outpatient facilities, as well as founding the

National Institute for Mental Health, an institution that has conducted and funded a great

deal of psychiatric research ever since. Later, in 1963, the Community Mental Health

99 Healy, The Creation of Psychopharmacology, 131; Therapeutic communities are

discussed further in the first chapter of this dissertation.
 146

Act called for the establishment of community mental health centers that would operate

independently of hospitals.100

The other factor that Bindman cites for the increased presence of mental health

professionals in schools is the passage of the National Defense Education Act of 1958.

This act, ostensibly inspired by the humiliation the nation felt in the wake of Sputnik’s

1957 launch, characterized federal funding of education as a matter of national security,

thus justifying a series of fellowships, grants and loans to schools across the country.101

Bindman states that the funds made available by the NDEA facilitated the expansion of

both intramural high school personnel (especially guidance personnel, but also school

psychologists), as well as the extramural community of professional services utilized by

high school administrations, including psychiatrists and social workers.102

The primary concern that this raises for Bindman is one of disciplinary

boundaries. Once a school system takes on some of the functions of the mental health

industry, it quickly becomes unclear where the professional responsibilities of the school

end and those of other institutions take over. Bindman observes that “the line between

school services and community based services…becomes fuzzier daily.”103 Of course,

the degree of integration between schools and mental health services will vary from

instance to instance, creating a spectrum of possible permutations. The most ambitious

100 Ibid., 147.

101 Ravitch, The Troubled Crusade, 229; Tyack, The One Best System, 275. Tyack
suggests that the NDEA was also a response to the increasing pressure that labor unions had
placed on the federal government to increase its funding of public education through the 1950s.
The launch of Sputnik, then, may have only been the final necessary push in this direction, and to
some degree, a cover for the government to not appear to be conceding territory to union
interests.
102 Bindman, “Introduction to the Problem,” 3.

103 Ibid.
 147

schools “have taken on long-term therapy cases of severely disturbed children.”104

Conversely, Bindman characterizes the least a school might participate in mental health

services is to offer “diagnosis (both through interviewing and testing), preventative

intervention and short-term counseling.”105 This is the most revealing moment in this

article, for by this standard, even those schools that “refuse to get involved in the

treatment process” are fully involved with mental health institutions.106 Throughout all

the articles in this issue of the Journal, integration of these two institutions is increasingly

taken for granted, even in statements that purport to differentiate schools from mental

health services. For example, Harry L. Isaksen, in his short article entitled "The Role of

the School Counselor in School Mental Health," states that “the schools are not in the

business of providing psychological, social work, medical, or other such services except

as they contribute rather directly to the improvement of a student’s performance in the

instructional program.”107 When one considers the concurrent trend to interpret poor
academic performance as the result of psychological and physiological pathology, one

can see how Isaksen’s statement, while ostensibly trying to separate mental health

services from school, actually provides the justification for such services to be provided

by school systems.

Other contributors to this issue of the Journal are much more up front about how

transparently these two institutions should be integrated. For example, Daniel Wolf, in a

1964 article entitled “Teacher and School Social Worker: Strategic Team for Mental

104 Ibid.

105 Ibid.

106 Ibid.

107 Henry L. Isaksen, "The Role of the School Counselor in School Mental Health,"
Journal of Education, Boston University, v. 146, no. 3 (Feb. 1964), 11, emphasis added.
 148

Health,” argues that the presence of mental health workers in the school is urgently

necessary as a response to what he perceives to be a crisis of “juvenile delinquency.”

This perception was a pervasive element of mid-1950s discourse, a kind of “moral panic”

which typically held that an entire generation of young Americans was being irreparably

damaged by the emergent popular youth culture and the failure of American families.

While there is little convincing evidence that juvenile crime was ever a significant threat

to the fabric of society, the fear that it might become so motivated many social activists

and decency leagues, such as the National Delinquency Prevention League and the
Continuing Committee on the Prevention and Control of Delinquency. In 1955, Senator

Estes Kefhauver chaired the Senate Subcommittee to Investigate Juvenile Delinquency at

a time when the juvenile delinquent inspired many popular films, most famously

Nicholas Ray’s Rebel Without a Cause, and a series of rather alarmist texts, such as

Benjamin Fine’s 1957 book, One Million Delinquents, which Wolf tellingly cites at the

outset of his article as a source for rates of juvenile delinquency.108

In establishing the urgency of the problem to be addressed by mental health

workers in the school, Wolf also cites legislative action such as the Community Mental

Health Act of 1963, and quotes President Kennedy addressing Congress as saying,

108 Wolf establishes his argument in the first paragraph of his article’s body thusly: “Our
first problem relates to crime in the United States, which is increasing four times faster than the
population...Predictions by some experts are found in Fine’s One Million Delinquents. He
estimates that by 1960, three-quarters of a million boys and girls a year would be going through
the juvenile courts. Adding to this total the number of delinquents not brought into court, the
total could reach the incredible number of 2,250,000 delinquents by 1965.” This statement is
problematic for a few reasons. For one, Wolf relies on predictions Benjamin Fine made in 1955
as a source for delinquency rates in 1963, even though those rates could have been verified
independently. Additionally, the larger estimation that Wolf quotes Fine as making takes into
account “the number of delinquents not brought into court,” which is problematic not only
because it fails to explain how this number would be established if not through its collection by
an institution like the courts system, but, moreover, such a construction stretches the definition of
“delinquent” – for what is a delinquent if not a juvenile who has run afoul of the courts system?
 149

“mental health and mental retardation are among our most critical health problems.”109

This helps Wolf make the case that psychiatric care – as opposed to social, political,

economic or legal interventions – is the best response to the threat of juvenile

delinquency. Thus, Wolf effectively collapses “delinquency” – an elastic and inexact

term for any number of activities defined as criminal (and linked to the perpetrator’s age)

into the umbrella term “mental illness.” This leads Wolf to address a disparate range of

issues – “crime and delinquency, dropouts and mental illness” – as a single problem, with

a single solution: “prevention,” which “must be stressed lest these massive problems

threaten the very fabric of our community and its values.”110

To deal with these massive problems, Wolf endorses an interdisciplinary, cross-

institutional model of preventative mental health services, because “it is obvious that no

one agency, public or private, can go-it-alone in attempts to do the job of prevention.”111

In this model, the school is important largely because of its universal and democratic

nature, which grants a kind of panoptic access to a large segment of the US population,

including not just students, but their families. Gaining access to this population in this

manner is necessary because “families in most need of counseling for mental health may

often be reluctant to look for it.”112 However, “mental health resources located within

schools may establish relationships with these families and children within the accepted

learning situation with the focus upon the child, thereby diminishing fear and reluctance

to be helped.”113 To this end, mental health professionals should be “constantly involved

109 Daniel Wolf, "Teacher and School Social Worker: Strategic Team for Mental
Health," Journal of Education, Boston University, v. 146, no. 3 (Feb. 1964), 36.
110 Ibid.

111 Ibid.

112 Ibid., 37.

113 Ibid.
 150

in helping the educator to increase skills in identifying symptoms of emotional pathology,

which interfere with the child’s accessibility to learning.”114 Wolf, then, doesn’t see

mental health officials as an integral part of a functioning school system; rather, he sees

the school system as a “strategic laboratory in which to detect anxiety, frustration and

insecurity on the part of child and parents,”115 a practical and convenient way for mental

health professionals to be granted access to a population in need of professional help.

This view of schools as a “strategic laboratory” for the work of mental health

professionals is apparent in many articles in this and other issues of the Journal. For

example, in an article entitled “The Role of the Guidance Consultant at the Elementary

School,” from the same issue of the Journal dedicated to the “Roles and Functions of

School Mental Health,” author Joan M. G. Helpern makes a similar point:

As the natural setting for the child – as the place in which

he spends the greatest number of hours, the longest number of
years in his early life – the school is particularly accessible and
meaningful…It offers adults a ‘normal’ or appropriate setting in
which to observe the child so his skills, his needs, his problems
may best be assessed.116
Helpern identifies this as the most significant of the “unique contributions which the

school can make in the area of mental health.”117 However, unlike Wolf, Helpern does
not view the integration of mental health services into the school system solely as an

extension of the mental health industry into the population at large. Rather, intramural

mental health services – as they are embodied in guidance personnel, for Helpern’s

purposes – help the school system to function more efficiently. Helpern presents a

114 Ibid.

115 Ibid., 36.

116 Joan M. G. Helpern, "The Role of the Guidance Consultant at the Elementary
School," Journal of Education, Boston University, v. 146, no. 3 (Feb. 1964), 19.
117 Ibid.
 151

teacher-oriented account of how guidance personnel can augment the effectiveness of

individual educators, especially when resources are scarce; “Teachers who have large

classes, new materials to consider, and demands made on them for achievement by

parents and supervisors frequently need additional help if they are to assess accurately the

needs of the children and of themselves.”118

This account seems to preserve the educational focus of the school system (at

least rhetorically), and resists the tendency to view the school as an appendage of the

mental health industry. But even as she apparently demarcates the roles of the two

institutions more clearly than Wolf, she extends the reach of mental health services to

encompass the entirety of the student body: “The elementary school guidance consultant

has as his focus not children with severe pathological problems…not children who have

been identified as potential delinquents…but all children.”119 By explicitly bringing all

students under the auspices of mental health professionals, the school becomes an even

more “strategic laboratory,” as it presents an effectively randomized cross-section of a

population. Just as in a clinical trial, the children without severe pathological problems

serve as a control group, against which the effectiveness of preventative and therapeutic

measures taken on “problem students” can be evaluated. In addition, as Helpern points

out, the environment in which these students find themselves from day to day is largely

standardized, just as researchers would strive to standardize the experimental

environment in a clinical trial. In this light, what Helpern describes as a “normal” setting

might better be thought of as a normalized setting. And, finally, where researchers are

118 Ibid.,17-18.

119 Ibid., 17; emphasis in original

 152

often vexed by the relatively high attrition rate for many clinical trials, continued

participation in the school system is mandatory and longitudinal.120

It is exactly this controlled environment that excites school psychiatrist Harry

Klein, another contributor to this issue of the Journal. In his article, “The School

Psychiatrist in a Municipal Department of Education,” Klein does not discuss being

particularly inspired by the need to help an endangered section of the population, as does

Wolf. Neither does he speak of the opportunity to help overloaded teachers, as does

Helpern. Rather, Klein is motivated by the furthering of the psychiatric profession

through the knowledge gained in the strategic laboratory of the school system.

Perhaps in no other area can the principles of preventive

psychiatry be more advantageously developed and practiced than
in a public school system. Here can be observed the entire
spectrum of interpersonal relationships, from the benign to the
malignant. Because the system is a fairly closed one, here can be
ascertained the factors and influences that affect these relationships
and steps taken…to improve upon them.121
To be fair, at another point in this same article, Klein is careful to back up from the cross-

institutional enthusiasm apparent in the above quote, stating flatly that “offering

psychiatric treatment is not a proper function of the public schools.”122 The apparent
contradiction between these two statements can only be reconciled if we grant that by

120 The mental health industry is not the only institution to take advantage of these
laboratory-like conditions of the school system. Law enforcement agencies and state legislators
have made strategic use of the school system, as well, blurring the lines between the school
system and state authority in general. As Helpern states in this article, the identification of
“potential delinquents…has been designated by state law as the major responsibility of the school
adjustment counselor in Massachusetts.” (pg. 17) While I find this fascinating – and particularly
illuminating of Louis Althusser’s characterization of the school system as the primary example of
a State Ideological Apparatus, fully complicit with Repressive State Apparatuses – I can only
speculate briefly on this point, as I have not yet researched this Massachusetts law.
121 Harry Klein, "The School Psychiatrist in a Municipal Department of Education,"
Journal of Education, Boston University, v. 146, no. 3 (Feb. 1964), 47.
122 Ibid., 44.
 153

“psychiatric treatment” Klein means only the direct application of therapeutic measures –

and does not include clinical observation, monitoring and evaluation of treatment, and

diagnosis – though all are conceivably aspects of a larger psychiatric treatment process.

Indeed, throughout the rest of the article he characterizes these activities as appropriate

within and even well-suited to the school system. Such a confluence makes clear that not

only are the roles of educators changed as a result of institutional integration, but the

various aspects of the psychiatric treatment process have been separated and, to a degree,

reallocated within the school system.

As aspects of the psychiatric process are incorporated into the school system,

responsibility for mental health evaluation and recommendation falls not only upon

intramural psychiatric professionals, but on teachers as well. In fact, in Klein’s view, the

primary role of intramural mental health professionals is to train teachers in their new

(primarily diagnostic) functions as an adjunct part of the mental health industry. As

Klein states, “constant effort is being made to acquaint teachers with the variety of

behavior patterns which point to trouble so that discovery and referral may be made

quickly.”123 Psychologist Gershen Rosenblum, another contributor to the same issue of

the Journal, outlines these roles even more plainly. “The [mental health] consultant

helps educators sharpen their skills in the early identification of emotional disturbances in

the classroom. At the same time he enables them to distinguish more sharply the normal

social, emotional, and intellectual developmental patterns of children.”124 (Note,

however, that the “normal” is never defined in its own terms; rather, the abnormal is

distinguished from the normal.) Upon being taught how to conceptualize classroom

123 Ibid.

124 Gershen Rosenblum, "The Role of the Mental Health Consultant to the Public
Schools," Journal of Education, Boston University, v. 146, no. 3 (Feb. 1964), 49.
 154

problems as mental health issues, “the teacher may be able to make a diagnosis of a

child’s difficulty.”125

This is an important point. Klein’s and Rosenblum’s articulation of the diagnostic

capacity of teachers is reiterated in every Journal article that takes as its subject sub-

clinical neuropathology, brain damage, endocrine dysfunction, etc. – in short, any of the

various attempts to physiologize learning difficulties (which are increasingly, throughout

the 1960s, characterized as “attention deficits”).126 In each of these iterations, a similar

pattern presents itself. First, the author(s) make a statement that denies teachers the

capacity to diagnose. Then, inevitably, in the same article, the author(s) will observe that

the teacher occupies a position that is uniquely suited to a diagnostic functionality. To

provide one last illustration of this, consider Winona Chang, Tina Federico and Elaine

Fitzpatrick’s article, in a 1968 issue of the Journal. The topic is the potential implications

of sub-clinical endocrine dysfunction. First, the authors state that “teachers in the

classroom will never be involved in the actual diagnosis or medical treatment of

endocrine patients.”127 Then, six pages later, without explicitly using the term
“diagnosis,” they go on to discuss what a teacher can contribute to the diagnostic process:

In her everyday association with pupils, a teacher learns

how each one looks and behaves when he is well. Through several

125 Ibid., 51.

126 Allow me to clarify once more that, in this statement, I do not mean to question the
reality of neuropathology, brain damage, endocrine dysfunction, or any other uncontroversially
physiological state that may truly inhibit one’s learning capacity. Rather, I am challenging the
application of the problematically elastic concept of sub-clinical dysfunction. It is only in the
sub-clinical cases that teachers are expected to contribute significantly to the diagnostic process.
In the more clear-cut cases of gross neuropathology, brain damage, endocrine dysfunction, etc.,
mental health professionals need no special assistance in making their diagnoses, as the
individuals suffering from these conditions show clinical symptoms.
127 W. Chang, T. Federico, and E Fitzpatrick, "Educational Implications of Glandular
Malfunctioning," Journal of Education, Boston University, v. 151, no. 2 (Dec. 1968), 36,
emphasis added.
 155

years of familiarity with a particular age group, the teacher tends to

know how a child compares with his classmates. She is in the
position, therefore, to notice significant changes for the worse in
appearance and behavior without the subjectivity of parents. Often
the teacher’s observation that a doctor’s advice is needed for a
particular child is valuable.128
The authors also point out that, in order to realize this function, “school personnel will

need to understand some of the manifestations of malfunctioning conditions,” requiring

the acquisition of physiological knowledge from articles such as the one by Chang, et al,

as well as through interaction with intramural mental health professionals.129

The pattern is revealing. On one hand, teachers clearly cannot be granted the

ability to make psychiatric or medical diagnoses, as a matter of legality. Psychiatry is,

after all, a licensed profession. For a teacher to make a diagnosis and a student to

subsequently embark on a therapeutic regimen (especially one that involves

pharmaceutical drugs), without the intervening authority of a psychiatrist, would be not

only irresponsible, but illegal. Further, psychiatrists have an interest in maintaining the

proprietary nature of their mental health functionalities, lest they lose their position of

authority. If teachers could diagnose these problems by themselves, then administrators

would not be likely to expend precious capital on psychiatric consultants and intramural

mental health professionals.

On the other hand, psychiatrists simply have no observational tool as powerful as

the one embodied in the position of the teacher. As Harry L. Isaksen states in this issue

of the Journal, “the teacher is recognized as the primary functionary in the school mental

health program.”130 This is the case for several reasons. First of all, one of the biggest

difficulties in observing behaviors in human subjects is the troublesome fact that those

128 Ibid., 42.

129 Ibid., 36.

130 Isaksen, “The Role of the School Counselor,” 11.

 156

behaviors are often affected by the awareness of being observed. Among the variables

that psychiatrists must control for when diagnosing is the effect of the psychiatrist’s

presence as an observer. Whether a child enters a clinical environment, such as a

psychiatrist’s office, or a psychiatrist enters a child’s everyday environment, the presence

of the psychiatrist is perceived as invasive, and at best, tends to make subjects

uncomfortable, thereby altering their behavior. In contrast, the presence of the teacher in

the school environment is utterly routine, rendering it effectively invisible to the subject

(e.g., the student) as an observational tool of the psychiatrist. As Helpern states, “When a
child is seen within the school setting he is not having his day completely disrupted. He

is able to accept attention as part of a normal association.”131 Additionally, when

attempting to diagnose sub-clinical disorders, the subtle signs that psychiatrists look for

(e.g. distractibility, inhibition, et al.) may be noticeable only over long periods of

observation. While this is impractical for psychiatrists, extended contact is already a part

of the job description for teachers. Further, the preventative approach to community

mental health requires monitoring an entire population, not just those already recognized

and identified as problematic. This is likewise simply too large of a task for the limited

mental health staff of a school to take on without enlisting the help of teachers.

To this end, teachers are encouraged to function in a diagnostic-referral capacity,

as an extension of the observational powers of psychiatrists. One might well point out

that a referral is not the same thing as a diagnosis. Indeed, the difference between a

referral and a diagnosis might be more than just a semantic quibble if referrals did not

directly lead to diagnoses. However, the observations of teachers account for the entirety

of symptoms in most cases of sub-clinical diagnosis, as, by definition, there are no

clinical signs for psychiatrists to corroborate with the observation of teachers. Further,

131 Helpern, "The Role of the Guidance Consultant,” 19.

 157

articles such as Gershen Rosenblum’s, mentioned above, measure the success of

intramural appointments of mental health professionals, and their concurrent diagnostic

cooperation with teachers, by the rate of diagnoses made upon a teacher’s referral:

Before the introduction of a school mental health consultant program in a

community mental health center, the mean age of referral of school children was 13.2

years. Ten years after school consultation services began, the mean referral age dropped

to 8.3 years. In addition, in recent years a significantly lower percentage of cases referred

by the schools were rejected or transferred elsewhere due to not being appropriately
referred to the children’s clinic.132

The goal, then, certainly seems to be making referrals by teachers as reliable as

diagnoses by psychiatrists. This requires a physiologically-minded reorientation on the

part of teachers, and presumably training beyond that traditionally associated with an

educational background. Such training may come from explicit ad hoc instruction on the

part of mental health workers, or it may simply be the result of everyday interactions

between members of a faculty that includes mental health professionals. While this is not

the official function of the intramural mental health worker, it may be, in fact, the most

profound role that he or she can play in the school system. In 1964, Klein dramatizes this

in his discussion of a program established by a school psychiatrist in New Haven,

Connecticut:

…weekly seminars were initiated with entire faculties of

elementary schools…psychological principles were delineated and
their practical application stressed…It was concluded that this
aspect of the work is the most important contribution the school
psychiatrist can make.133

132 Rosenblum, "The Role of the Mental Health Consultant,” 49.

133 Klein, "The School Psychiatrist in a Municipal Department,” 45.

 158

Many other articles also emphasize the importance of familiarizing principals and

teachers with the psychiatric perspective. This influence, from within the school system,

likely had far more impact on educators than did either the concurrent psychological

research on attention or educational theorists’ uneasy response to that research. As the

organization of school systems changed through the expansion of mental health services,

teachers came into contact with the mental health industry, and their perspectives on

education could hardly be unaffected.

Of course, diagnosing sub-clinical disorders by proxy was a new job. One might
question why teachers, notoriously overworked as a profession, would take on this

responsibility. Note, however, that in exchange for taking on this diagnostic function,

responsibility for the most difficult-to-teach students is also shifted away from the

traditional teacher and onto mental health services. In some cases, students might be

placed in special education classes, thus reducing the teacher’s class size. In this manner,

the incentives for adopting diagnostic functionalities would actually increase with the

teacher’s workload; the more overworked a teacher, the more likely that teacher might be

to refer problematic students to mental health professionals.

Therefore, it is reasonable to consider the economic situation of a school system

as another social factor that may contribute to the diagnosis of an “attention deficit.” The

administrative community of a school system, and economic incentives for teachers to

rely upon the mental health resources available to them, may have as much influence on a
student’s diagnosis as any behaviors displayed by that student. Such influences were

exacerbated by historical contingencies. The school consolidation movement

standardized administrative communities, to a significant degree, throughout the 1950s

and 1960s, at a time when mental health services were increasingly incorporated into
 159

those structures.134 The integration of these institutions was facilitated by federal

funding, beginning with the National Defense of Education Act and reaching its height

during the presidency of Jimmy Carter.135 Then, in the 1980s, President Ronald Reagan

made serious inroads into federal funding of education (also in the name of national

defense), which supplied teachers with new economic incentives to rely upon the mental

health services that were, by that point, fully integrated into the school system.

But the teachers are not the only individuals to have their functionality modified

as a result of the integration of school systems and mental health services. The strategic

laboratory has an effect on the mental health professionals who interact with it regularly,

as well. As Harry Klein, in the same article discussed earlier, states:

...the psychiatrist...undergoes definite change in the frame

of reference of the public school system. He becomes more aware
of the effects of social pressures on mental illness. He develops
respect for the problems of the educator. He views the morbid
effects of psychopathology, at subclinical levels for the most part,
but nevertheless disturbing, on a massive scale…This can add a
broader, new dimension for him in the specialty of psychiatry.136
Thus, as Klein argues, viewing psychopathology from within an educational

environment, from the perspective of educators, brings the psychiatrist to “respect” the

problems of educators, and to view educational difficulties as the “morbid effects of

psychopathology.” Moreover, this environment causes the psychiatrist to become more

attuned to “subclinical” psychopathology. In other words, the psychiatrist in an

educational environment is more likely to view the problems of education as expressions

of psychopathology than he or she would be if encountering the same children in a

different context.

134 Ravitch, The Troubled Crusade, 327.

135 Ibid., 319-320.

136 Klein, "The School Psychiatrist in a Municipal Department,” 46.

 160

Arthur Bindman, in his Journal article "The School Psychologist and Mental

Health" (1964), extends this observation, clarifying further that psychologists’

assessments are not only affected by their interactions with educational systems, but by

their administrative placement within the structural institution of the school. For

example, intramural psychologists – with offices inside the school building – tend to

reach different conclusion than consulting psychologists – who may only visit the school

on occasion, and may only encounter students when they are specifically referred. The

intramural psychologist, in contrast, has the opportunity to observe all students. The
result is an increased awareness of subclinical pathology, and higher rates of

intervention.137

The placement of the mental health worker within the institutional structure is

important not only because of the difference of perspective different positions afford, but

also because the nature of this position may itself have an impact on future interactions

with the student population. As medical historian Joel D. Howell describes in

Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century

(1995), when a function of an institution is assigned to a particular station within the

institution the function of that station has a tendency to perform its function as it relates

to the institution, rather than as it relates to the world in which the institution functions.

To illustrate this, Howell offers a history of the use of the x-ray machine in hospitals at

the beginning of the 20th century. While, from the outset, X-ray machines were

advertised by hospitals as advanced technologies, adding distinction to the institutions in

which they are housed, it is not until the development of the specialized position of the

radiologist that the machines’ use became common. Once this occurred, X-ray

technology was routinely used – even in cases where it provided no additional medical

137 Arthur J. Bindman, "The School Psychologist and Mental Health," Feb. 1964.
 161

knowledge. (Specifically, an X-ray is unnecessary in the majority of cases of broken

bones; the break is most often obvious to the naked eye, and in such cases, bone-setting

techniques are generally unaffected by the process of X-ray analysis.) Radiologists,

however, sought to demonstrate the utility of the newly established radiology

departments by regularly exercising their institutional function, irrespective of the

demands presented by the patient population.138 Applying this insight to the case at

hand, the more intimately mental health professionals are tied into the structure of the

institution, the more incentivized they are to exercise their function as a performance of

their utility and centrality to the function of the system as a whole, exhibiting a kind of

institutional momentum.

Just as the mental health worker’s placement within the educational system

structures their behavior within that system, the placement of students within the school

system – often determined by the student’s behavior in the first place – is in turn affected

by classroom placement. This behavior, in turn, continues to inform the diagnostic status

– especially in the “subclinical” cases. The Journal of Education contains an ongoing

discourse about the effects of placement on students. For example, as William Kvaraceus

points out in his article, “Mental Retardation and Norm Violation,” behaviors associated

with MBD (and now ADHD) display themselves in predictable patterns in relation to the

student’s placement. As Kvaraceus reports, in contrast to popular expectation that

“delinquency” is related to low intelligence, the relationship of delinquency to

intelligence (as represented, for Kvaraceus, by the IQ test) is dependent on class

placement, such that:

138 Joel D. Howell, Technology in the Hospital: Transforming Patient Care in the Early
Twentieth Century (Baltimore, MD: Johns Hopkins University Press, 1995).
 162

The brighter the youngster in the special class the more apt
he or she was to turn up as a norm violator. Conversely the dullest
youngster in the special classes proved to be the best behaved139
This brings Kvaraceus to conclude that “brighter pupils who are marginal placements

may be rebelling to assignment in these classes.”140 This observation has been made by

other educators, as well. For example, Thomas Eames, in his 1960 Journal article, had

also said "children with considerably higher IQs, though even better able to do the work,

are often bored by its simplicity (to them), and turn to misbehavior to amuse

themselves."141 But Kvaraceus goes beyond this observation to offer an alternative

interpretation with different, but equally significant ramifications:

at the same time it may be that the brighter youngsters may

be misplaced and represent the more obstreperous youngster who
has worn out his welcome in the regular classes.142
Either interpretation bears implications for the practice of placement itself. As Kvaraceus

states:

This may well raise questions concerning referral practices

and degree of frustration in special class placements. Since the
more academically able appear more delinquent in the special
classes, the data suggest that it is hazardous to be a marginally
retarded special class pupil in our culture, that we may be placing
disturbed and disturbing pupils in the special classes as well as
some “bright” youngsters who perhaps do not belong there, who
are rebellious, and who form a resistance movement.143
Ultimately, Kvaraceus’ article questions educators’ ability to differentiate between

behavioral problems and mental dysfunction when making placement demarcations:

139 William Kvaraceus, "Mental Retardation and Norm-Violation," Journal of

Education, Boston University, v. 147, no. 1 (Oct. 1964), 19.
140 Ibid.

141 Ibid., 17.

142 Ibid., 19.

143 Ibid., 24.

 163

One might ask: In how many instances, for a marginal child

with a fairly 'high' I.Q., is placement in a special class made
because he is a behavior problem?144
These critiques are echoed within a concurrent discourse on creativity as an education

concept. In 1963, an issue of the Journal titled “Education Through Creative

Expression” (1963), addressed this by expressing dismay at the lack of emphasis placed

on nurturing creativity and predicting tragic consequences for failing to correct this

oversight.145 For example, Adolph Maniol, in his article in this issue of the Journal

titled “The Affectional-Intellectual Dimension: A Continuum or Dualism?” (1963),

expresses concern that students who are oriented toward and/or invested in creative

expression or other values that are marginalized by the school system may be identified

as being out of step with achievement, and subsequently placed into special curricula.

Just as Kvaraceus had speculated that rebellious students get identified as MBD and/or

placed into alternative curricula, in spite of their “intelligence,” so too does Maniol

suggest that creative students are misplaced into special classes. In fact, the discourse

surrounding creativity in the Journal explicitly provides an alternative context for

“willfulness” – in which it is perceived as a positive attribute. This suggests that

identifying a “willful” student as a behavioral problem or as a driven and creative student

has as much to do with the institutional disposition towards creativity as it has to do with

the neurological status of the student in question.

This discourse on creativity extends to the furthest conclusion of social

constructionism, with some journal contributors equating all such behavioral problems to

the antagonistic attitude of educational institutions to creativity. For example, Harlan

Hoffa opens his article “Conformity and Creativity” (1963) by plainly asserting that,

144 Ibid., 21-22.

145 Gene D. Phillips, ed. “Education Through Creative Expression” Journal of

Education, Boston University, v. 145, no.3 (Feb. 1963).
 164

"The relationship of conformity to creativity is, in the simplest possible terms, a negative

one."146 He goes on to quote psychologist Abraham Maslow, who:

pointed out that society as a whole will look upon the

creative individuals as troublemakers in an organization –
unconventional, unrealistic, undisciplined, inexact, unscientific or
a little bit queer. Their more compulsive colleagues may refer to
them as crazy, wild, unresponsible, speculative, uncritical,
irregular, emotional and so on.147
This is significant because the description of the “misunderstood artist” – offered here by

Hoffa and echoed by several other contributors to the Journal – recapitulates descriptions

that would, two decades later, become associated with the ADHD profile. Similarly,

many of the pedagogical practices advocated within the creativity discourse (novelty,

individuated instruction, movement, multisensory engagement, etc.) intended to promote

creativity in general, as well as academic engagement with creatively-oriented students,

are recapitulations of the non-pharmaceutical interventions offered to engage with

problem students in the era before the normalization of pharmaceutical interventions.

Similar interventions are likewise presented as alternatives to amphetamines by ADHD

skeptics, many of whom also tie the distractible and willful nature of children diagnosed

with ADHD to an underappreciated creative drive.148

This discourse about the potential pitfalls of placement (here sampled from the

early 1960s) highlights the impact of social realities over biological ones, while openly

discussing relationship of power and the subjective experience of “problem students.” In

this way, these discussions mirror the educators’ contemporaries in the antipsychiatry

146 Harlan Hoffa. "Conformity and Creativity,” Journal of Education, Boston

University, v. 146, no. 3 (Feb. 1964), 51.
147 Ibid., 52.

148 Edward Hallowell and John Ratey. Driven to Distraction: Recognizing and Coping
with Attention Deficit Disorder from Childhood Through Adulthood (New York: Anchor Books,
1994; 2011). This will be discussed further in chapter 4 of this dissertation.
 165

movement. While this reflects the visibility of antipsychiatric perspectives in the early

1960s (discussed previously in chapter 1), it illustrates the contested environment of

public schools, which were embracing mental health workers into their institutional

structures, at the same time that many were questioning the tenets of psychiatry. (In fact,

ironically, the success of de-institutionalization – an early antipsychiatric priority –

contributed to the dispersal of psychiatrists into other institutions, such as the schools.)

In line with what would be expected from the most strident critiques of antipsychiatrists,

some contributors to the Journal go on to question the ontological status of distinctions

based on IQ tests at all. For example, Frank Garfunkel, in "Probabilities and Possibilities

for Modifying Behavior of Mentally Retarded Children: Tactics for Research" (Oct.

1964), explicitly questions the use of IQ tests, and asks: "Is not mental retardation a

rather transient phenomenon that is consistently related to only one thing –

placement?"149 By asking this question, Garfunkel is implying what antipsychiatrists

suggested about mental illness – that the condition is actually created by the tools

intended to treat the condition. Garfunkel states this a bit more clearly when he asserts,

with facetious sincerity, that

The aim of the diagnostic process is not to determine

whether or not the child is mentally retarded but, rather, whether or
not the child should be made mentally retarded by administrative
fiat.150
When Julian Myers expressed a similar conviction in “Education and Rehabilitation”

(Dec. 1962), he directly cites antipsychiatrist Thomas Szasz’s influential Myth of Mental

Illness (1961):

149 Frank Garfunkel, "Probabilities and Possibilities for Modifying Behavior of Mentally
Retarded Children: Tactics for Research," Journal of Education, Boston University, v. 147, no. 1
(Oct. 1964), 47.
150 Ibid., pg. 47.
 166

There is little evidence to support the idea that the

"functional" neuroses and psychoses are organically caused, or that
the treatment of choice should be medical. Szasz suggests that
what we call mental illnesses are really 'expressions of man's
struggle with the problems of how he should live.'151
The tensions within psychology and psychiatry at this time resemble the tensions within

education. Just as educationists diverged on locating the problems of troubled students in

their environment or, alternatively, in their neurophysiology, so did psychiatrists diverge

on intervening with people environmentally or physically. Ironically, it is the social

movement that succeeds in placing mental health officials in the school system. Once

there, however, the administrative structure of the schools tends to favor the biological

approach.

Chemical Pedagogy
The capacity of amphetamines to promote attensity was first identified in medical

literature in 1937 when Charles Bradley demonstrated this by administering Benzedrine

to a population of brain-damaged children. Amphetamines were subsequently exploited

for just this effect by the military throughout WWII. However, as this review of articles

in the Journal of Education demonstrates, this use of amphetamines was barely

acknowledged among educators in the US up to and throughout the mid-1960s. In 1960,

for example, the decidedly biodeterminist Thomas Eames spoke eagerly about the “great

research potential for studies involving neurological, biochemical, and pharmacological

aspects of learning and behavior,” but rather than referencing Charles Bradley’s 1937

work on this topic, or the experience of US soldiers in WWII, Eames was instead inspired

by “recent experience in studying the development of learning the Rhesus monkey.”152

Research into the specific administration of amphetamines to manage learning and

151 Myers, "Education and Rehabilitation," 117.

152 Eames, "Some Neural and Glandular Bases of Learning," 17.

 167

behavioral problems in children – as understood in terms of “attention deficits,” rather

than “hyperkineticism” – began in earnest in the 1970s. The beginning of the line of

research that contributed directly to the development of the ADHD diagnosis in 1980 is

often marked by Virginia Douglas’ paper “Stop, Look, and Listen: The Problem of

Sustained Attention and Impulse Control,” presented at a Canadian conference in

1972.153 By the end of the 1960s and the beginning of the 70s, such developments in

cognitive research begin to filter into these discussions more frequently, though it is not

until the appearance of ADHD in the DSM-III in 1980 that this use of amphetamines to

promote attention in problem students is fully embraced.

Even before this, however, there was an active discourse among educators about

problem students, sub-clinical retardation, MBD, hyperkineticism, and a number of other

terms applied to students who – despite being “rationally” organized according to social

expectations and lacking in any perceptible physiologic disturbance – chronically fail to

attend to the proscribed range of stimuli mandated by the educational system. Thus, the

chemical technology of Ritalin did not solely or directly lead to the establishment of

ADHD as a recognized disorder in US culture. Rather, the discourse of attention and

distraction within education developed independently of attention-promoting chemical

technologies. This discourse – while anything but unanimous in its disposition towards

the use of drugs for educational purposes – nonetheless prepared and made

comprehensible the possibilities that the development of ADHD/Ritalin later made

available.

This chemical technology (itself not new, but newly promoted for this purpose)

comes onto the scene in the midst of an old educational debate – whether it’s better to

153 Virginia Douglas. “Stop, Look, and Listen: The Problem of Sustained Attention and
Impulse Control.” Canadian Journal of Behavioral Science. 4:1972. pg. 259-282.
 168

offer individualized attention to students, or to standardize education for students (a

debate that speaks to the inherent tensions in the very notion of universal education).

This technology shifts the ground of that debate by making a new solution feasible –

standardizing the mental states of students, thus making them fit the expectations of

standardized curricula. Articles from the Journal in the late-1960s and early-70s address

this remarkably frankly, as can be observed even in the articles’ technocentric titles, such

as “Technology Revolutionizes Education” and “Chemotherapy and the Hyperkinetic

Child.”154 Many of these express faith in technology to solve the problems created by

the organizational structure of the educational system. Even within these discussions,

however, many educators advise caution in regard to chemical technology. For example,

authors Estelle Epstein, Nancy Harrington, Judith Meagher, Elisabeth Rowlands, and

Ruth Simons, in their Journal article “Chemotherapy and the Hyperkinetic Child” (1968),

interview a number of educators and review the extant literature on the use of stimulants

to treat hyperkineticism – the diagnostic category that immediately precedes the

development of ADHD, and which many ADHD researchers therefore suggest is

essentially the same condition, differing only in nomenclature. Epstein et al uncover a

growing use of stimulants for this purpose, and speak with a number of educators who

welcome the use of stimulants in the educational environment. At the same time,

Epstein, et al come across educators, researchers, and psychiatrists expressing concerns

that sound remarkably like those expressed by ADHD skeptics in the 1980s and 90s. For

example,

Dr. Richard Curran does not approve of the use of drugs

with over-active children... He feels that often drugs are prescribed
to placated the teachers and/or parents. They are unable to cope

154 Estelle P. Epstein, Nancy D. Harrington, Judith A. Meagher, Elisabeth L. Rowlands,

and Ruth K. Simons. “Chemotherapy and the Hyperkinetic Child” Journal of Education, vol. 151,
no. 2 (Dec. 1968).
 169

with the children, and, therefore, find the calmer child on drugs
much more to their liking.155
Epstein, et al, conclude their article with the following, notably nuanced summary,

organized into four take-away points:

1. The drug most commonly employed in the treatment of hyperkinetic children is

the classification called amphetamine.

2. Experimentation to this date has been more clinical observation rather than

statistical analysis.

3. The long range and side effects have not yet been fully determined...

4. Opinions vary greatly as to the value of using drugs for treating hyperkinetic

children.156
While many of the contributors to the Journal strive for a detached impartiality in

their assessments of chemical technologies in education, as seen in the balanced and

cautious conclusions of Epstein, et al, other contributors make little effort to hide their

concerns. Albert T. Murphy, in “Educational Materials and Individual Psychology”

(1969), for example, was particularly attuned to the wider implications of the debate. In

speaking of the influence of the control technologies on education – personified as a

group of administrational “behavior engineers” – Murphy accurately observes that “the

behavioral engineers...have hopes of managing the learner’s internal environment through

chemical technology.”157 He goes on to predict that, based on current trends, “the

education of impaired children and youth will move toward mass production

procedures.”158 Accordingly:

155 Ibid., 56.

156 Ibid., 58.

157 Albert T. Murphy. “Educational Materials and Individual Psychology,” Journal of

Education, Boston University, vol. 152, no. 1 (Oct. 1969): 59-68. pg. 64
158 Ibid., 60.
 170

The hope of educational engineers or technologists is that

teachers will become behavioral scientists; that they will join the
long file of workers who have used the areas of physics and
mathematics as models – the empiricists; the positivists; the
psychological elementalists, associationists, operationalists, and
behaviorists.159
Further, recognizing the forces of institutional momentum, Murphy anticipates that:

Once...having invested increasingly large sums of money in

technology, educators will feel a strong need to justify the
investments, whatever the education values of such investments
turn out to be.160
In Murphy’s estimation, this situation can only lead to a crisis, culminating in “the

dehumanization of man through science.”161 Consequently, Murphy casts the potential

salvation to this dystopic vision as pedagogical imperative to resist the atomizing forces

of techno-capitalism:

When teachers believe that all changes in functionality

involve the total organism because the organism functions as a
totality; when they stress the importance of context uniqueness of
any event; when they stress the importance of the interdependence
of structure and function, regard motive forces as originating from
within the person...then the change in teacher-functioning wished
for by technologically-oriented educators will be met with
resistance.162
Murphy extends his observations beyond the scope of education, to consider the dramatic

changes to subjectivity such educational decisions entail, and is thus notable for his

anticipation of many of the concerns later raised by posthumanist theorists, discussed

further in chapter 5.

As the next chapter details, those who defend the validity of ADHD and promote

its diagnosis point to attention research from the 1950s and 1960s – such as that reviewed

159 Ibid., 61.

160 Ibid., 60.

161 Ibid., 59.

162 Ibid., 63.

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by Mostofsky, Blum and Adcock, and Crosby and Blatt – as the proto-history of ADHD,

leading incontrovertibly to proof of the diagnosis. But a close analysis of the educational

literature of this period shows that educational theorists were, in fact, drawing very

different conclusions about the import of such research, which was not perceived by them

as the clear beginning of a new direction in education, but rather as the muddled

perpetuation of very old debates. By examining a moment of interpretive flexibility,

before the “black box” was closed on attention deficits, we discover an active debate

about the very nature of attention. What we see is not an evolution in progress, or an
accumulation of knowledge based on an unwavering foundation of first principles, but a

rhetorical contest, the outcomes of which were contingent, open, and unpredictable.
 172

CHAPTER 3

MAKING HISTORY: ADHD ON TRIAL

[The] diagnosis of Attention Deficit Disorder is supported

by a mountain of evidence going back more than 50 years.

--Stephen Mirin, medical director of the American

Psychiatric Association, 9/4/2000

The sharpest of critical perspectives on ADHD considers the diagnosis to be not

only false, but a fraud perpetrated in the interest of corporate profits and/or social control.

This contention found its most concrete expression in a series of five separate lawsuits

filed over the span of a few months in 2000. The suits – filed in Texas, California, New

Jersey, Florida and Puerto Rico – differed in small (and strategic) ways, but they were

each a part of a coordinated legal campaign to bring a class-action lawsuit, collectively

accusing the manufacturers of Ritalin, the American Psychiatric Association and a non-

profit patient advocacy group of conspiring to “manufacture a disease” with overly broad

diagnostic criteria, in order to promote and profit from the increased sale of Ritalin. The

plaintiffs did not succeed in these efforts, however, and the trials ultimately served the

interests of the defendants; the legal confrontation became, instead, an occasion to

challenge the critics of ADHD. Though these lawsuits were unsuccessful, the event of

their filings created an archive that reveals the variety of belief structures vis-a-vis
ADHD, the inherent contradictions therein, and the social processes through which the

legitimacy and authority of different bodies of knowledge are established and challenged.

Additionally, consideration of this archive provides an opportunity to critically address

the popular origin story of ADHD, as it has been presented by ADHD researchers and

advocates. This critical analysis of ADHD origin story, in turn, demonstrates the
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rhetorical value and power of appeals to history, particularly as it relates to contestations

over the social construction of scientific knowledge in late-20th century technoculture.

The Ritalin Lawsuits

The Ritalin lawsuits – as they have come to be known – were spearheaded by

lawyers Richard Scruggs of Pascagoula, Mississippi, and John P. Coale of Washington,

DC, both of whom had been instrumental in winning landmark settlements against

tobacco companies in 1998.1 Scruggs was inspired by Dr. Peter Breggin, a psychiatrist

who writes critically of the state of American psychiatry and its relationship with the

pharmaceutical industry.2 Upon reading his book Talking Back to Ritalin (1998),
Scruggs contacted Breggin and secured him as a medical consultant and expert witness.3

Scruggs and Coale subsequently recruited C. Andrew Waters and Peter Kraus to the legal

team, lawyers from Dallas, Texas, who had successfully litigated a number of asbestos-

related class action lawsuits.4

The stated goal of the five lawsuits that collectively comprise the Ritalin lawsuits

was not only monetary compensation, but an injunction on the practice of diagnosing

children with ADHD. While the notion of suing a mental disorder out of existence may

sound incredible, the use of litigation to bring about large-scale institutional change in

this manner is not unprecedented. In terms of mental health practice, a series of lawsuits

1 Castano v. American Tobacco Co., 84 F. 3d 734 - Court of Appeals, 5th Circuit 1996.

2 See Peter Breggin, Toxic Psychiatry (New York: St. Martin’s Press, 1991); The War
Against Children (New York: St. Martin’s Press, 1994).
3 See Thomas B Johnson and Andrea Canter, “Ritalin on Trial: Class Action Lawsuit
Filed Against Drug Company, Psychiatrists and ChADD” National Association of School
Psychiatrists Communiqué, Volume 29, No. 4. http://www.nasponline.org.
4 Bob Van Voris “Ritalin Class Actions: Fast Start, Big Stumble” The National Law
Journal July 27, 2001.
 174

in the 1960s and 70s challenged both the safety of antipsychotic drugs and the

constitutionality of the involuntary administration of them to psychiatric patients, which

led to substantive changes in admitting and treatment practices in mental health

institutions. Subsequently, the psychiatric survivors’ movement in the 1980s continued

to use litigation as a means of further establishing a patient’s right to refuse medication

and controversial psychiatric practices like electroshock therapy.5 Throughout the 1980s

and 90s, concurrent class-action litigation played a significant role in the discontinuation

of the industrial use of asbestos. Scruggs and Coale successfully employed a similar

class-action strategy of litigation against Big Tobacco companies in the late 1990s,

dealing a significant blow to the power, respectability, and profits of the tobacco industry.

The legal team behind the Ritalin lawsuits hoped that this strategy of legal and

engagement with the pharmaco-psychiatric complex could ultimately discredit the

ADHD diagnosis altogether, and discourage the industry from marketing drugs in such a

manner in the future. This goal of social change is evident in the legal strategy employed

by these lawyers, as well as in their public statements. As a presiding judge pointed out

in the summary of one of the cases, “One of the Plaintiff’s lawyers here is quoted as

saying ‘We’re going to make it very, very costly for any company to make a profit off of

this. It’s going to be very, very expensive to prescribe Ritalin from now on.’”6 As Coale

was quoted as saying in the course of a fail 1987 lawsuit against the APA, “Our goal is to

put [Ritalin] off the market.”7

5 As discussed in chapter 1 of this dissertation.

6 Vess et al v. Ciba-Geigy Corp USA et al 00-CV-1839-B, US District Court, Southern

District of California (San Diego).
7 http://www.pbs.org/wgbh/pages/frontline/shows/medicating/backlash/lawsuits.html
 175

Though the Ritalin lawsuits required the combined motivations and efforts of

multiple parties working in concert – including those diagnosed with ADHD or the

parents/guardians of children diagnosed with ADHD – the role of the legal team in such

an endeavor is especially significant. The design and scope of this proposed suit, and the

courtroom strategy that was specifically adopted, necessitated the efforts of career

lawyers working across several states, and would not have been possible without a legal

team motivated to bring about the desired social changes at stake. Furthermore, the

identity and motivations of the legal team became issues both in the Court and in the
media coverage of the cases. And, ultimately, it was the actions of the legal team, more

so than the underlying merits of the complaints of the plaintiffs, that caused the suits to

fail.

But, however critical the role of legal counsel, these cases would not have been

possible with the aggrieved plaintiffs who brought suit. To clarify their role, first let us

clarify the protocols of class-action litigation. In order to file a class-action suit, an

individual or several individuals (subsequently distinguished as the “named plaintiffs”)

must initially file a lawsuit in their own name on behalf of a larger group of similarly

aggrieved individuals. Once the initiating suit is successfully filed (e.g., has successfully

survived any of the defendants’ objections or motions to have the case dismissed), the

plaintiffs must then file a motion asking the Court to certify the proposed group of

plaintiffs as a class – a consideration which carries its own set of criteria. In this
instance, the lawsuits failed to proceed past the initial pleading stage, not even reaching

the motion for class certification. So, while the plaintiffs involved in the proposed class-

action may have potentially included thousands of individuals, the lawsuits that were

filed were limited to the handful of named plaintiffs working with lawyers in four

different states and a US territory. These people were either the parents of children

diagnosed with ADHD, or persons who themselves were diagnosed with ADHD, and
 176

who initially participated in the process of ADHD diagnosis and treatment with Ritalin –

but later came to feel they had been deceived, cheated, and exposed to unnecessary risks

for the sake of someone else’s profit.

In addition to the lawyers and those directly aggrieved by the defendants, the

plaintiffs’ legal team included consultants and expert witnesses like Peter Breggin. As a

longtime and outspoken critic of psychiatric pharmacy, his participation in these lawsuits

provided an opportunity to promote his own efforts to foster social change. As a

psychiatrist who challenges the accepted positions of mainstream psychiatry, Breggin

continues the tradition of 1960s antipsychiatrists like Thomas Szasz, David Cooper, and

R.D. Laing.8 At the same time, Breggin’s work is distinct from the antipsychiatry of the

1960s and 70s because the bulk of his high profile work has been written in the era of

diagnostic psychiatry, following the diagnostic turn in 1980. This context led Breggin to

be especially critical of the diagnostic and pharmaceutical regime.9 Though Breggin is

himself a controversial figure, and the tone of his work is particularly strident, he is

nonetheless representative of a growing number of critics of diagnostic psychiatry,

notably, Thomas Szasz, whose critiques are increasingly focused on the pharmaceutical

industry.10 Starting in the mid-1990s, this group had been pushing back against trends in

8 David Cooper, Psychiatry and Antipsychiatry (London: Tavistock, 1967); R.D. Laing,
The Divided Self: An Existential Study in Sanity and Madness. (Harmondsworth: Penguin, 1960);
Szasz, The Myth of Mental Illness.
9 There is significant cross-over between antipsychiatry of the 1960s and 70s and the
critics of diagnostic psychiatry. For example, the administration of antipsychotics like Thorazine
was a significant issue for antipsychiatrists, and it continues to be an issue for Breggin. However,
Breggin’s work is especially focused on pharmaceutical practices, with far less attention to issues
of confinement, institutional coercion, or other controversial psychiatric therapies like
electroshock. Accordingly, his work primarily addresses psychiatric consumers (and potential
consumers) in the book-buying public, and is less concerned with advocating on the behalf of
individuals institutionalized in psychiatric hospitals.
10 Thomas Szasz, The Medicalization of Everyday Life (Syracuse, NY: Syracuse
University Press, 2007).
 177

pharmacological use and mood disorder diagnostic practices generally, and ADHD

specifically.

First Case Filed

The first of these five lawsuits was filed in Texas. In May 2000, three Texas

parents filed suit on behalf of all parents of children diagnosed with ADHD. The parents

– Maria Hernandez, Miguel Hernandez, and Heather Butler – accused three parties of

conspiring to commit fraud: the Novartis Pharmaceuticals Corporation,11 the American

Psychiatric Association (APA), and a non-profit organization called Children and Adults

with Attention Deficit Disorder (ChADD). Novartis was identified as the exclusive or

primary manufacturer12 of methylphenidate, under the brand name Ritalin, since 1955,
profiting from a huge increase in sales during the 1980s.13 The APA was identified as

the publisher of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the

primary diagnostic reference book used by health professionals across the country, which

has included the diagnosis of ADHD since the publication of its third edition (DSM-III)

in 1980.14 The advocacy group ChADD – formed in 1989 by parents of children

diagnosed with ADHD15 – is identified as being responsible for promoting the diagnostic

11 The suit initially named CIBA-Geigy Corporation USA as the manufacturer of Ritalin.
However, as a point of order in the legal proceedings, this was amended to Novartis, which is the
successor corporation to CIBA-Geigy, formed in 1996 through a merger with Sandoz
Pharmaceuticals.
12 The exclusive patent on Ritalin expired in 1970, at which point generic and competing
brands of methylphenidate also became available.
13 William Schmidt, “Sales of Drugs Are Soaring for Treatment of Hyperactivity” New
York Times, May 5, 1987
14 Though in the DSM-III, the diagnosis was identified as Attention Deficit Disorder
(ADD); later editions modified this title to Attention Deficit/Hyperactivity Disorder (ADHD).
This shift in nomenclature is practically inconsequential to discussion at hand.
15 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and
Treatment, 32.
 178

category of ADHD among educators and parents. The suit alleges that the defendants

"planned, conspired, and colluded to create, develop and promote the diagnosis of [ADD]

in a highly successful effort to increase the market for its product Ritalin." As the

presiding Judge Hilda G. Tagle paraphrased in the case summary: "In short, the suit

alleges that ADHD is being promoted in order to make money."16 In their complaint, the

plaintiffs cite the inclusion of Novartis representatives in the drafting process of the

DSM-III, together with undisclosed financial contributions made by Novartis to both the

APA and ChADD, as evidence of the unfair influence the company maintains in the

health care market, amounting to misrepresentation and fraud. The plaintiffs further

claimed that Novartis failed to inform consumers about both the lack of long-term

efficacy and the significant health risks of Ritalin. The plaintiffs sought compensation

for monetary damage, as well as damages for physical injury incurred from taking

Ritalin, allowing parents of children diagnosed with ADHD who had purchased Ritalin to

benefit from any remuneration resulting from the suit, even if they themselves had not

taken the stimulant drug.

The plaintiffs in this case were represented by Dallas lawyers C. Andrew Waters

and Peter Kraus, in consultation with Richard Scruggs. Upon filing this suit, lawyers

Waters and Kraus began soliciting plaintiffs to join the proposed class-action lawsuit. To

this end, they established a website under the URL “ritalinfraud.com.” The text of the

single-page website states the conspiracy and fraud allegations of the complaint,

identifies Dr. Peter Breggin as a consulting physician, lists an exhaustive array of 46

possible side effects of Ritalin, and solicits information from aggrieved parties interested

in joining the class-action suit.17 Dr. Breggin concurrently published his own press

16 Hernandez, et al v. CIBA-Geigy Corp USA, et al.

17 This page, as it was originally published, is now accessible only through internet
archive services: http://web.archive.org/web/20010305071938/www.ritalinfraud.com/default.htm
 179

release on the internet, denouncing ADHD as a fraud and encouraging individuals

affected by it to contact Waters and Kraus.18

While the allegations put forth on ritalinfraud.com and accompanying web

documents were neither novel nor unique (bearing more than a little resemblance to the

claims of the antipsychiatry movement of the 1960s and 70s), their re-presentation at this

historical moment and in this format garnered new attention, partly by virtue of the

rapidly developing internet and its expanding use as a means of mass communication and

social networking at the turn of the 21st century. These allegations of fraud drew

significantly more attention when, just three months after the filings of Hernandez v.

CIBA-Geigy, similar class action suits were filed in New Jersey and California, followed

shortly thereafter by suits in Florida and Puerto Rico.19 The concurrent legal actions
were reported in a number of national publications, such as The New York Times, The

Wall Street Journal and The Washington Post, as well as in psychiatric, medical and legal

journals around the country. The high profile of the lawyers involved, having defeated

Big Tobacco just two years earlier, contributed to the notoriety of the lawsuits.

Most of the larger media outlets were cautiously reserved in their speculation of

the potential ramifications of the suits, citing previous legal actions against ADHD

and http://www.royalrife.com/ritalinfraud.html. The text of this page, however, is widely quoted

and/or embedded in a number of other websites, granting it a life on the Internet beyond the
retirement of the original URL. In multiple discussions, the text is mistaken for (or
misrepresented as) a current or ongoing class-action lawsuit, bolstering popular skepticism of
ADHD. For example, the text is reproduced on
http://www.unsolvedmysteries.com/usm116009.html. Additionally, ritalinfraud.net is still
maintained by Fred Baughman.
18 This page, as it was originally published, is now accessible only through Internet
archive services. It is also reproduced on a number of sites, such as: http://www.add-
free.com/ritalinsuit.html
19 Jill Krueger, “Ritalin Catches Attention of Florida Parents.” Orlando Business
Journal, Dec. 11, 2000.
 180

diagnostic practices that had failed.20 Professional and trade publications within the

psychiatric industry reported on the claims of the lawsuits with interest and predictable

derision. A few other journalists, however, were more dramatic in their presentation of

the case at hand, in some cases revealing their own critical perspectives on ADHD or the

psychiatric industry as a whole. In this way, the lawsuit became an opportunity to

publicly rehearse both critiques and defenses of ADHD – which, considering the

lawsuits’ ultimate failure, may be the most significant contribution to the public debate

about ADHD to arise out of the Ritalin lawsuits.

Some journalistic responses lauded the suit, among them “Writing May Be on

Wall for Ritalin,” by self-styled investigative journalist Kelly Patricia O’Meara,21 which
appeared on October 16th, 2000, in Insight Magazine, a conservative-leaning (and now

defunct) sister publication of The Washington Times. O’Meara reports on the filing of

the lawsuits and goes on to speculate that in order to respond to the accusations of fraud

and conspiracy, Novartis and the APA would have to present scientific evidence

supporting the legitimacy of ADHD:

...if the beating the tobacco industry took at the hands of

these attorneys is any indication of what the defendants should
anticipate, the psychiatric community, pharmaceutical industry and
mental-health advocacy groups finally may be called upon to put
their science where their mouths are...To fight the claim...the

20 John Coale had attempted a series of class action lawsuits in 1987 that had ultimately
failed. Those suits, however, aimed at school boards and individual doctors who promoted the
use of Ritalin, and did not identify Novartis as a co-conspirator. By including Novartis in the
2000 lawsuit, Coale had identified a defendant with enough financial power to render a sizable
settlement, if successful.
21 I characterize O’Meara as a “self-styled” investigative journalist because her
publication history is relatively scant, limited to a small number of second-tier publications, and
almost entirely dedicated to the single issue of psychiatric skepticism. Furthermore, the capstone
to her career is a self-published book (Psyched Out: How Psychiatry Sells Mental Illness and
Pushes Pills That Kill, 2007), and she has recently made appearances in forums of questionable
journalistic integrity, such as the conspiracy theory-laden radio and web broadcast, The Alex
Jones Show.
 181

APA...will be required to cough up its medical and scientific data

to support the...ADHD diagnosis. This may be difficult given the
growing number of physicians, scientists and even psychiatrists
who long have argued that the diagnosis...is not based in science –
that the diagnosis is a fraud based on subjective assessments. 22
Any failure to do this, O’Meara contends, would not only cause the pharmaceutical

company to lose the case and be forced to pay out billions of dollars to consumers, it

would also publicly blow the lid off the alleged ADHD conspiracy, vindicating critics

such as Peter Breggin and perhaps heralding an end to the controversial trend of routinely

medicating schoolchildren: “The reverberations through the pharmaceutical industry

could be devastating.”23 O’Meara’s article gives voice to the goal of the lawsuits,

though in hindsight its rhetoric seems a bit breathless and premature. In spite of this,

O’Meara’s article is frequently reposted and embedded on different sites around the

internet, and continues to be cited as a source among skeptics of ADHD.24

Of course, Novartis and the APA responded to the allegations of the lawsuits in

their own press releases, dismissing them as “ludicrous and totally false,”25 going on to

argue that “Ritalin has been used safely and effectively in the treatment of millions of

ADHD patients for over 40 years, and is the most studied drug prescribed for the

disorder.”26 Speaking on behalf of the APA in an ABC interview, Dr. Steven Mirin,

medical director of the APA from 1997-2002, asserted that “the diagnosis of attention

deficit disorder is supported by a mountain of evidence going back more than 50

22 Kelly Patricia O’Meara, “Writing May Be on Wall for Ritalin” (www.insightmag.com,

Oct. 16, 2000).
23 Ibid.

24 For instance, at: http://www.chappellhealth.com/special-needs-children/add-

adhd/writing-may-be-on-wall-for-ritalin-2/
25 Richard B. Schmitt, “Lawyers Allege Maker of Ritalin, Psychiatric Group ‘Created’
Disease,” The Wall Street Journal, September 14, 2000.
26 Ibid.
 182

years.”27 To defend the APA against allegations of fraud, Mirin defended the validity of

the ADHD diagnosis. Specifically, Mirin appealed to the rhetorical power of history,

alluding to a medical archive of evidence accumulating since sometime before 1950. If

the defendants could present this history alluded to by Mirin in a court of law, it would

render the charge of conspiracy incredible, if not impossible. A history of more than 50

years would locate the origins of ADHD before the establishment of Ritalin as a brand in

1955. This would make it impossible, then, for ADHD to have been invented in order to

boost sales of Ritalin, as the brand name Ritalin did not yet exist. Thus, the defendants

directly attacked the logic of the conspiracy charge. The defendants could not have

conspired to invent ADHD to sell Ritalin, if ADHD was invented before Ritalin.

This appeal to the history of ADHD was the same defense eagerly offered by

Novartis and the APA to the “court of public opinion” through industry press releases to

the media outlets. In front of judges in courtrooms in Texas, California, and New Jersey,

however, the defendants followed a different legal strategy, which ultimately allowed

them to avoid presenting a defense of any kind. Before Novartis, the APA or ChADD

was forced to respond to the charges against them, the defense attorneys for all three

accused organizations, in all five lawsuits, moved to have the cases dismissed, citing a

failure of the plaintiffs to comply with several Federal Rules of Civil Procedure that

apply to class actions and allegations of fraud. This prompted a series of legal exchanges

between the plaintiffs and the Court in an effort to remedy their claims to the Court’s

satisfaction. While the results of these exchanges differed in each case, none of the

lawsuits made it to trial.

27 John McKenzie, “Conspiracy Theory Suits Filed Against Ritalin Manufacturer,

Doctors” 9/4/2000.
http://more.abcnews.go.com/onair/worldnewstonight/wnt000914_ritalinsuit_feature.html
 183

Ultimately, the Ritalin lawsuits failed in the legal technicalities of the filing

process, before the Court had the opportunity to judge the substance of the complaint or

the defense. Thus, on one hand, the results of the trial cannot be easily read as a

judgment of the substance of the plaintiffs’ argument, or of the defendants’ response. On

the other hand, neither should the judgment granting the defendants' motion to dismiss be

perceived as merely a legal technicality, unrelated to the merits of the conspiracy charge;

rather, as a detailed analysis reveals, this outcome is directly related to the substance of

the case.

First Ruling Returned: Federal Rules of Civil Procedure

9(b) & 12(b)(6)

Though the first of the lawsuits to be filed was Hernandez, et al v. CIBA-Geigy

Corp USA, et al in Texas, the first judgment to be returned was from the California suit,

Vess, et al v. Ciba-Geigy Corp. USA, et al, decided on April 26, 2001.28 The plaintiff

bringing this suit was San Diego resident Todd D. Vess. Just 15 years old at the time of

filing, Vess had been diagnosed as having ADHD and prescribed Ritalin in 1994, at age

9, and subsequently took Ritalin for an unspecified number of years. The plaintiffs,

represented by Scruggs and Coale, sought financial restitution, punitive damages,

disgorgement of revenues and profits, as well as injunctive relief – meaning, basically, a

“cease and desist” on the prescription of Ritalin to children, if not on the deployment of

the ADHD diagnosis itself.

In response, the defendants immediately moved to dismiss the case before trial,

citing the Federal Rules of Civil Procedure 9(b) and 12 (b)(6). Rule 12(b)(6) pertains to

28 The plaintiffs appealed this initial judgement; final judgment in the case was filed on
April 30, 2001; Vess, et al v. Ciba-Geigy Corp. USA, et al 00-CV-1839, US District Court,
Southern District of California (San Diego).
 184

the process of establishing a class action lawsuit, in which a conventional lawsuit is first

brought by a single party. The party’s claim is accepted as meritorious or dismissed as

frivolous, only after which is a judgment made about granting the class-action status.

Rule 12(b)(6) stipulates four criteria for qualifying for class-action status: the proposed

class must demonstrate commonality of complaint among its members; those complaints

must typify the complaints of its members; the proposed class must be able to adequately

represent the interests of all members; and the class needs to be large enough that

individual lawsuits would be impractical.

While the claim against Rule 12(b)(6) challenges the applicability of class action-

status to the lawsuit, the challenge of Rule 9(b) is a challenge to the underlying lawsuit

itself, and a more fundamental challenge. Federal Rule of Civil Procedure 9(b) states

that, in cases of fraud, "the circumstances constituting fraud or mistake shall be stated

with particularity," including "the nature of the fraud, some details, a brief sketch of how

the fraudulent scheme operated, when and where it occurred, and the participants."29 In

other words, if one alleges that certain parties conspired to commit a crime, one has to

include in one’s allegations a reasonable amount of detail, including exactly what said

parties were conspiring to do, how they intended to accomplish this, who met when and

where to conspire, etc. Rule 9(b) is designed to prevent “fishing expeditions,” a term

which refers to the practice of using the litigation process as a means of investigation.

Such “fishing expeditions” take advantage of the fact that one of the first steps in the

legal process in a fraud suit is to subpoena the records of the defendant as evidence –

referred to as the discovery phase. Thus, a party could conceivably make an entirely

baseless allegation against another party (e.g., a competitor in the marketplace) simply to

gain access to proprietary or otherwise guarded information in order to gain a strategic

29 Ibid.
 185

advantage, either in the marketplace or in subsequent legal battles. Rule 9(b) prevents

this by forcing the plaintiffs to state clearly and specifically the manner in which the

alleged fraud is thought to work. This allows the Court an initial opportunity to evaluate

the merit of the claim, and thereby dismiss any accusations that appear baseless or

frivolous before the discovery phase.

Additionally, in instances in which the Court grants hearing to the plaintiffs’

claims, compliance with Rule 9(b) guides the record acquisition process of the discovery

phase by establishing which and how many of the defendants’ records are germane to the
claim at hand. Circumscribing the scope of discovery through Rule 9(b) both insures that

plaintiffs cannot acquire information beyond the scope of the case at hand, and affords

the accused party a fair opportunity to prepare an appropriate defense. In the case of Vess

v. Ciba-Geigy, the defendants pointed out that, although the plaintiffs claimed that the

organizations misrepresented themselves, the plaintiff failed to identify any particular

instance of this misrepresentation, or provide a single piece of literature that either Todd

Vess or his guardians had encountered that fraudulently led them to participate in the

diagnostic and treatment process. With no material evidence to serve as this piece of the

causal chain of their argument, the plaintiffs could not maintain that they were defrauded

in this manner.

The defendants also invoked California’s “anti-SLAPP” legislation. Similar in

spirit to Rule 9(b), the anti-SLAPP regulations were put in place to discourage abuses of
the litigation process. Specifically, anti-SLAPP regulations address the use of litigation

to quell free speech (SLAPP stands for Strategic Lawsuit Against Public Participation).

These rules create penalties that can be imposed on parties who bring baseless lawsuits as

a means of financially damaging and/or effectively silencing perceived antagonists. The

defendants argued that any of the unspecified statements the plaintiffs could be referring

to as alleged misrepresentations were instances of free and protected speech. Therefore,

 186

if the plaintiff could not demonstrate a reasonable likelihood of prevailing in their claims,

the case should be dismissed, and, as provided for by anti-SLAPP regulations, the legal

costs of the defendants should be assigned to the plaintiff.

The Court acknowledged and concurred with the defendants’ objections to the

plaintiffs’ original complaint. In response, the Court allowed the plaintiffs to amend their

complaint – a common courtesy in such cases.30 However, as presiding Judge Rudi M.

Brewster noted in her summary, the amended complaint failed to provide any of the

details necessary to comply with Rule 9(b). Instead, the plaintiffs argued that the nature

of this particular conspiracy was distinct from common fraud because of its massive

scale, and should therefore not be held to the same rules of civil procedure as a common

fraud case, to the effect that Rule 9(b) should not apply. The plaintiffs further requested

that the Court grant them the right of discovery, at which point their claims could be

stated with more particularity. Finally, they also argued that the anti-SLAPP law should

not be applied in this case, because the plaintiffs represented “the little guy”31 fighting a
large corporation. The plaintiffs argued this situation was not in keeping with the spirit

of anti-SLAPP laws, which were drafted with a mind to keeping wealthy individuals or

capital-rich corporations from silencing the voices of average citizens.

The plaintiffs’ amended complaint lays bare Scruggs’ and Coale’s legal strategy:

in fact, the lack of specificity in the plaintiffs’ claims of misrepresentation was not the

result of an oversight, but of strategic calculation. Had the plaintiffs presented a

particular piece of Novartis or ChADD literature as pivotal to Vess’ decision to

participate in the diagnostic and treatment process, that single piece of literature would

30 J. Gordon Cooney, “Ritalin Class Action Litigation: A Defense Lawyer's

Perspective.” Presented at the American Conference Institute Ritalin Litigation, New York,
03/01/01.
31 http://caselaw.findlaw.com/us-9th-circuit/1213341.html#sthash.JqCBlZmq.dpuf
 187

then be established as a key piece of evidence in the case. This would introduce a new

difficulty for the plaintiffs down the road, due to the particular rules of class-action

litigation, as per the above discussion of Rule 12(b)(6). In order to be a class-action suit,

the conditions of each plaintiff have to be sufficiently similar as to warrant their

aggregation into a class. In this instance, that would mean that each member of the class

would have had to have encountered the same piece of allegedly deceptive literature.

The more specific Vess’ claim, the more difficult it would be to subsequently convert it

into a class action suit.32

The plaintiffs’ amendment to their initial claim further makes clear that, as per

their strategy, the goal of the initial phase of litigation – in which conspiracy claims were

made without particularity – was simply to get to the discovery phase, at which point the

plaintiffs could gain access to the material that would eventually serve as the substantive

base of their claims. This strategy had worked brilliantly in Scruggs’ and Coale’s Big

Tobacco case, Costana v. American Tobacco Company, in which the initial conspiracy

claims were judged just plausible enough to allow access to internal documents,

whereupon several pieces of “smoking gun” evidence were uncovered and subsequently

wielded against the tobacco companies.33 Undoubtedly, the defendants’ legal team was
cognizant of this; by moving to dismiss the case based on Rule 9(b), this is exactly the

strategy that the defendants sought to forestall.

Despite the success this strategy yielded in the Big Tobacco cases, however, in

this instance, the Court was not impressed with the arguments presented in the plaintiffs’

32 Cooney, “Ritalin Class-Action Litigation.”

33 Cooney, “Ritalin Class-Action Litigation;” Castano v. American Tobacco Co.; Peter

Pringle, ”The chronicles of tobacco: an account of the forces that brought the tobacco industry to
the negotiating table.” (Symposium: Tobacco Regulation: The Convergence of Law, Medicine &
Public Health). William Mitchell Law Review. Vol. 25 No. 2 (Spring1999): 387-395.
 188

amended claim. Citing precedent in a series of cases, the Court dismissed the case.

Moreover, it dismissed the case with prejudice – meaning that the lawsuit could not be

brought again later. In addition, as provided for by anti-SLAPP legislation, all court

costs were assigned to the plaintiffs.34

Second Ruling Returned

Hernandez v. Ciba-Geigy was the next of the five lawsuits to be decided, with

presiding Judge Hilda Tagle ruling on May 17, 2001. At the same time that proceedings

had been going on in California, the defendants in Texas had also moved to dismiss,

citing the same Federal Rules of Procedure cited in Vess v. Ciba-Geigy. In response to

the defendants’ citation of Fed. R. Civ. P. 9(b), the plaintiffs in Hernandez v. Ciba-Geigy

filed a series of motions in an effort to clarify their allegations to the Court's satisfaction

in regard to particularity. In the course of this exchange, the Court raised several

concerns, but the most consequential of these was the scope of the accusation against the

defendants. As Judge Hilda Tagle writes in the summary of the Court's ruling on

Hernandez, et al v. CIBA-Geigy Corp USA, et al:

In their initial complaint, plaintiffs hinted ambiguously that

ADD and ADHD were complete fictions and that Ritalin® was
completely useless. Given that suggestion, it was not clear that
plaintiffs needed to allege that their own children were
misdiagnosed and mistreated; the entire premise of their case was
presumably that every child diagnosed with ADD/ADHD and
treated with Ritalin® was misdiagnosed and mistreated.35
To clarify this point, she added:

...the Court pointed out the marked difference between a

fraud theory based on the nonexistence of Attention Deficit

34 Vess subsequently appealed, and got the SLAPP fines waved as per Novartis, though
was still required to pay the legal fees of the APA and CHADD.
35 Hernandez, et al v. CIBA-Geigy Corp USA, et al, U.S. District Court, Southern
District of Texas (Brownsville) Civil No. B-00-082, filed Dec. 15, 2000, p. 13, italics in original.
 189

Disorder...and a fraud theory based on over-generalized criteria for

diagnosing ADD/ADHD.36
The Court had asked the plaintiffs specifically to clarify themselves on this distinction,

and the plaintiffs’ lawyers had responded:

...the thrust of our case is that we do not deny that there are
a small – what we believe to be a smaller or much smaller number
of children who have a serious problem, a smaller subset of whom
can be appropriately treated with methylphenidate.37

In summary, therefore, Judge Tagle clarifies that the “plaintiffs have

acknowledged that ADD/ADHD exists and that Ritalin is an appropriate treatment, at

least for some children.”38 From this, she then goes on to conclude that

The Plaintiffs have jettisoned their fraud theory based on

the nonexistence of ADD/ADHD, and instead characterize this suit
as concerning the overbroad criteria used to reach a diagnosis of
ADD/ADHD in the DSM.39
This was a perfectly appropriate clarification for the Court to demand, because this is the

primary distinction distinguishing the various critics of ADHD. Each theory would rely

on the research of different physicians and scholars, would implicate different parties in

different capacities, and would require an entirely different response from the

defendants.40

36 Hernandez, et al v. CIBA-Geigy Corp USA, et al, U.S. District Court, Southern

District of Texas (Brownsville) Docket # 2000-05-1888-D [71-1] pg. 3-4
37 Hernandez, et al v. CIBA-Geigy Corp USA, et al, U.S. District Court, Southern
District of Texas (Brownsville) Civil No. B-00-082, filed Dec. 15, 2000, pg. 12, italics in original
38 Hernandez, et al v. CIBA-Geigy Corp USA, et al, U.S. District Court, Southern
District of Texas (Brownsville) Civil No. B-00-082, filed Dec. 15, 2000, pg. 13
39 Hernandez, et al v. CIBA-Geigy Corp USA, et al, U.S. District Court, Southern
District of Texas (Brownsville) Docket # 2000-05-1888-D [71-1] pg. 5
40 This distinction is relevant to the larger goals of this dissertation. In this observation
Judge Tagle was observing two distinct criticisms of ADHD that critics of the diagnostic category
often fail to separate or understand as logically incompatible. Refer to the differential diagnostic
chart I have provided in my introduction.
 190

One might assume that the plaintiffs would have opted to pursue the more

sweeping of these two fraud theories laid out by the court. Certainly, the confrontational

rhetoric Waters and Kraus deployed in their press releases, and in web documents such as

ritalinfraud.com, would seem to communicate their intention to pursue the “nonexistence

theory,” rather than the “over-generalized theory.” More important, key elements of

Scruggs’ and Coale’s overall legal strategy – such as the securing of Peter Breggin as an

expert witness – appear to be “based on the nonexistence of Attention Deficit Disorder.”

Breggin's wide-ranging work, including Toxic Psychiatry, Brain Disabling Treatments in

Psychiatry and The War Against Children, challenged not only the validity of ADHD, but

the validity of most other behavior disorders, the safety and efficacy of psychotropic

drugs in general, and the field of modern psychiatry as a whole. Nevertheless, Waters and

Krauss stopped shy of defending the wholesale rejection of ADHD. In part, the lawyers

had negotiated themselves into this position in the course of their pre-trial exchanges with

the Court. As Judge Tagle pointed out in her summary, part of the problem was that in

the course of the proceedings, "the plaintiffs admitted that some children can be

appropriately treated with Ritalin."41 On its own, this statement hardly seems

controversial; however, it was the beginning of the end of the plaintiffs’ case. Based on

this statement, the Court concluded that "it is uncontested by the Parties that a subset of

children does exist who can be effectively treated with Ritalin."42 Following this

exchange, the “nonexistence of ADHD” was abandoned in the plaintiffs’ subsequent

amendments to their complaint.

A series of consequences follows from this outcome. Had the nonexistence

theory of fraud been pursued, the conspirators could have been constrained to the parties

41 Ibid.

42 Ibid., 4.
 191

named in the lawsuit, and all others involved in the diagnostic process (including those

diagnosed with ADHD and their guardians, diagnosing physicians, and individual

pharmacists) would be victims of fraud, and as such, absolved of responsibility.

However, in the over-diagnosis theory of fraud, some individuals diagnosed with ADHD

might be the victims of fraud, while others would not be – a distinction which already

begins to threaten the integrity of the proposed class, as per the stipulations of Federal

Rule 12(6)(b). Moreover, the overdiagnosis theory of fraud shifts the site of alleged

fraud away from the exclusive domain of the named defendants, and towards the moment
of diagnosis for each individual. This diagnosis, while perhaps structured by institutional

technologies like the DSM, is nonetheless realized by individual physicians, whose

judgment is, necessarily, the final arbiter in the diagnostic process. Pursuit of this theory

would therefore require the additional deposition of individual physicians, testifying to

their reliance on allegedly over-broad criteria provided by the APA through the DSM. In

addition to once again challenging the integrity of the proposed class as per Rule

12(6)(b), the over-diagnosis theory shifts the debate from one of overt deception to one of

legitimate demarcation between categories of “normal” and “deficient” along a spectrum

of continuously distributed traits. The precise location of those boundaries is a matter of

legitimate professional dispute, but is less convincingly a case to be decided upon by the

Court.

It should not be surprising that the Court cited the uncontested efficacy of Ritalin
as it ruled out the charge that ADHD does not exist. The logic the Court used was quite

popular and is still commonly deployed by ADHD experts. Novartis' public statement in

response to the class action suits relied on this logic as well, coupling it with an appeal to
 192

history that mirrors the statements of the APA: "Ritalin has been used safely and

effectively in the treatment of millions of ADHD patients for over 40 years."43

Despite the inherent flaws in this logic, the efficacy of Ritalin was nonetheless

taken by the Court as evidence of ADHD, which went uncontested by the plaintiffs’

lawyers. In response, the plaintiffs amended their complaint to allege that Novartis,

ChADD and the APA conspired to commit fraud not by creating a fictional disorder, but

by making the diagnostic criteria for a bona fide disorder overly broad, thereby leading to

large numbers of "normal" children being mistakenly diagnosed with ADHD, and

unnecessarily medicated with Ritalin.

Upon filing this amendment, the defendants again moved to dismiss the case,

again based on a lack of particularity as required by Fed. R. Civ. P. 9(b). At this point the

flaws in the plaintiffs' case become more evident. Rule 9(b) requires the plaintiffs to

describe how this conspiracy worked to cause them harm. The plaintiffs argued that

Novartis colluded with the APA by participating in the drafting of the DSM-III, the DSM-

III-R and the DSM-IV, for which the APA was financially rewarded by Novartis. As a

result, the diagnostic criteria represented in the APA's publication were stacked in the

favor of over-prescribing Novartis' product, Ritalin. However, as the Court pointed out

in its response, "the Plaintiffs fail to plead an essential link in the causal chain which

would connect the DSM to any misdiagnosis and subsequent Ritalin prescription."44 In

other words, because Ritalin is a prescription drug, there is an intermediary between

Novartis and Hernandez, et al.: "It is the treating physician who diagnoses ADD/ADHD

43 Ken Hausman, “Parents Accuse APA, Novartis of Conspiracy Over Ritalin Sales”
(American Psychiatric Association, Aug. 4, 2000; http://www.psych.org/pnews/00-08-
04/parents.html)
44 Hernandez, et al v. CIBA-Geigy Corp USA, et al, U.S. District Court, Southern
District of Texas (Brownsville) Docket # 2000-05-1888-D [71-1], pg. 10
 193

and prescribes Ritalin, yet the Plaintiffs do not identify a single treating physician."45 In

order for the conspiracy charge to hold up, the plaintiffs would have to identify the

diagnosing physician, and the physician, in turn, would have to have testified that he

relied on the diagnostic criteria presented in the DSM in making his or her diagnosis.

Without this testimony, the Court had no evidence of a link between the plaintiffs and the

APA or Novartis. On these grounds, the case was dismissed.46

Had the plaintiffs identified a diagnosing physician in their complaint and

satisfied the Court's request for particularity, they would still have had a lot to prove. No

doubt, the defendants would have tried to discredit that physician, emphasizing that

responsibility for competent diagnosis rests on the physician, not the sources from which

he or she gathers his or her information. Furthermore, a different physician would be

implicated for every individual participating in the class action suit. In such an instance,

the defendants would be able to cite a failure to comply Fed R. Civ. P. 12(6)(b), which

necessitates that the plaintiffs demonstrate that class-action is an appropriate legal

strategy for the pursuit of the redress at hand. If each individual claimant is required to

demonstrate the chain of causation as it relates to their circumstances, then the case

devolves into a series of individual suits, and is therefore inappropriate to pursue as a

class-action.

45 Ibid., 11.

46 The Court cited several other shortcomings in the Plaintiff's complaint, though they
were all of this nature, and failure to comply with Fed. R. Civ. P. 9(b) was clearly the most
crippling to the case.
 194

The Remaining Cases

Shortly after the second lawsuit was dismissed, the lawsuits in Florida and Puerto

Rico were all pulled voluntarily by the plaintiffs.47 By pulling the cases voluntarily once

the legal strategy being employed had failed in the other two cases, the plaintiffs avoided

being saddled with further legal fees as well as the possibility of having the case

dismissed with prejudice, which would bar the plaintiffs from bringing a similar suit at

any time in the future.

The final case, Dawson v. Ciba-Geigy in New Jersey, took longer to resolve.48

Having failed to get any of the previous lawsuits off the ground, the legal team now

concentrated on this case, moving through several strategies in an attempt to get beyond

the hurdles that had tripped them up so far. Up to this point, variations in state law had

allowed the lawyers to approach the suit in subtly different terms, in order to hopefully

break through to a discovery phase in one venue or another. With that luxury gone, the

plaintiffs made great efforts, as Court documents demonstrate, to try to avoid being

subject to Fed. Rule Civ. P. 9(b), changing the basis of the claim several times and

making several novel arguments in an effort to get past the plea stage and on to the

discovery phase. None of these strategies were effective, however, and ultimately the

plaintiffs withdrew the case in New Jersey before the Court could issue a final ruling.49

47 “Florida Becomes Third State to Witness End of Ritalin Suit” Psychiatric News
August 17, 2001; “Another Group of Plaintiffs Drop Ritalin Lawsuit.” Psychiatric News
September 21, 2001.
48 Dawson et. al. v. Ciba-Geigy Corp USA et. al., 00-CV-6162, US District Court for the
District of New Jersey (Hackensack) docket # 8911.
49 Ken Hausman, “Last of Ritalin-Based Lawsuits Against APA Comes to a Close.”
Psychiatric News, April 5, 2002.
 195

Aftermath of the Ritalin Lawsuits

It is ironic that the plaintiffs’ legal strategy was dismissed for a lack of

particularity, because it is exactly a lack of particularity in the concept of ADHD that

inspired the lawsuit. Had the plaintiffs gotten through to the discovery phase, perhaps the

case would have resolved as Kelly O’Meara had eagerly prognosticated. But, in the U.S.

legal system, individuals are put on trial and held accountable for their actions, not

hypothetical constructs. The use of Fed. R. Civ. P. 9(b) was not just a shrewd legal tactic;

it gets to the heart of the issue at hand. How many people were involved in this

conspiracy to commit fraud, if there is one? How could all of these people ever actually

be identified and held responsible? As Dr. Steven Mirin pointed out to the press, the

DSM has been "developed through an open process involving more than 1,000 nationally

and internationally known researchers and clinicians drawn from a wide range of mental

and general health fields."50

The conclusion of the Ritalin lawsuits received much less attention in the press

than had their commencement. This is perhaps unsurprising, considering each lawsuit

ended in a dismissal or withdrawal, rather than a more decisive verdict of “guilty” or

“innocent.” Pre-trial dismissals also preclude any exciting or controversial courtroom

testimony. Further, the long, slow process of amendments and appeals dragged out

longer than the attention span of most media outlets. The notable exception to this was in

professional journals and news sources with a vested interest in the lawsuits. For

example, in Psychiatric News, journalist Ken Hausman reported on the lawsuits’

conclusion, including an interview with then-APA president Richard Harding. Harding

spoke of his satisfaction with the outcome:

50 Hausman, http://www.psych.org/pnews/00-08-04/parents.html.
 196

It is very gratifying to see our judicial system work. Once

the facts were brought into the open, there was no doubt about
what the eventual outcome of these cases would be....While the
whole episode was a tremendous waste of time, money, and
resources for all the parties, we made it clear from the beginning
that APA would do whatever was necessary to defend the scientific
basis of diagnostic nomenclature, our profession’s freedom to
choose appropriate treatments for the patients we serve, and
vigorously take on those who oppose these principles in the court
and in the court of public opinion....The medical profession never
stands taller than when it refuses to allow a court to modify or ban
a proven medical intervention for a proven medical disorder.51
Irrespective of one’s position on ADHD, it is quite a stretch to characterize the outcome

of the Ritalin lawsuits as Harding does, as the conclusion of a debate in which “facts

were brought into the open” that demonstrated the “scientific basis of diagnostic

nomenclature.” Rather than standing or falling on the merits of any claims, the Ritalin

lawsuits failed because the legal strategy that drove them failed. That strategy was a kind

of bluff – the plaintiffs felt so certain that the pharmaceutical industry held no cards that

they tried to force the defendants to show their hand. The plaintiffs made the mistake of

presuming that the perceived righteousness of their cause would prevail on principle.

Thus, they deluded themselves into proceeding in spite of obvious procedural flaws in

their case.

Following the dismissal of the lawsuits, Breggin went on to testify against the

validity of ADHD as part of a Congressional hearing the following year, along with

fellow skeptic and author of self-published book The ADHD Fraud: How Psychiatry

Makes “Patients” of Normal Children (2006), Fred Baughman. Breggin has served as an

expert witness in a number of other lawsuits against pharmaceutical companies.

Famously, in the course of Breggin’s involvement in a protracted legal battle with Eli

Lilly, starting in 1994, over the potentially suicidal/homicidal effects of Prozac, the legal

51 Hausman, Ken. “Last of Ritalin-Based Lawsuits Against APA Comes to a Close.”

Psychiatric News, April 5, 2002.
 197

team representing Eli Lilly aggressively attacked Breggin’s credibility and integrity, both

inside the courtroom as well as publically, in a PR campaign that characterized Breggin

as a Scientologist. Because the Church of Scientology is dispositionally antagonistic to

psychiatry as a whole (as discussed further in chapter 4), associating Breggin with the

Church was intended to suggest that his antipsychiatric testimony was not representative

of scientific conclusions or professional opinion, but of irrational religious conviction.

Rhetorically, this strategy characterized the conflict as one of science – as represented by

Eli Lilly – against religion and superstition, recapitulating the apocryphal tales that
typically serve as the starting point of traditional histories of science.52 While Breggin

concedes openly that he had worked with the church of Scientology on psychiatric reform

projects between 1972 and 1974, he had also publicly denounced the organization as a

cult in an open letter published in Reason magazine in 1975, and discontinued any further

contact with the Church.53 Despite Breggin’s protestations, the Scientology label stuck

with Breggin through the duration of the Ritalin lawsuits, serving the purpose Eli Lilly’s

legal team hoped it would.

52 Often referencing the Catholic Church’s opposition to Copernicus, Galileo, and the
heliocentric model of the solar system in general, these narratives cast religion as inherently
dogmatic and oppressive, while “science” is celebrated as unerringly rational and liberating.
Much like the origin story of ADHD advocated by Barkley, Hallowell, et al, this origin story of
science serves the ideological interests of a scientistic worldview by placing the origins of
modern science further back in antiquity than may be justified (modern science may more
reasonably trace its beginnings back the mid-19th century, rather than the early-17th), artificially
polarizing the positions of the parties involved (the Catholic church presented not only dogma in
defending the geocentric model of the solar system, but also rational argument and
experimentation), obscures the complexity of social relations underlying the conflict (including
Galileo’s own public and personally antagonist actions against Pope Urban VIII, and internal
Vatican pressures to publicly address the growing number of “heretics”), and ignores even earlier
precedents that complicate the notion of historic “origins” altogether (such as the existence of
heliocentric models of the solar system in Greek and even Mesopotamian civilizations).
53 Peter Breggin, “Joe McCarthy Lives!: He’s Whispering in the Ear of Eli Lilly & Co.,
Manufacturer of Prozac.” Originally published in The Rights Tenet (Autumn 1994) archived:
http://web.archive.org/web/19981201222709/http://www.breggin.com/Joemccarthylives.html
(Last accessed: 4/29/2014).
 198

In fact, Scientology has played a significant role in public perception of the

Ritalin lawsuits since their conclusion, and not only because of Eli Lilly’s accusations

against Peter Breggin. John P. Coale, lawyer for the plaintiffs, was also associated with

the Church of Scientology. In the late-1980s, Coale worked with the notoriously litigious

Church of Scientology, as well as with the Citizens Commission on Human Rights

(CCHR, an antipsychiatry organization founded in 1969 by Thomas Szasz, often

characterized as Scientology front) on a series of unsuccessful anti-Ritalin lawsuits

against the APA and various school districts which had embraced the ADHD
diagnosis.54 Both Coale and Breggin have been asked about the Church’s involvement

with the Ritalin lawsuits, during the proceedings and since their conclusion, and both

have maintained that the Church was not involved. Moreover, both have dismissed any

attempt to bring up the Church of Scientology in connection with the Ritalin lawsuits as a

“red herring” intended to discredit their critical perspective on psychiatry through ad

hominem attack.55

Whatever the actual degree of involvement Scientology had with the Ritalin

lawsuits, the circumstantial association between the lawsuits and the Church of

Scientology’s critical stance vis-a-vis psychiatry in general, and ADHD in particular, has

certainly influenced how the Ritalin lawsuits are now remembered. For the many critics

of Scientology, the connection between the two is a foregone conclusion. A small and

somewhat paranoid community of Scientology watchdogs keep this notion alive on the

internet, where they continuously research the influence of Scientology on a number of

different cultural institutions and “out” influential people as being under the Church’s

sway. Finding connections between Scientology and critics of psychiatry is not difficult.

54 http://www.pbs.org/wgbh/pages/frontline/shows/medicating/backlash/lawsuits.html.

55 http://www.pbs.org/wgbh/pages/frontline/shows/medicating/interviews/breggin.html.
 199

For example, Kelly O’Meara, author of the often-cited “Writing May Be on the Wall for

Ritalin,” has also been associated with the CCHR. While such coincidences may be

innocent, for Scientology critics these connections are themselves reason enough to

dismiss the Ritalin lawsuits. For example, on an internet forum maintained by a group of

pediatricians, a commenter identifying himself as Dan Nussbaum had this to say on May

14, 2000, in response to Peter Breggin’s initial announcement of the Texas lawsuit:

As one who was sued by the Church of Scientology for

perscribing [sic] Ritalin, I feel very comfortable making the
following statement. The whole purpose of the suit is for
publicity. The plaintiffs know they have no case and have no
intent to pursue one. They only wish to cause an uproar and to
make the use of Ritalin and other stimulants seem controversial,
thus dissuading parents from using them for their children. The
interesting thing is that whenever they have a press conference and
receive a lot of publicity, no one bothers to ask any of the plaintiffs
about their connections to the Church of Scientology.56
Of course, a review of the media attention the Ritalin lawsuits received, both at the time

and since, reveals that many people did in fact bother to ask about the plaintiffs’

connections to the Church of Scientology, to the point where the cases are often

dismissed in precisely that manner that Nussbaum himself deploys.

Challenging the Origin Story: The “Science” of History

In spite of the APA’s and Novartis’ press releases, both before and after the

Ritalin lawsuits – in which they expressed their eagerness to bring into the open the facts

of the case for ADHD – the legal tactics the defendants employed in fact precluded such

a discussion. However, based on the statements made on their behalf by representatives

such as the previously quoted Dr. Mirin, several elements of their proposed defense can

be reconstructed. Most significant among these statements are the frequent appeals to

history, a long history that was pivotal to the case the defendants made “in the court of

56 http://www.pedsource.com/node/4415.
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public opinion” – to use APA president Richard Harding’s phrase. But if these claims are

true and the history of ADHD stretches back to the early-20th century, then how can we

account for the sharp rise in ADHD diagnoses only since 1980? How could there be so

much evidence for ADHD, and yet so little consensus about the disorder’s etiology,

diagnosis and treatment?

To resolve these issues, we must turn our attention to the history that Dr. Mirin

himself characterized as a “mountain of evidence.” Though the defendants were never

required to present this history in court, Dr. Mirin’s appeal to the “40 years” of safe and

effective Ritalin use, and a legacy of ADHD that goes back “more than 50 years,” signals

a defense based upon a particular history of ADHD and Ritalin, an history of the

diagnosis that is not explicitly named, but is nonetheless recognizable even by the broad

outlines suggested in APA and Novartis press releases. This is the popular origin story of

ADHD.

This origin story has its own metahistory, rising out of the sub-genre of popular

science and self-help literature aimed at consumers with ADHD and consumers who have

children with ADHD. Starting in the mid-1980s, this cottage industry entails a range of

authors offering a range of dispositions towards the diagnosis, from skeptical to

enthusiastic. However, almost all works within this genre – even those which advocate

alternatives to pharmaceutical treatments, or use the ADHD diagnosis as a soapbox from

which to decry the relentless speed of technoculture – take for granted the “reality” of

ADHD. This is perhaps unsurprising, as the reality of ADHD predicates the very market

to which these books are aimed.

A great number of the popular ADHD books, at some point within their text,

recount the “history” of ADHD. Although different authors go into more or less detail,

the basic outline of events narrated is remarkably similar from text to text. What emerges

is an origin story of ADHD, the reiteration of which both fulfills a genre expectation and
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serves the ideological function of legitimating the concept of ADHD – while providing

relatively little historical insight. In fact, as this chapter demonstrates, the origin story of

ADHD both ignores and obscures a number of historical realities in order to construct a

narrative that culminates in the “discovery” of ADHD as it is currently defined. The fact

that there is no consensus definition of ADHD at the present moment is only one of the

facts this origin story renders invisible. This narrative of discovery constructs ADHD as

an uncontested material reality, relying upon and simultaneously reinforcing a largely

mythical understanding of scientific discovery.

While there are any number of texts in the subgenres of ADHD self-help, I will

here consider the origin story as it appears in the following especially popular books:

Driven to Distraction by Edward Hallowell and John Ratey (New York: Touchstone,

1994; a popular self-help book, often referred to as “the ADHD bible”), Thom

Hartmann’s Complete Guide to ADHD by Thom Hartmann (2000), Attention-Deficit

Hyperactivity Disorder: A Handbook for Diagnosis and Treatment by Russell A. Barkley

(1990; a relatively scholarly example of the genre, aimed primarily at diagnosticians –

though most of Barkley’s work is self-help), Scattered by Gabor Mate (1999), You Mean

I’m Not Lazy, Stupid, or Crazy? by Peggy Ramundo and Kate Kelly (2006, aimed

explicitly at adults with ADHD), and Ritalin Nation by Richard DeGrandpre (2000).

The origin story of ADHD typically consists of the following narrative events: 1.)

George Frederick Still’s account of distractible and willful children in 1902; 2.) The
encephalitis outbreak in North America in 1917; 3.) Eugene Kahn’s and Louis Cohen’s

research into behavioral disorders arising from organic brain damage, published in 1934;

4.) Charles M. Bradley’s administration of Benzedrine to brain-damaged children in

1937; 5.) The development of the diagnostic category of Minimal Brain Dysfunction

(MBD) in the 1950s; and 6.) Development of the diagnostic category of Hyperkinetic
 202

Syndrome in the 1960s – all of which, according to the origin story, leads organically and

seamlessly to the contemporary understanding of ADHD.

Notably absent in these recapitulations of the origin story of ADHD is any

mention of the diagnostic turn in psychiatry, or developments in pharmaceutical

regulations, though both of these factor directly into the development of ADHD. This

absence is itself revealing, and a symptom of the dramatic paradigm shift represented by

the diagnostic turn. Popular narratives of science – in which science is presented as an

exclusively rational and methodical engine of self-perfection – necessitate the erasure of

such dramatic shifts and the disavowals of earlier epistemes. Through such erasures, the

liberal humanist fiction of collective progress and unitary knowledge is perpetuated.

Based on the APA’s and Novartis’ public appeals to a history of ADHD

stretching back “more than fifty years,” their courtroom defense of the “reality” of

ADHD would almost certainly rely on three key elements of the ADHD origin story – the

work of George Frederick Still, the encephalitis outbreaks, and Charles Bradley’s use of

amphetamines with brain damaged children. But a closer historical investigation of these

three key historical moments shows that the popular origin story of ADHD obscures,

rather than illuminates, a complicated history that does not, in fact, lead unidirectionally

or seamlessly to the emergence of a scientific consensus on the diagnostic category of

ADHD.

George Frederick Still, 1902

The origin story begins with British pediatrician named George Frederic Still,

who, in 1902, delivered a series of lectures to the Royal College of Physicians, in which

he discussed a group of 5 girls and 15 boys from his practice, all of whom were identified

by the age of 8 as being defiant, willful, lawless, and lacking in "inhibitory volition." In

spite of these "moral defects," these children were "without general impairment of the
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intellect," although they demonstrated an "abnormal incapacity for sustained attention."

Particularly curious to Still was the fact that all of these children came from "good-

enough" households, apparently ruling out bad parenting as a cause of their behavior. In

the absence of this explanation, Still hypothesized that the children's lawlessness might

be attributable to either head trauma sustained in birth or a hereditary disposition.57

At the time Still was lecturing, there was no such diagnosis as Attention Deficit

Disorder; but, in the origin story of ADHD, Still's lecture of 1902 emerges retrospectively

as the beginning of the disorder’s history, universally identified within the genre as the

first moment in which ADHD is recognized. In Driven to Distraction, for example,

authors Hallowell and Ratey explicitly compare the behaviors described by Still to the

diagnostic criteria for ADHD as they appear in the DSM. While Still did not use

precisely the same vocabulary to speak of these behaviors, the behaviors he described –

"abnormal incapacity for sustained attention," "willfulness," "lawlessness" – while

alluding to the prevalent category of juvenile delinquency, could be seen as falling under

the general categories of inattention, hyperactivity and impulsivity.

However, rather than simply identifying a similar constellation of behaviors

(which are, after all, common behaviors, all of which rely on subjective judgment), Still’s

inaugural position in the origin story of ADHD is more centrally justified by the fact that

Still had characterized these behaviors as the common result of a single neurobiological

event.58 This is important, as Barkley, Hallowell and Ratey, and most other late-20th

century ADHD researchers and diagnostic psychiatrists continued to operate under this

same assumption – namely that a single, identifiable, and causal neurobiological event

underlies the eventuating symptoms.

57 George Frederic Still, "Some Abnormal Psychological Conditions in Children" Lancet

1920; 1:1008-1012.
58 Ibid.
 204

Moreover, in the process, Still created a diagnostic cohort of subjects upon which

ADHD diagnosis would eventually – albeit retrospectively – be established. This, in

itself, is not groundbreaking. While the expression of these behaviors may well have

been especially profound in the group of children studied by Still, the behaviors

themselves certainly were not unique, neither to these 20 children, nor to that particular

moment in American history and culture. Defiant, willful, impulsive, inattentive children

had vexed parents and educators since well before the beginning of the 20th century. But

Still characterized this group of children differently, in several important ways.

First, Still notes that these are children from "good-enough" households – middle-

class, otherwise moral and law-abiding. This observation is presented by Still as a

confounding element to the diagnosis, the implication being that problematic behaviors,

such as the ones displayed by these children, were typically attributed to questionable

parenting and/or the inexorable destiny of class position. Since the assessment of good or

bad parenting skills is hardly an objective process, such judgments are among those most

obviously informed by social and economic biases. For example, a lack of sufficient

resources or positive social support was understood to limit the quality of parenting in

impoverished communities and encourage the development of these "moral defects."59

Had the children analyzed by Still been raised in less affluent or more obviously

immoral, disease-ridden households, their behavior would not have been so remarkable.

Impulsive, defiant, and inattentive behavior in children, then, fell under Still's scrutiny

only in the absence of these more common social and economic explanations and as a

problem for late-Victorian middle-class values.

59 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and

Treatment, 5.
 205

Further, Still also isolated these behaviors from any "general impairment of the

intellect," pointing out that one six-year old boy, "in manner...and conversation...

appeared as bright and intelligent as any child could be." Ostensibly, this clarification

merely points out that these behaviors are not attributable to more profound medical

conditions, such as mental retardation. In addition, this observation demonstrates that

attentiveness is not necessarily a function or a product of intelligence. Rather, in Still’s

view, attentiveness and intelligence are conceivable as distinct and independent traits.60

And yet, oddly, instead of proceeding to address attentiveness, independent of

intelligence, Still continues to speak of these two traits in conjunction as if they were

essentially related. Still's fascination with generally intelligent, yet inattentive and

defiant children, illustrates his assumption that while a variable range of intelligence

between individuals is normal and acceptable, a range of behaviors is less so. Instead,

Still apparently feels that behaviors should be prescribed according to one's intelligence

(as well as one's social and economic status); he assumes, it seems, that intelligence and

bourgeois social and economic status go together: Still presents no other evidence for

why inattentive behavior should necessarily be considered in relation to intelligence, nor

does he carefully consider why a lack of attentiveness should be less worrisome as a

symptom in less intelligent children. The result is that he concerns himself with

explaining a discrepancy between two independent traits, intelligence and attentiveness,

in a way that mirrors his concern over a socio-cultural discrepancy between the

60 To think of consciousness as a collection of discreet and measurable traits was itself a

relatively recent development, beginning with the founding of the first psychology laboratory by
Wilhelm Wundt in 1879 at Leipzig University. See Jonathan Crary’s Suspension of Perception
(2000). Crary identifies this moment, and the concurrent industrial revolution, as the beginning of
the modern concept of attention, developed as a means of managing the new experience of wage
labor.
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privileged social status of the parents and the negative behavior perceived in these

children.61

It is also crucial to note that the behaviors Still identifies are specific to particular

contexts. On one hand, Still remarks that “in…conversation” these children

“appeared…bright and intelligent,” indicating that under normal circumstances, one

wouldn’t consider these children to be abnormal at all. As it turns out, their undesirable

behaviors were only apparent in more prescribed circumstances, most notably the

classroom. In describing these children, Still coupled his own observations with those of

the children's parents and their schoolteachers. Already in 1902 this raises an

unanswered question: did these children display these undesirable behaviors only in

certain contexts, or are these behaviors only undesirable in certain contexts? In the

proper circumstances, "defiance," for example, may be a desirable behavior for a person

to display. In Britain, the social position of a child in grade school, however, did not lend

itself readily to such a circumstance – as the education institutions of Britain at the turn of

the century demanded compliance from children. The "problem" with Still's problem

children, then, must be understood as being located not so much in the behavior of the

children themselves, but in the relationship between the children's behavior and their

social environment, as well as between their socioeconomic status and the impression

(rather than measurement) of their intelligence.62

But Still did not make note of this set of behaviors in order to consider them in

social contexts, nor did he offer his observations to a community of educators. Rather, he

61 Still’s own class position and social status earned him access to observe these
children.
62 IQ tests were a contemporary and controversial process to Still, though an ineffective
measure of something as elusive, fluid and multifactorial as intelligence.
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placed them in a medical model, as part of a discourse of illness, by submitting them to

the Royal College of Physicians as a lecture, and subsequently to the premier journal of

medicine, then as now, The Lancet. In this medical context, these behaviors became

signs of some basic somatic disturbance, including some kind of "organic" brain damage.

In other words, for Still, the pathological nature of these behaviors was not understood as

arising from a particular social and historical context; instead, the pathological nature of

these behaviors was understood as a consequence of a physical abnormality in the

neurobiology of difficult children. Still claimed explicitly that the behaviors in question
are the result of an underlying biological cause, and therefore beyond moral – and,

problematically, socio-economic – reproach. The novelty of this diagnosis in 1902 is

evidenced by the fact that, even as Still makes the suggestion that these behaviors are at

their root biological, he is forced to describe these behaviors with a vocabulary marked

by a moralistic understanding of behavior, using terms such as “willfulness” and “moral

defects.”

In 1902 the act of linking behavior to biology in this manner was itself a relatively

recent development. Just 40 years earlier, Paul Broca, a French surgeon, had published

the first medical evidence that was widely recognized to support a hypothesis that

comports with current models of localized brain function.63 By observing the

pathological behavior of adult patients while alive and dissecting their brains upon their

death, Broca illustrated the consistency with which particular linguistic incapacities

seemed to accompany lesions in specific areas of the brain. Like his contemporary

Broca, Still links behavior to biology, but goes further to suggest the cause of behavior:

63 Phrenology was still a concurrent model of brain function localization, though an

example of one that does not comport with current models. T. M Parssinen, "Popular Science and
Society: The Phrenology Movement in Early Victorian Britain," Journal of Social History Vol. 8,
No. 1 (Autumn 1974).
 208

in this case, brain damage. Since the brain damage observed by Broca was, in fact,

commonly the result of strokes, the young age of Still’s population would have made this

explanation seem less plausible. Instead, Still hypothesized that the brain damage that

explained the willful behavior of the children he observed may have been due to birth

trauma.64

In addition to Broca’s work, turn of the century medical neuro-biology drew upon

a genetic model of heredity. In 1900, just two years previous to Still’s lectures at the

Royal College, Hugo DeVries, a Dutch botanist, had illustrated the significance of plant

hybridization research conducted by a nearly forgotten Austrian monk named Gregor

Mendel and overlooked for nearly 50 years. Following DeVries’ work, Walter Sutton

employed Mendelian genetics to propose human chromosomal theory in 1902.65 He did

so in the very same year that Still suggested such a theory may be used to explain

inattentive behavior in children. Considering the central role genetics have come to play

in medicine in the late twentieth and early twenty-first centuries, one might

retrospectively consider Still to have been doing cutting edge research. However, and

perhaps due to the lack of development in the field of genetics at that time, the genetic

model Still proposed was received less enthusiastically than the brain damage model,

which got most of the attention among pediatric neurobiologists and educational

psychologists for the first half of the twentieth century.

64 There are other factors that may have contributed to Still’s notion that birth trauma
could have been responsible for brain damage. This was an era in which the birth process was
becoming medicalized, and was increasingly perceived to be a dangerous experience for both
mothers and babies. The medicalization of birth also introduced iatrogenic health risks into the
birth process. For example, the use of forceps has been known to cause head trauma during birth.
Judith Walzer Leavitt, Brought to Bed: Childbearing in America, 1750-1950 (Oxford: Oxford
University Press, 1986).
65 W. S. Sutton, “On the Morphology of the Chromosome Group in Brachystola
Magna,” Biological Bulletin 4 (1902): 24-39.
 209

Though Still correlated preliminary findings to hypothesize that this set of

behaviors was symptomatic of an underlying biological problem, he did not prove that

this was the case. Still proposed two hypothetical mechanisms of action – trauma and

genetics – but could not identify any mechanism of action responsible for the display of

the behaviors in question. Despite the creativity, popularity and persuasive rhetoric of

Still's suggestions, his theory was difficult to confirm. Before the development of brain

imaging technology, it would be impossible to empirically assess brain damage in living

subjects; only an autopsy afforded the opportunity to observe the brain directly. As a
result, the diagnosis of brain damage was used to explain excessive impulsivity,

distractibility and restlessness in children, even while the actual presence of brain damage

or head trauma could not be corroborated by clinical evidence. This state of affairs

continued throughout the first half of the twentieth century, eventually leading to the

diagnostic category of Minimal Brain Damage or Minimal Brain Dysfunction (MBD), an

etiological catch-all used throughout the 1950s and 60s to explain a number of conditions

related to learning difficulties in school children, including the symptoms now associated

with ADHD.66

Still's early intuition was correct – to a degree. On one hand, it has been

empirically established that damage to particular areas of the right frontal cerebral cortex

may lead to difficulty in sustaining attention over long periods of time. Primate research

supports this hypothesis; it has been recognized since 1876 that lobotomized monkeys

tend to display an inability to sustain attention.67 Plus, the advance of brain imaging

technology, such as Positron Emission Tomography (PET) scans, Magnetic Resonance

66 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and

Treatment, 6.
67 David Ferrier, The Functions of the Brain (New York: Putnam, 1876).
 210

Imaging (MRI), and, most recently, functional Magnetic Resonance Imaging (fMRI),

now makes it possible to detect lesions and abnormalities in the brain without surgery.

This technology has been used to show that patients with sustained frontal cortex damage

often display behaviors identified with ADHD.68

On the other hand, since the development of neuroimaging in the 1980s,69 PET

scans and MRIs have also shown that there is no apparent brain damage present in over

95% of the children diagnosed with ADHD. What the new technology has helped make

clear, in fact, is that inattentive, impulsive and hyperactive behaviors, by themselves, are

insufficient for a positive diagnosis of brain damage to the frontal cortex or any other

segment of brain tissue.

What does all this mean for the history that Mirin, Barkley, Hallowell and Ratey,

and other ADHD researchers created from early work by Still, in the interest of defending

their diagnosis? By identifying George Frederic Still’s 1902 lectures at the Royal

College as the starting point of ADHD research, Barkley and Hallowell implicated

themselves in a diagnostic conundrum and an unstable origin story; as Gabor Maté

clearly states in his book Scattered (1999): "The names given to [ADD] and its exact

descriptions have gone through several mutations."70 In other words, Mirin’s suggestion
– that Still and current ADHD researchers, while using different vocabulary, were indeed

writing about the same condition – is based only on the surface similarity of a set of

behaviors interpreted as signs of an underlying disorder, despite the fact that different

disorders can be, and often are first noted by similar signs. While an illness is first

68 Tamimi and Leo, eds. Rethinking ADHD.

69 Joseph Dumit, Picturing Personhood: Brain Scans and Biomedical Identity (Princeton
University Press, 2004).
70 Gabor Maté, Scattered: How Attention Deficit Disorder Originates and What You Can
Do About It (New York: Plume, 1999), 7.
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recognized by symptoms, it is ultimately understood and identified by a biological

mechanism of action. In fact, regardless of the similarity of the signs identified by Still,

the vast majority of children and adults diagnosed with ADHD today are not suffering

from an illness anything like Still's hypothetical etiology. Maté's suggestion that the

name "ADD" somehow evolved from the name "Minimal Brain Damage" (as Mate's use

of the word "mutation" implies), obscures the fact that the hypothetical etiologies of

Still’s children – and the etiologies of children diagnosed with ADHD since 1980 – is

unproven, and that brain damage of any degree is unrelated to ADHD in the vast majority
of cases.71

Brain Damage, Amphetamines, and the Myth of

“Paradoxical Efficacy”: 1917-1970

In the origin story of ADHD, as recounted by Barkley, Hallowell and Ratey, et al,

the next significant event is an outbreak of encephalitis that occurred in North America in

1917. Children who survived encephalitis often suffered permanent brain damage due to

the swelling of the brain caused by the infection. Many of these children found it

difficult to control their impulses or sustain attention for long periods of time, and were

consequently labeled as having Postencephalitic Behavior Disorder.72 This data set

allowed Eugene Kahn and Louis Cohen, in 1934, to demonstrate a link between those

behaviors and brain damage – particularly to the right frontal lobe of the cortex –

resulting from an identifiable organic disease.73 The work of Kahn and Cohen is

presented in the popular narrative as the vindication of Still’s hypothesis of a biological

71 Tamimi and Leo, eds. Rethinking ADHD.

72 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook, 5.

73 Ibid., 5-6; Hallowell, Driven to Distraction, 272.

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explanation for distractible behaviors. However, Still’s hypothesis bears only the most

general resemblance to Kahn and Cohen’s conclusions. Still hypothesized that a

biological process was responsible for the distractibility and willfulness of a population

of research subjects, but he hypothesized that entirely different biological processes (birth

trauma and genetic inheritance) than those investigated by Kahn and Cohen.

Significantly, Still’s population did not suffer from brain injury as a result of encephalitis

infection. Further, from the perspective of Kahn and Cohen in the 1930s, their research

was inspired by the unanticipated conditions brought about by an outbreak of

encephalitis; it was not the continuation of a line of investigation started by Still. Only

from a moment later in history, after the establishment of ADHD as a diagnostic

category, can these moments be retroactively made to speak to each other, through the

process of producing the origin story of ADHD, for the rhetorical purpose of presenting a

deep pedigree.

This population of children disabled by encephalitis inspired the creation of

institutions such as the Emma P. Bradley Home (now called the Emma P. Bradley

Hospital) in East Providence, Rhode Island in 1931. This institution, named after the

daughter of the hospital's founder, was dedicated to research and service for children

who, like Emma Bradley herself, were afflicted with Postencephalitic Behavior Disorder

and similar neurological problems.74 One of the first superintendents of the Emma P.

Bradley Home was pediatrician Charles Bradley, a distant cousin of the hospital's

founder. In the course of his care and research, which involved rigorous cognitive testing

on children with behavior disorders, Bradley administered the amphetamine Benzedrine

to relieve his subjects' headaches.

74 Henry H. Work, “George Lathrop Bradley and the War Over Ritalin.”
http://www.cosmos-club.org/journals/2001/work.html.
 213

Amphetamines had been discovered in 1887, in an attempt to synthesize the

effects of naturally occurring stimulants like cocaine and ephedrine, but their medical

applications didn't emerge until 1927.75 When Charles Bradley administered Benzedrine

to his young patients in the 1930s, the drug was being marketed primarily as an asthma

medication and as a stimulant for adults. Serendipitously, he discovered that not only did

the drug relieve their headaches, it improved their ability to concentrate on mental tasks

such as arithmetic. Subsequently, Bradley experimented with administering Benzedrine

to children with Post-Encephalitic Brain Disorder, who displayed inattention, impulsivity

and hyperactivity.76
Bradley reported his findings in a 1937 article in The American Journal of

Psychiatry, entitled "The Behavior of Children Receiving Benzedrine." The results,

overall, were positive in his estimation; Benzedrine appeared to calm these children and

allow them to focus more clearly on their schoolwork. Bradley did not understand the

mechanism that would explain this effect, but his work nonetheless established the

efficacy of administering amphetamines to excessively distractible, restless and impulsive

children for the purposes of managing attensity.77 For this reason, Bradley’s work is a

75 “Methamphetamine Fact Sheet.”

http://www.chestnut.org/LI/trends/Street%20Drugs/Methamphetamine.html.
76 Of course, this manner of experimentation on human subjects would be in violation of
current US law and international accords, such as the Nuremberg Code established after WWII;
but these were different times, when much scientific discovery was made through casual
experimentation – often experimentation of doctors on themselves – rather than through the
highly mediated clinical trial model, now effectively mandated by law.
77 Throughout the 1980s and 90s, the most commonly administered stimulant for this
purpose was methylphenidate, marketed as Ritalin. However, as a phenethylamine derivative,
methylphenidate exhibits dopaminergic pharmacological properties almost identical to
amphetamine salt admixtures (such as those marketed as Benzedrine and Adderall) and
amphetamine stereoisomers like dextroamphetamine (marketed as Dexedrine) – all of which have
been administered to individuals diagnosed with ADHD.
 214

significant development in the chemical and pharmaceutical instrumentalization of

consciousness – even if its role in the development of ADHD is tenuous.

Furthermore, Bradley’s work of 1937 is cited repeatedly in the origin story of

ADHD for two distinct reasons. First, it is claimed to be the moment at which stimulants

are established as an effective treatment for a condition that was yet-to-be-recognized as

ADHD. However, positioning this event in this way ignores the fact that Bradley was

investigating an entirely different diagnostic category – postencephalitic behavior

disorder as a result of neurological trauma. Second, describing Bradley’s research into

organic brain damage as a step in the development of ADHD furthers the assumption that

ADHD, too, is the result of a biological disturbance like brain damage – in spite of the

fact that the majority of individuals now diagnosed with ADHD have no brain damage,

from encephalitis or otherwise. Irrespective, the association between organic brain

damage and the efficacy of amphetamines is used by authors like Hallowell and Ratey, et

al, to suggest that the efficacy of neurochemical manipulation in children diagnosed with

ADHD is evidence of the neurochemical nature of the disorder itself.

By reaching back this far back in history, Novartis could identify a period in

which Ritalin and other stimulants were administered to treat attentional problems that

resulted from, or were presumed to have resulted from brain damage, which, as we have

seen, is distinct from ADHD. However, as a biological disturbance, even if a different

biological disturbance than the ones ADHD researchers continue to search for,
associating ADHD with brain damage comports with the presumption of physiologic

mechanisms for behavioral disorders built into the perspective of diagnostic psychiatry.

Though Bradley was administering a drug nearly identical to those prescribed for ADHD

and though that administration brought about modifications in behavior similar to those

sought for individuals diagnosed with ADHD, Bradley was using this drugs for a

different purpose, to treat a condition that is not ADHD, in a context in which the idea of
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an “attention deficit” was not an operational hypothesis. Only from a presentist

perspective could this be constructed as similar.

But authors such as Hallowell also use Bradley’s 1937 account as evidence of the

biological basis of attentional problems. They argue circularly that the efficacy of

neurochemical treatment was early evidence of the neurochemical nature of Attention

Deficit Disorder. This assertion is especially beguiling to Hallowell and Ratey because of

the "counterintuitive" nature of being able to calm hyperactive children with stimulant

drugs – what Bradley referred to as the “paradoxical” calming effect of stimulants.78

This was a serendipitous discovery that was quite

counterintuitive; why should a stimulant help hyperactive children
become less stimulated? Like many important discoverers in
medicine, Bradley couldn’t explain his discovery; he could only
report its veracity.79
For Hallowell and Ratey, the paradoxical nature of this fact is itself presented as evidence

of the physical nature of ADHD. Because the effect apparently defies rationality, it must

be a fact originating outside of the rational realm of human activity. Bradley is

characterized as a true scientist not because he understands or explains this effect, but

because he reports what he observes objectively.

This is related to the argument presented by Novartis and the APA to the press in

their own defense, in which they stated that "Ritalin has been used… effectively in the

treatment of millions of ADHD patients for over 40 years." When Novartis cites the “40

years” in which “Ritalin has been used...effectively,” they are responding to a question

about the legitimacy of a diagnosis by offering a statement about the efficacy of a drug,

implying a causal relationship between the two. The link between these two statements

relies on an unspoken premise, in this case, that a drug can only be efficacious if there is

78 Hallowell and Ratey, Driven to Distraction 272.

79 Ibid., 272-3.
 216

already a disorder present. Only if this statement is true can the efficacy of Ritalin be

used as evidence of the existence of ADHD. This unspoken premise is, of course, false.

The efficacy of a stimulant drug is measured by the behavior changes it produces – in this

case, causing a child to fidget less and pay attention longer. But, contrary to popular

misconception, these changes can be produced in almost any individual who consumes

stimulant drugs (regardless of ever having been diagnosed as ADHD, or the degree to

which he or she displays the behaviors associated with ADHD).

Even while this misconception is entertained by Novartis, popular science writers,

and much of the reading public, health care providers have begun warning against this

false logic in their professional literature. As ADHD researcher Keith Conners states, in

his professional guidebook on the diagnosis and treatment of ADHD:

Some people skip diagnosis and assessment altogether

because they falsely believe that if a child responds to a stimulant
drug (like Ritalin®), he or she must have ADHD.80
Numerous studies have investigated this retrospective illogic, with obvious conclusions.

As G. S. Golden wrote in a 1991 article in Seminars in Neurology:

the response to the drug cannot be used to validate the

diagnosis. Normal boys as well as those with ADHD show similar
changes when given a single dose of a psychostimulant.81
Similarly, the Drug Enforcement Administration’s 1995 report on methylphenidate

reports:

Contrary to popular belief, stimulants like methylphenidate

will affect normal children and adults in the same manner they
affect ADHD children. Behavioral or attentional improvements

80 Keith C. Conners and Juliet L. Jett, Attention Deficit Hyperactivity Disorder (in
Adults and Children): The Latest Assessment and Treatment Strategies (Kansas City, MO:
Compact Clinicals, 1999), 39.
81 Breggin, Brain Disabling Treatments in Psychiatry, 165.
 217

with methylphenidate treatment therefore are not diagnostic

criteria of ADHD.82
In other words, if response to Ritalin cannot be used to validate an ADHD diagnosis in an

individual, then it can no more justifiably be used to validate the diagnosis at the

population level.

The fallacy of this belief is further illustrated by other, pre-WWII studies in the

archival record. For example, in 1938 in Sweden, amphetamines were available over the

counter, and they were marketed to businessmen who were growing weary of

concentrating while at work, with slogans such as "Two pills beat a month's vacation."83

The boost in mental alertness advertised here is precisely the same effect that allows

distractible children to concentrate better in school when prescribed a regimen of

stimulant drugs. In Sweden, these effects were mass-marketed with no gesture made to

any pathological condition that might predicate that effectiveness.

Since their discovery in the 1930s, amphetamines have been "effective" in

treating a wide range of conditions and disorders with widely differing etiologies, from

asthma to obesity – many of which are not neurochemical in nature. This further

illustrates that the mechanism of action involved in treating symptoms of a disorder is not

necessarily related to the nature of the disorder itself. If there was a one-to-one

relationship between the mechanism of the drug and the illness it treats, then how could

one drug affect several different etiologies? The efficacy of a drug, then, does not

necessarily reveal anything about the nature of a condition. A drug may be observed to

affect a behavior associated with a particular disorder, while not treating the disorder at

all – just as taking an aspirin when one has a sinus infection may help to relieve a

82 Drug Enforcement Administration (DEA) “Methylphenidate (A Background Paper)”

(Washington DC: Drug and Chemical Evaluation Section, Office of Diversion Control, DEA,
U.S. Department of Justice, 1995).
83 Palfai and Jankiewicz, Drugs and Human Behavior, 290.
 218

headache, while having no effect on the infection that is causing the headache.

Amphetamines affect behavior, but, like aspirin, this effect is temporary, and the

offending behaviors return when the pills wear off, not altering in a lasting way any

underlying pathology that could lead to such behavior. The “paradoxical calming effect,”

in this way, functions much as the development of the dopamine theory of schizophrenia

did in the wake of discovering the efficacy of Thorazine. The hypothesis was formed

retroactively, in order to comport with experimental results.

Furthermore, the "paradoxical calming effect” of stimulants is not at all

paradoxical. Nor did it start with Charles Bradley in 1937, as it is often attributed in the

origin story of ADHD. Hallowell’s and Ratey’s reading of Bradley, in fact, writes the

paradox into Bradley’s research. While Bradley’s 1937 study acknowledges that, at first,

“It appears paradoxical that a drug known to be a stimulant should produce subdued

behavior,”84 in the following sentence, Bradley went on to hypothesize an explanation

for this apparent paradox that is remarkably similar to 21st century models of

neuroanatomical function:

It should be borne in mind, however, that portions of the

higher levels of the central nervous system have inhibition as their
function, and that stimulation of these portions might indeed
produce the clinical picture of reduced activity through increased
voluntary control.85
As Bradley is pointing out, if one takes the word "stimulant" very literally, then it might

seem odd that such a drug would calm a child down. But stimulant drugs, like

Benzedrine or Ritalin, aren't called "stimulant drugs" because they stimulate physical

84 Charles Bradley, “The Behavior of Children Receiving Benzedrine,” American

Journal of Psychiatry

94 (Nov, 1937): 577-585, pg. 582.

85 Ibid.
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activity per se. Rather, stimulants stimulate is the release and/or the availability of

neurotransmitters called catecholamines (specifically, dopamine and norepinephrine).

The resulting surplus of neurotransmitters available in the central nervous system (CNS)

produces a number of different effects, including mild euphoria and mental alertness,

"enabling users to sustain their attention and concentration for a long time."86

It is true that stimulants may also stimulate the sympathetic nervous system

(SNS), resulting in increased heart rate, breathing, and motor activity – all signs more

commonly associated with the idea of "speed." Stimulant drug users – and psychiatrists

prescribing stimulants to children – adjust the relative dosage of the drug(s) in order to

balance the more positive effects of stimulants on the CNS against the less desirable

effects on the SNS. In some individuals, the SNS response to amphetamines greatly

outweighs the benefits of the CNS response; others may experience almost no SNS

response. Some individuals respond better to one form of stimulant than another, while

other individuals may respond to almost any stimulant in the same manner. The

discrepancy between different individual’s reactions is hypothesized to be rooted in

individual variations in body chemistry – the same kind of variations that cause people to

react differently to caffeine or alcohol (or, for that matter, different kinds of alcohol).

There is no conclusive evidence that these discrepancies are in any way linked to the

presence of ADHD symptoms. About 20% of people diagnosed with ADHD report that

stimulants make them "jittery,"87 which is comparable to the rate reported among people

without signs of ADHD.88 Even by Hallowell’s account, not all people diagnosed with

86 Palfai and Jankiewicz, Drugs and Human Behavior, 292-3.

87 Hallowell, Driven to Distraction, 237.

88 Drug Enforcement Administration (DEA), “Methylphenidate (A Background Paper).”

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ADHD are prescribed stimulants – which in itself should logically invalidate any claim

that the efficacy of amphetamines establishes the biological root of ADHD symptoms.

This analysis of the retrospective popular “history” of ADHD makes clear, then,

that from 1937 to 1980, awareness of the efficacy amphetamines preceded the

establishment of the condition for which efficacy is being sited as legitimating. This

explains the rhetorical necessity of establishing George Fredrick Still as the beginning of

the ADHD story. By establishing the existence of a proto-ADHD before Charles

Bradley, Bradley’s “discovery” of a “paradoxical calming effect” of amphetamines can

be positioned as the solution to an already established problem, thereby making the

history of ADHD comport with an established and comfortable narrative of scientific

experimentation and conclusion. In fact, in the 1930s, Bradley was not revisiting or

reflecting upon Still’s brain damage hypothesis when he discovered the efficacy of

amphetamines in the treatment of cognitive impairments resulting from encephalitis. He

was not even trying to address attentional deficits, per se. The discovery of

amphetamine’s “paradoxical calming effect” by Bradley came from their administration

to children complaining of headaches, and was only later, in the 1970s, administered

specifically to children displaying inattention.

In other words, the efficacy of amphetamines and their “calming effect”

(“paradoxical” or not) was established independently from the presence of ADHD-like

signs. This makes clear that as ADHD was hypothesized and formalized in the 1970s,
directly leading up to the publication of the DSM-III in 1980, researchers were

assembling populations of children displaying behaviors that would be responsive to the

already-known effects of amphetamines.

Bradley’s work did not lead directly to the widespread administration of

amphetamines to distractible children because these effects of amphetamines were

framed in terms of the biological pathology of brain damage. Amphetamines were not
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being administered to address “attention deficits,” but to address brain damage. The use

of amphetamines to address a condition understood as an “attention deficit” –

independent of the presence of brain damage – was not realized until the 1970s, in the

work of Virginia Douglas and her colleagues at McGill University in Montreal.89

Identifying the treatment of brain-damaged children as a historical precedent allows the

origin story of ADHD to extend decades further into the past, while simultaneously

associating ADHD with established physiological phenomena. However, it is not until

diagnostic categories such as MBD begin to fall out of favor (for their overly broad

definitions and lack of clear therapeutic indication) that psychiatrists and cognitive

researchers like Douglas begin to describe cognitive disabilities characterized by

distractibility in the absence of brain damage. Influenced by behaviorism, this research

demarcated is subject (the “attention deficit”) entirely by observable behaviors, leaving

aside the question of physical etiology.90 Moreover, it was Douglas’ research method –
administering identical continuous performance tests (CPTs) to subjects before and after

the administration of stimulant drugs, then comparing the results in order to retroactively

establish a baseline of attensity – which led directly to the design and publication of

diagnostic assessment tools which continue to be used by psychiatrists to diagnose

individuals with ADHD.91

Douglas’ work, however, doesn’t even make it into the origin story of ADHD in

most accounts, in spite of its immediate procession to the publication of the DSM-III.

89 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook, 12-13.

90 In fact, this shift from observing physical symptoms to observing behaviors is

identified by as a demarcating shift in the history of ADHD by the editors of the critical
anthology Rethinking ADHD: From Brain to Culture ed. Sami Timimi and Jonathan Leo
“Introduction,” 1-17; 2.
91 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook, 13.
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But considering the rhetorical work that the origin story of ADHD is asked to do, this

omission is unsurprising; it does not carry with it the historical pedigree that the work of

Still and Bradley carry. Placing the origin of ADHD so close to the present would open

the history to much closer scrutiny. Bruno Latour, when writing about science and

technology, speaks of the “black box” effect, which is:

the way scientific and technical work is made invisible by

its own success. When a machine runs efficiently, when a matter of
fact is settled, one need focus only on its inputs and outputs and
not on its internal complexity. Thus, paradoxically, the more
science and technology succeed, the more opaque and obscure they
become.92
What we see in the origin story of ADHD – with its erasure of multiple layers of context

and even the cognitive science research that directly precedes the creation of the

diagnostic category – is a historical “black boxing” of the diagnosis itself.

What we discover upon close examination of the origin story of ADHD, then, is

that medical history of the early-20th century offers no clear proof of ADHD's organic
reality; it is itself a retrospectively assembled history of investigative hypotheses

regarding the causes of inattention, hyperactivity and impulsivity, and the effects of

stimulant drugs. Barkley accurately refers to this as “the search for structural differences

in the brain that underlie [ADD].”93 But, of course, a history of a search is not the same

thing as a history of a neurological disorder; the story of the medical investigation into

something is not, by itself, evidence for the existence of the thing being sought. The

APA’s appeal to an ADHD history of “more than 50 years,” then, is at its core more than

slightly misleading, and valuable mostly for its rhetorical power over those without

access to the historical record.

92 Latour, Pandora’s Hope.

93 Barkley, Attention Deficit Hyperactivity Disorder: A Handbook, 36.

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Because of the success of the APA’s, Novartis’s, and CHADD’s preemptive legal

defense, they did not have to present the origin story of ADHD to scrutiny within the

courtroom. However, through press releases and interviews in mass media, the APA

used the notoriety of the Ritalin lawsuits as an opportunity to present a defense consistent

with the ADHD origin story to the public. Subsequently, the conclusion of the Ritalin

lawsuits was characterized by Novartis, the APA, and others invested in the diagnostic

category of ADHD as a vindication of the origin story itself.

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CHAPTER 4

ADHD IN U.S. POPULAR CULTURE SINCE 1980

In chapter 1, I outlined the wide range of beliefs about ADHD across diverse,

often contradictory discourse communities, while tracing the ontological distinctions that

implicitly underwrite those positions and justify their implantation in human

consciousness. In chapters 2 and 3, I have discussed how the public education and legal

systems have critiqued, and been deployed to construct, popular and professional

“histories” of ADHD. In this chapter, I will consider how film, television, graphic novels,

comic strips, children’s literature, popular science magazines, hip hop music, museum

displays, internet forums, and advertising have differently contributed to the

consolidation and critique of ADHD and the “chill pill.” I consider four tropes most

commonly used to deal with ADHD, using examples from a range of media, mostly since

the 1990s: Some of these texts present ADHD and the use of Ritalin as a form of
brainwashing. Others present ADHD as the medicalization of normal childhood, or

conversely, as a mark of genius or superpower; while yet others suggest that ADHD is a

product, a symptom, or a form of expression of late-20th century technoculture.

Brainwashing: Brain Candy, “Pillz” by Lyrics Born, The

Whitest Kids U Know, and Scientology

Brain Candy

In 1996, the Canadian comedy troupe Kids in the Hall released Brain Candy, a

feature film that satirized the pharmaceutical industry as beholden to profiteering

corporate interests at the expense of the public’s well-being. While the film is certainly

more of an irreverent comedy than a political statement, its tone is sufficiently

polemical—even strident—to effectively articulate a critique of the psychiatric industry.

 225

No doubt it is this uneasy mixture of comedy, shock, and social commentary –

epitomized in the tag-line featured on the promotional poster: “Shove this up your mind”

– that contributed both to the film’s lack of box office success upon its release, as well as

to its ascendency to cult status in the years since.

Figure 2: A promotional movie poster for The Kids in the Hall: Brain Candy (1996).
 226

The film’s main character, laboratory scientist Chris Cooper, is presented as

sympathetic and sincere at the beginning of the narrative. Working in an underground

bunker identified as “The Depression Project,” Cooper stumbles upon a powerful new

drug that can produce happiness in the clinically depressed. At this point, early in the

narrative, it seems the film is not contesting the existence of mood disorders as legitimate

diagnoses, nor the potential effectiveness of using drugs to treat such diagnoses. Instead,

the film’s barbs are set for the corporate management of Roritor Pharmaceuticals, the

fictional company that employs our protagonist, Cooper. In the company boardroom, we
learn that Roritor profits are declining in the wake of recent marketing failures—

including the failure to introduce a new “back-to-school” drug for the upcoming fiscal

year. This small joke is important and revealing; though the film primarily deals with

depression and anti-depressants, this passing reference to Ritalin makes it clear that the

critiques articulated extend to drug treatments for other mood and behavioral disorders,

including ADHD. Financial concerns have pressured Cooper and his lab mates to rush

their new drug into production, foregoing the standard testing regimen. From there, the

drug moves out of the lab and into the boardroom for marketing analysis. Discussions

here include the drug’s ideal color (orange), name (GLeeMONEX), and slogan (“Makes

it feel like it’s 72 degrees in your head. All the time.”) –which receive vastly more

attention than the drug’s safety or its chemical mechanism of action. Once

GLeeMONEX starts bringing in record profits, prompting CEO Don Roritor to exclaim,
“We beat penicillin!”, the company moves to make GLeeMONEX available over-the-

counter, greatly expanding the potential market and, subsequently, profits.

As use of the drug spreads, its social effects become evident, not all of which are

positive. One of the film’s sub-plots involves a loud Goth-rock band with a dark and

moody vocalist, seemingly modeled on Trent Reznor of the industrial band Nine Inch

Nails, or possibly Glenn Danzig of 1980s punk band The Misfits. The singer of the band

initially dismisses talk of the drug during an on-stage monologue, concluding by shouting
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“Fuck ‘Happy!’” But later, when he starts taking GLeeMONEX, he loses all credibility

with his core audience by writing folk-pop songs with titles like “Happiness Pie.” These

songs are commercially successful, thus re-instantiating the narrative of “selling out,”

while also suggesting that audiences susceptibility to vacuous pop music is due, in part,

to their own chemically induced blandness.1 More disturbing, however, is the fact that

people taking GLeeMONEX start falling into comas of happiness, their minds fixed in a

fugue-like state on a single happy memory. At this point, our scientist-turned-celebrity

protagonist, having been seduced by the money and fame Roritor has plied him with,
realizes that things have gotten out-of-hand, and attempts to bring the scandal to the

public’s attention. After revealing that The Depression Project housing hundreds of

coma victims, Cooper expects Roritor’s success to crumble. Instead, the company

doubles down and introduces a new product: comatoriums, in which to care for family

members and loved ones living out the rest of their lives in happy comas, thereby

sidestepping the accusation of crass carelessness while further increasing Roritor profits.

This leads to a dystopian and tyrannical reign of vacant happiness that finds Cooper

working in a secret laboratory on a depression drug to counteract the influence of

GLeeMONEX on society.

Brain Candy was met with lukewarm reviews. Many critics were unimpressed

with the rather heartless jokes about suicide and leukemia. Among the lukewarm reviews

is one that showed up in an unexpected venue – the British Medical Journal (BMJ) – by
bioethicist Carl Elliot. In his 2007 publication Better Than Well: American Medicine

Meets the American Dream, Elliot discusses the ethics of “enhancement technologies,”

which he defines as “drugs and procedures that are employed by doctors not just to

1 For a discussion on “selling out” narratives in popular culture, see Hugh Barker and
Yuval Taylor, Faking It: The Quest for Authenticity in Popular Music (New York: W.W.Norton,
2007).
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control illness, but also to improve human capacities or characteristics.”2 Distinguishing

between technologies that are used as treatments, and technologies that are used as

enhancements, is essential in determining which ones are legal, ethical, and/or eligible for

public funding. Both Ritalin and Prozac fall within the scope of Elliot’s discussion.

Elliot’s critique of Brain Candy isn’t simply about the crassness of its humor, but

about how the film handled GLeeMONEX as a stand-in for Prozac—or as Elliot puts it,

“a mythical idea of Prozac.”3 Elliot finds it tedious and predictable that the film relies on

the trope of undesirable side-effects that render the promised miracle illusory, a trope as
common in Science Fiction as the story of the fountain of youth. He argues that if the

film had not relied on the “side-effect” ruse, we would have been forced to ponder the

more serious bioethical questions: can someone be too happy? Conversely, couldn’t

anyone stand to be a little bit happier than they are now? Or as Elliot poses it, “is

happiness always a good thing?”

While Elliot is correct in observing that more profound questions are obviated by

the narrative development of GLeeMONEX, as a bioethicist he apparently fails to

appreciate that the target of the satire is not the phenomenon of enhancement technology,

but the business of pharmacy. Throughout the film, the boundaries of “clinical

depression” are never prodded. Even at the climax of the film, as Cooper is publicly

denouncing Roritor, he distinguishes himself from the corporation by re-iterating that he

made a drug to help people who were clinically depressed, while it was Roritor that
marketed it to a larger population. Cooper’s good intentions, and his articulation of

“clinical depression” as a legitimate mood disorder, are not challenged. Within the film,

the problem doesn’t lie in the socially-constructed definitions of illness, because the

problem lies within the business practices of Roritor, which skimped on safety testing and

2 Elliot, Better than Well, xvii-xviii.

3 Carl Elliot, “The Elvis of Pharmaceuticals” BMJ vol. 313 (October 12, 1996), 950.
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aggressively expanded the drug’s indications in order to make money. The problem is

that the corporation overlooked or downplayed potential side-effects that don’t show up

until the drug is taken by a large population of patients. This turn of events has been seen

in the real world many times over, with a number of different pharmaceutical drugs

deployed for all kinds of applications in recent decades.

The real-life regularity of this particular storyline is emphasized in an early scene

in Brain Candy that directly references the Thalidomide affair. When a scientist admits

that the drug he’s been developing has had a few side-effects associated with it, a Roritor
executive jests, “Well, as long as there’s no flipper babies, right?” After an awkward

pause, the scientist is escorted from the room, protesting that, “It was only a few flipper

babies!”

At moments, the film comes close to broaching some of the questions that Elliot

is interested in asking – however tastelessly. But for the most part, Brain Candy puts

forth the argument that the real problem with pharmacy is the aggressive manner in

which it is marketed for profit. Note that one need not question the status of mood or

behavioral disorders, nor the authority of psychiatry in general, to make this criticism.

Instead, Brain Candy merely critiques the tendency of diagnoses (legitimate or not) to

expand and embed themselves, while identifying this phenomenon as the result of profit-

seeking behaviors of the pharmaceutical industry. It depicts the industry as driven by

profits and marketing, actively involved in the creation of new disease categories in order
to sell their drugs.

The plot of Brain Candy accuses the pharmaceutical industry of engaging in

brainwashing on two different levels. On a physical level, the drug GLeeMONEX truly

brainwashes those who take it by rendering them blissfully comatose. But on another

level, the advertising campaign that supports the release of the drug, and guarantees the

reputation of the corporation, is also a kind of brainwashing. This double critique is

echoed elsewhere in pop culture – and had largely been vindicated by a body of research
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into the production mechanisms and marketing techniques of the pharmaceutical industry

by authors such as Carl Elliot, Peter Breggin, and David Healy who have sharply

criticized the ascendance of marketing concerns within the industry.4

“Pillz” by Lyrics Born

The critique of the pharmaceutical industry’s profit motive is echoed in the lyrics

of hip-hop artists Lyrics Born and Gift of Gab, in a song from Lyrics Born’s 2010 album

As U Were, entitled “Pillz.” Drawing on the hip-hop tradition of drug-dealer narratives

(and referencing fictional drug dealer Avon Barksdale from the television drama The
Wire), Lyrics Born directly equates the business practices of the pharmaceutical industry

to those of illegal drug dealers:

Ok, now you go see the doc, I mean go see the D R

He signs that little green card, you take that down to D R
This time when I say D R, I mean Dwayne Reed, The Store
Dwayne runs every street corner on the Eastern Seaboard
He’ll get you what you need, get you right, get your lean on
It’ll bring you to your knees, but it ain’t nothin’ you can’t sleep off
If you’re out in California and you’re jonesin’ even harder
there’s a Walgreens on the corner; ain’t no police on the corner
He’ll get you straightened out, get you loaded, get you sorted
get you up, get you off, bring you down, do it often
See, we don’t cop from Avon Barksdale or from a Save-On tonk sale
It’s easier than buyin’ barbells at a yard sale
This shit sells itself; it ain’t like the shit’s a hard sell
The doctors, the pharmacists, the companies: they all down
They’ll mix it up for ya like bartenders do a cocktail
They got the hottest package; they run the largest cartel
Later in the song, guest lyricist Gift of Gab tells a story that comically exemplifies the

tendency of diagnoses to multiply, while linking this again to profiteering, particularly as

it is enabled through contemporary insurance billing practices. Further, he specifically

mentions Ritalin and the ADHD diagnosis as being a part of this problem:

4 Elliot, Better Than Well; Breggin, Brain Disabling Treatments in Psychiatry; Healy,
The Creation of Psychopharmacology.
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My herbalist got antsy when I asked a simple question:

If nature has the answers what’s the deal with all the medicine?
I know a guy who was prescribed a cure for his depression
It only made a mess; he went from one to poppin’ seven a hour
I popped a tab to clear my indigestion
Now I’m coughin’ up a storm and thus another new prescription
So now I can’t control the runs; I ran into the kitchen
to pop a cure to counter that and now I’m seeing visions
I woke up in the psych ward but the doctor didn’t listen
She said I must have ADD and OCD both mixed in
She shoved a funnel in my mouth and filled it full of Ritalin
then gaffled my insurance card and took a trip to Italy
Insidiously; while I’m laying on the table, trembling
Is this the end of me? Where’s the sympathy? Where’s the humanity?
This is insanity; my mirror’s gonna break
and all that I was tryna do was fix a stomach ache
“Pillz” and Brain Candy both critique the marketing practices of the pharmaceutical

industry, suggesting that mass audiences are the unwitting dupe to a kind of

brainwashing. In these instances, the brainwashing is independent of the drug and is

inseparable from media marketing practices and calculated ad campaigns.

The Whitest Kids U Know

Other texts including comedy theater take this critique further, suggesting that the

pharmaceutical industry is involved more literally in a form of mind control. Here, it’s

not only the marketing practices of the industry that are identified as controlling; the

physical effects of the drugs themselves are also directly implicated in the criticism.

Usually this more extreme critique goes beyond the profit motive, suggesting something
even more nefarious—like social control—is at the root of the diagnosis. A concise and

clear example of this position is exemplified by a skit performed by the American

comedy troupe, The Whitest Kids U Know. This skit appears in an episode of the IFC

show that aired on June 3, 2011.5 This short skit (only one minute, 26 seconds long)

5 Season 5, episode 7. Directed by Zach Cregger and Trevor Moore. Release date: June
3, 2011.
 232

shows a group of school children standing by their desks in a classroom, reciting what

starts as the pledge of allegiance, but quickly turns into a satire of American foreign

policy, corporate profiteering, and marketing practices that cross the line into

brainwashing:

I pledge allegiance to the flag of the United States of

America.
Thank you very, very much for letting us little kids live here.
It really, really was nice of you.
You didn’t have to do it.
And it’s really not freaky to have little, little kids mindlessly recite
this anthem every day, and pledge their life to a government
before they’re old enough to really think about what they’re
saying.
This is not a form of brainwashing.
This is not a form of brainwashing.
This is not a form of brainwashing.
This is really the greatest country in the whole world.
All the other countries suck.
And if this country ever goes to war, as it’s often wont to do, I
promise to help go and kill all the other countries’ kids.
God bless Johnson and Johnson.
God bless GE.
God bless CitiGroup.
Amen.
At the conclusion of this automaton-like recitation of this pledge, the teacher, from the

front of the classroom, blandly announces, “Very good kids. Now come and get your

Ritalin.” By connecting the use of Ritalin directly to the classroom recitation of fascistic

oaths, the skit suggests that ADHD is a fraud with an even more profound motivation

than profit – that of calculated social management. That the teacher administers Ritalin

to the entire class pointedly suggests the notion of “diagnostic creep,” suggesting that

soon all American schoolchildren will be administered Ritalin routinely.

This fits into a long history of 20th Century popular texts that have presented
psychiatry as a tool of social control. Brave New World, by Aldous Huxley (1931), was

one of the first English language novels to take on the chemical technologies of

governmentality, and it remains the most commonly-cited example of a dystopian future

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of chemically-ensured state compliance. Ken Kesey’s novel One Flew Over the

Cuckoo’s Nest (1962), later turned into a successful film in 1975, is another notable

example. Though Kesey’s story is concerned primarily with a small number of

individuals in a single institution, unlike the population-wide doping of Brave New

World, the tools of psychiatry are revealed as a means of collective control of problem

men, rather than as tools of individualized therapy. Both the novel and the film lend

themselves to skeptical readings of psychiatric practices as a whole.

In other, related films, behavior-modifying drugs are used to brainwash

individuals to participate in larger plots to manipulate or control a population. Such cold-

war era films include The Manchurian Candidate (1962) and The Parallax View (1974),

both of which imagine brainwashing as part of assassination plots. More recently, Dark

City (1998) and Equilibrium (2002) fit this category. In Equilibrium, a society is kept

complacent through the daily administration of mood-stabilizers. The main character, a

cop who is in charge of enforcing this consumption of drugs, comes to stop taking them

himself, and discovers he is a different person when not on the drugs. By linking the use

of mood stabilizers to state control – and their rejection to individual liberty –

Equilibrium is perhaps the closest in spirit to Brave New World. In Dark City, by

contrast, a race of aliens experiments on a small population of human beings by

systematically manipulating the material and emotional circumstances of their lives.

While the residents of a city sleep at night, the aliens and their agents secretly alter parts
of the city and its residents’ lives, in order to scientifically study the different reactions of

the resilient humans. Among the reality-altering powers they employ are chemicals

purported to generate motivations, desires, and memories. Though interdimensional

aliens are behind these experiments, the experiments are facilitated by a cooperative

human psychiatrist, who manipulatively brainwashes subjects with pharmaceutical drugs.

The representation of the scientist in his laboratory – complete with a labyrinth for his pet

rats – recalls behaviorist psychiatry of the 1950s, linking Dark City to real-world
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psychiatric atrocities, including the Nazi mind control experiments conducted on

prisoners in WWII, or the CIA-funded “psychic driving” experiment during the Cold War

(discussed in chapter 1).

While these examples of brainwashing in film, comedy, and fiction don’t always

explicitly name ADHD, they are manifestly critical of psychiatry and the pharmaceutical

industry in general, in storylines that the critics of ADHD can easily (and have often)

adopted as shorthand ways of characterizing and critiquing ADHD diagnosis and

treatment.

The Church of Scientology

As noted in chapter 3, the Church of Scientology has been publicly critical of

psychiatry. Many consumers of mass journalism came to learn about Scientology's view

of psychiatry in 2006, when Tom Cruise, in the middle of a long series of what proved to

be public relations missteps, criticized Brooke Shields' use of anti-depressant medication

to treat postpartum depression after the birth of her child. In an appearance on the Today

show, Cruise made it clear that he was speaking out of his deep personal concern for

Brooke Shields, and then went on to state confidently that "psychiatry is a

pseudoscience," denouncing many aspects of psychiatry, but focusing especially on the

use of amphetamine drugs in the behavior-modification of children diagnosed as having

ADHD.
This interview received a lot of attention in the televisual media and on the

internet, and almost all of it negative in its view of Cruise. Advising someone to not take

medication prescribed to them goes against every guideline espoused by psychiatry, and

even psychiatric skeptics typically view such as actions as irresponsible.6 Further,

6 Psychiatric survivors’ groups that promote and provide information about alternatives
to psychopharmaceutical drugs, such as the National Empowerment Center and The Icarus
Project, caution against ignoring psychiatric advise altogether. Instead, they encourage
psychiatric consumers to work with their mental health providers, and to be wary of the affects of
abruptly discontinuing prescribed medications. For example, The Harm Reduction Guide to
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Cruise's comments run counter to the efforts of many non-profit citizen organizations

working to raise awareness of postpartum depression. So, unsurprisingly perhaps, Cruise

was consistently referred to as "kooky" or "crazy ol' Tom" for challenging the legitimacy

of psychiatry. In addition, such reports were careful to point out that Cruise is a

Scientologist – a fact that is also well known; indeed, Cruise may be the most visible face

of this young and controversial, American-born religion. Not every article on Cruise

explicitly attributed this antipsychiatric stance to his Scientology beliefs, but the negative

juxtaposition of Cruise's statements with words like "crazy" and "Scientologist"

communicated that impression. For his part, Cruise actually distanced his antipsychiatric

views from Scientology, claiming that his opinions were formed by his own research into

the history of psychiatric atrocities, incidental to his conversion to Scientology.

However, this rhetorical move was made to avoid the accusation that he had been blinded

by his religion. His defensive attempts to appeal to rationality were perhaps too strident,

leaving many viewers with the sense that he “doth protest too much.” In fact, discussions

of Cruise’s conspiratorial view of psychiatry resonated with the conspiratorial tone of

most press coverage that Scientology receives.

In 2008, I toured one of several museums established by the church of

Scientology. This particular museum, located in Los Angeles, was originally christened,

simply, Psychiatry Kills. Later, whether in response to complaints or in a failed effort at

subtlety, the exhibition's title was changed to Psychiatry: An Industry of Death. In the
interest of brevity, I will continue to refer to this museum exhibit by its original, shorter

title. It should be noted that, ostensibly, the Psychiatry Kills museum is not explicitly

connected to the church of Scientology; the name Scientology appears nowhere on or in

Coming Off Psychiatric Drugs (Second Edition, 2012), published by The Icarus Project and
available online under a creative commons license, prominently bears this warning:
“…psychiatric drugs are powerful, and coming off – especially suddenly or on your own – can
sometimes involve risks greater than remaining on.” pg. 2.
http://www.willhall.net/files/ComingOffPsychDrugsHarmReductGuide2Edonline.pdf
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the building. Instead, the museum is the work of the Citizens Commission on Human

Rights (CCHR), an organization whose mission is to "investigate and expose psychiatric

violations of human rights and to clean up the field of mental healing." Through free

literature available at the museum as well as through the accompanying script of the

attendants, the CCHR touts the role of psychiatrist and critic of psychiatry Thomas Szasz

in its founding. Szasz, author of the controversial and influential book The Myth of

Mental Illness (1960), played an instrumental role in the antipsychiatric movement of the

1960s. In his work, Szasz takes the most extreme position of social constructionism,
claiming that all mental disorders, even profound psychosis and schizophrenia, are

merely the product of ideology. Szasz's work is sometimes used as an example, even

among social constructionists, of taking social constructionism beyond its reasonable

application. Even many critics of psychiatry distance themselves from Szasz.

Nonetheless, his work represents a highly visible contribution to the antipsychiatry

movement, which was successful in many of its efforts to curb psychiatric abuse. Szasz

is cited, in museum literature, as a sign of the institution’s legitimacy.

Though the museum does not advertise the role of Scientology in its founding,

even cursory research reveals that the CCHR was co-founded between Szasz and the

Church of Scientology in 1969. Moreover, the Church of Scientology is the primary

source of funding for the organization. The CCHR defends this relationship, claiming

that it is no different than the Catholic Church’s funding of the Red Cross. This claim
seems dubious, however; it might be more appropriate to consider the CCHR as one of

the many satellite organizations in a remarkably complicated bureaucracy that the Church

has developed over the course of its 55-year history.

Why set up an organization and a museum that exclusively espouses one of the

central tenets of your religion and then go to lengths to remove your name from it? It is

this behavior on the part of Scientology that lends to suspicions of its conspiratorial

goals. Such behavior is demonstrative of Scientology’s religious structure, which is

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essentially that of a mystery cult. Such belief systems are structured around secret

knowledge that is only granted to the initiated. This structure is typical of many religious

or quasi-religious groups in the Western esoteric tradition that garnered renewed interest

in Britain and the US after WWII – coterminous with the founding of Scientology. These

late-20th century religious groups are often typified by the various iterations of Wicca that

were created at this time, as well as the revitalization of the Order of the Golden Dawn,

itself a reinvention of the Rosicrucian mystery cult.7 Such traditions are often organized

in concentric circles of “cells” or “rings,” with the innermost maintaining guarded access

to secret knowledge, while the outermost are the only ones presented to the uninitiated.

The CCHR and the Psychiatry Kills museum, then, operate as the outermost ring of

knowledge; only through the hierarchical authority of the Church and its satellite

organizations can the truth about psychiatry be presented to initiates.

Upon entering the museum, the visitor is greeted by an attendant, who manages

the flow of people through the museum space and distributes the RFID controlled headset

that narrates your walk through the museum. While these devices have become a nearly

ubiquitous piece of museum technology in recent years, these headsets serve a very

particular role in this museum. Even before entering the museum, one is asked to read

several salacious warnings that they will be exposed to disturbing material. No one under

18 is allowed to enter. The warning signs themselves bear the silhouette of a psychiatric

patient receiving electric shock therapy; here the warning serves equally as an

advertisement of the shock value of the exhibit as much as anything else.

Once prepped, the museum visitor is guided into a padded cell, equipped with a

screen at one end and a row of theatre seats at the other. One is informed that one is being

7 Nevill Drury, The History of Magic in the Modern Age (New York: Carroll & Graff,
2000); Kembrew McLeod, Pranksters.
 238

locked into this room for the duration of a short film presentation, after which the door on

the other side of the chamber will unlock and the visitor is free to wander through the rest

of the museum at will. The film itself is well-produced, maybe even a bit too slick, in a

manner that seems to borrow from cable programming, a style that is part History

Channel, part reality TV show “COPS”. The initiatory film, while clearly intended to be

shocking, is actually relatively innocuous, perhaps because of how generic this form of

narrative has become. The padded room in which the audience sits is, however,

unsettling. But the ritual of the locked room is so far the most effective aspect of this
experience. In spite of all the attempts to erase the authorial presence of Scientology, this

first stage of the museum is distinctly religious, recalling the antechamber of the holy of

holies, or the first stage of the cross. It ushers the visitor through a structured space,

preparing him or her for the revelation that nears.

Once released into the museum at large, visitors are free to move through the

museum space, which is organized into a series of rooms. These rooms are organized

chronologically at first – with each room representing a period of psychiatric history. By

the end of the exhibit, however, rooms are organized by theme rather than historical

period. Each is filled with objects, labeled with plaques, and each room has a screen,

which shows another short film when the visitor approaches.

The history of psychiatry presented at the museum dwells on the worst atrocities

of psychiatry. In this regard, the museum does not have to make much up. In outlining
the gruesome techniques of medieval medicine, the Pavlovian and Skinnerian

experiments performed on animals as well as human subjects – in Nazi concentration

camps, Soviet gulags, and US and Canadian prisons – the methods of psychiatry are

truthfully shown to have a dark past. Through a presentation of the eugenics movement

in the US, and the role of IQ testing, the motivations of psychiatrists are reasonably

called into question. As the visitor approaches the present, other methods, such as electro

shock therapy and lobotomy are held up as typical of institutional psychiatry.

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Particularly unnerving is the room with a full size restraint bed, complete with a dummy

patient in restraints and hooked up to ECT current. The switch to turn on the current can

be thrown by the visitor, in a kind of restaging of the Milgram experiments, in which

participants were asked to deliver electric shocks to what they were led to believe were

other innocent participants. One room has a time line on the wall with an ever-increasing

number of behavior modifying drugs placed on it at the time of their FDA approval. This

is juxtaposed with a timeline of the profitability of the pharmaceutical industry as a

whole. The argument is implicit in the space of the room, inviting the spectator to
conclude that this correlation reveals the true motivations of the industry.

What is left out of the museum is any consideration of the possibility that

anything less than pure malevolence was intended by psychiatric practitioners. As one is

led through a history of the worst moments of psychiatry, in several different national

contexts, one is led to connect the dots between disparate historical and geographic

moments, and consider them all as representative of a monolithically constructed

organism, whose only purpose is to maim and steal. Through most of the museum, this

argument is mostly implicit, articulated only through a complete lack of evidence to the

contrary. Near the end of the sequence of rooms, though, the tone gets a bit more

strident: the penultimate display, for example, is a kind of graveyard, with monuments to

people who have been killed as a result of psychiatric care, bringing home the original

title of the museum. But even more specifically, and in keeping with the Hollywood
location of the museum, this is a graveyard of actors and artists who have been killed

under psychiatric care. The implication is hardly subtle. The museum is suggesting that

psychiatrists are targeting actors and artists for extermination. As in the ritualized

entrance room, this penultimate room is where the influence of the Church of Scientology

is intelligible.

The final room shows a short film that summarizes the material presented in the

museum, recalling the first film in both style and effect. Then, while exiting the museum
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proper, the visitor is confronted with a gift shop. In this, Psychiatry Kills is

unremarkable, as gift shops are a standard museum appendage. This gift shop is notable,

though, for the impossible-to-miss signage, in metallic letters, that greets the visitor,

whose eyes blink to adjust to the brighter lighting. The sign reads, “As long as we're here,

you're still safe.” While exiting, the visitor is asked to return the headsets to an attendant,

who proceeds to talk with visitors about their experience in the museum. Visitors who

show interest in the content of the exhibit are presented with a follow-up set of questions,

eventually leading to a request for contributions, or, perhaps if a visitor fits a

predetermined profile and expresses enthusiastic interest, an invitation to view the next

level of the mystery in the official headquarters of the Church of Scientology

International, just a few blocks away in the Hollywood Guaranty Building.8 In this way,

the Psychiatry Kills museum operates as a recruiting tool and screening mechanism for

the Church of Scientology.

So, why has the church decided to construct itself in opposition to psychiatry, at

the risk of being dismissed as kooky and conspiratorial, as was Tom Cruise after his

Today show appearance? Though ostensibly damaging to its public perception, the

Church’s behavior, in this instance, is similar to mystical and charismatic iterations of

other mainstream religions, including Christianity. When such religions are predicated

upon exclusive access to a truth outside of all other regimes of knowledge, all other

regimes of knowledge are necessarily devalued, if not utterly condemned. By outlining

an intellectual land of Zion, the church must condemn Babylon, and vice versa. This

antipathy to alternate bases of knowledge is one of the similarities between science and

other human institutions of knowledge production observed by Thomas Kuhn, in The

Structure of Scientific Revolutions. Just as one scientific paradigm is only rejected for

8 This building houses another museum exhibit, The L. Ron Hubbard Life Exhibition,
detailing the life of Hubbard, the founder of Scientology.
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another when in a state of crisis, the Psychiatry Kills museum suggests to the visitor that

an established paradigm (e.g., diagnostic psychiatry) is in a state of crisis, in order to

prepare the visitor to accept the alternative paradigm offered by Scientology.

But there's another reason Scientology picks this fight with psychiatry. This is

revealed as the visitor leaves the penultimate room, in which the symbolic graveyard

implicitly impugns psychiatry with intentionally targeting actors, and encounters the

message, “As long as we're here, you're still safe.” This juxtaposition suggests that the

intended audience, hailed by the “you” in the signage, is presumed to be an actor. This
rhetorical strategy goes beyond the museum’s dramatic flair and effective use of film

technology effectively throughout the museum. Significantly, actors are the most

powerful and wealthy individuals in the community of Los Angeles, which houses a

significant portion of the entertainment industry of the US. As powerful and wealthy

consumers, Hollywood actors also represent a valuable market for the psychiatric and

pharmaceutical industries. The Psychiatry Kills museum, then, can be read as a site of

competition between the Church of Scientology and psychiatry, in general, for the dollars

of Tom Cruise, et al. The high profile of Hollywood actors in the Church of Scientology,

in turn, further promotes the Church and its causes in a consumer culture that is

infatuated with celebrity.

In spite of the centrality of these antipsychiatric beliefs to Scientology as it

currently presents itself, psychiatric skepticism was not a foundational element of the
religion. On the contrary, in 1949, L. Ron Hubbard – the founder of Scientology – sent a

series of articles to the Journal of the American Medical Society, the American Journal of

Psychiatry and the American Psychological Association, outlining his theory of mind and

his own particular brand of psychotherapy, which would later become a basis of much of

the practice of Scientology. Nevertheless, every journal rejected his submissions.

Undeterred, he went into a psychotherapeutic practice of his own, teaching a technique

for overcoming psychosomatic illnesses that he named Dianetics. However, soon after,
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he was charged by the New Jersey Board of Medical Examiners for teaching medicine

without a license, and prosecuted by the FDA for using medical devices that had not been

properly licensed, and was forced to declare bankruptcy. It was around this time that he

was famously quoted as saying to fellow science fiction writer Harlan Ellison, “If a man

really wants to make a million dollars, the best way would be to start his own religion,”

which is precisely what Hubbard has done. The religio-medical antipsychiatry stance of

the Church of Scientology has extended beyond the space of the museum, established in

2005. The CCHR has an active web presence, and produces videos widely distributed on
YouTube.

One video produced recently by the CCHR features a child wearing a T-shirt that

labels him ADHD.9 When he removes the label, his shirt simply says “Kid” in its place.

Apart from the more extreme claims of the CCHR in other instances, or the more extreme

claims of its associated Church of Scientology, the claim made in this commercial is

slightly more modest. While still calling into question the legitimacy of the diagnosis –

as well as the entire paradigm of diagnostic psychiatry – it stops short of assigning any

direct culpability or motivations to the creators of the diagnosis, leaving open the

possibility that psychiatrists are making a well-intentioned error: mistaking the normal

processes of childhood for a medical disorder. This concern – that the normal behavior

of children has been pathologized – can be seen in many popular cultural texts,

particularly ones in which children are protagonists, such as comic strips and children’s

literature.

9 This video, “Psychiatry: Labeling Kids with Bogus Mental Disorders,” can be seen on
YouTube: http://youtu.be/Wv49RFo1ckQ
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Let Kids Be Kids: “The Last Calvin and Hobbes” Hoax and

Captain Underpants

The Last Calvin and Hobbes

Bill Watterson’s comic strip Calvin and Hobbes ran in newspapers from 1985 to

1995. Critically praised and widely loved, the strip featured an imaginative young boy,

Calvin, and his stuffed animal/imaginary friend, Hobbes. Whenever a third character

appears in the comic, Hobbes is depicted as a rather tattered stuffed animal. Whenever

the two are alone, Hobbes appears alive and animated, as a full sized anthropomorphic

tiger, reminiscent of Tigger from the Winnie-the-Pooh franchise.

Watterson is notoriously principled and tight-lipped, choosing to express himself

almost exclusively through his work. He rarely grants interviews, and when he has

occasionally spoken at professional conventions and events, he exhorts his peers to resist

the lucrative temptations of product licensing in order to maintain the highest levels of

artistic integrity. Watterson himself has resisted all such temptations, in spite of the

obvious marketing opportunities available to a comic strip showcasing a lovable stuffed

animal. To the very end of the strip’s run, moreover, Watterson stayed true to his basic

formula for the strip, which never experienced a decline in quality. Watterson’s

announcement in 1995 that the final strip would be published on the last day of that year

prompted public eulogies and speculation about how the strip would come to a close. In

one such tribute, Washington Post columnist Frank Ahrens predicted a melancholy end to

Calvin and Hobbes, reflecting the inevitable end to all imaginary friends from childhood:

...they well be building a snowman together...

Calvin will say he hears something; maybe it’s a

monster.

“What’s that?” he’ll ask Hobbes.

“It’s just your imagination,” Hobbes will reply.

 244

Then Calvin will turn away for a moment, to fashion

the snowman’s head. He will need help lifting it onto the torso, so
he will call for his best friend, Hobbes. But Hobbes will not
respond.

Calvin will turn around.

Hobbes will be there. But he will be small and stuffed

and have short, blunted paws and button eyes. He will be slumped
forward in the snow, flaccid, lifeless.

Calvin will blink. “Huh.”

And then he will simply shuffle away, off the page,

leaving behind his stuffed tiger, and the unfinished snowman, and
his wonderful, wonderful childhood.10
Ahrens’s vision for the final strip makes sense—but even he admits it’s not an ending he

desires to read.

As it turned out, instead of the sober ending Ahrens envisioned, Watterson’s last

strip maintains the innocent optimism that made the strip so well-loved, and preserves the

strip’s central conceit to the end:

10 Ahrens, Frank. “So Long, Kid: An Obituary for a Boy, His Tiger and Our Innocence”
The Washington Post, Nov. 19, 1995
 245

Figure 3: Bill Watterson’s final Calvin and Hobbes strip (December 31, 1995).

In this final strip, the relationship between Calvin and Hobbes is preserved, continuing on

forever, implicitly. But note the final panel: the abundance of snow throughout the strip,

but especially in the last panel, allows Watterson to rely on negative space, with only a

few sparse lines to communicate movement of the sled through the snow. This

abundance of negative space suggests the disappearance of the comic strip. It seems to

be fading before our eyes. Yet, even as he is signaling the strip’s disappearance, Calvin

and Hobbes are portrayed as surviving on, even diffusing into the world – a much more

uplifting ending, and much more in the spirit of Watterson’s vision.

Crucially, however, along with Watterson’s official final strip, another strip began

to circulate on the internet beginning in the early 2000s, that is also purported to be
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Watterson’s final Calvin and Hobbes strip. In fact, there have been two revisions of this

“ghost” strip, both of them focusing on Calvin at a desk, working on his homework.

Figure 4: A hoaxed “final strip” of Calvin and Hobbes, widely circulated on the Internet.

Alternately, this version of the comic is sometimes posted as the final strip:
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Figure 5: An alternate iteration of the Calvin and Hobbes “final strip” hoax.

Sometimes this strip is accompanied with a conspiratorial explanation, suggesting that

this is the one Watterson intended to be the last strip, but the newspapers made him

change it. Sometimes, conversely, claims are made that this was the authentic final strip,

with no attempt to reconcile this claim to the easily verified existence of the real final

strip. Other times, it is accompanied by a disclaimer, like, “I know this is a fake Calvin

and Hobbes comic, but it’s really really sad.”11 Especially in this latter iteration, it is

fairly obvious that these are panels from a Calvin and Hobbes strip that have been

appropriated and altered to make a kind of Calvin and Hobbes remix. Here is the original

1989 Calvin and Hobbes strip that was the source for the “fake” panels:

11 An example can be found on the online image hosting service, Imgur:

imgur.com/Uwvdr
 248

Figure 6: Bill Watterson’s Calvin and Hobbes strip (July 13, 1989) that served as source
material sampled in the “final strip” hoax.

The last panel of the 1989 strip is duplicated in every one of the four frames of the second

iteration of the allegedly “final strip.” Duplicating images from panel to panel while

changing only dialogue is not unheard of, but it’s a technique that Watterson never

employed and exactly the kind of shortcut he railed against as a comic artist. The

dialogue isn’t a very good approximation of Watterson’s strip, either. Rarely, if ever,

does Hobbes call Calvin by name, for example. Considering these stylistic giveaways, as

well as the anticipation and publicity associated with the authentic final Calvin and

Hobbes strip, it’s remarkable that this one is credulously received as often as it apparently

is. Yet it is presented so regularly online that a Google search for “last Calvin and

Hobbes” brings up this strip before Watterson’s.

When this fake pastiche of a final strip is discovered for the first time by some

young blogger, a fairly consistent chain of events unfolds: the strip is posted and labeled

as the final Calvin and Hobbes strip, and the first responses posted express profound

sadness.12 Soon, another post ventures to comment about the over-prescription of

Ritalin and the inevitable zombification of school children. This is soon followed by a

12 For example, see “Adventures of Accordion Guy” (blog):

www.joeydevilla.com/2008/01/08/calvin-and-hobbes-now-with-ritalin/
 249

counterpoint, either from someone with ADHD or a family member of someone with

ADHD, defending the diagnosis or attacking the kneejerk rejection of the diagnosis. A

heated exchange of posts then ensues, most often ending at a predictable detente: ADHD

is legitimate and some people probably benefit from Ritalin, but it probably is

overdiagnosed a bit.13 This is a reasonable conclusion insofar as it grants all sides

involved in the debate some ground, and it keeps the peace, though it is not, to say the

least, the most coherent of positions.

At some point, then someone will point out the indications that the comic is a
fake, which then starts a debate as to the merits of copyright law and fair use for the

purposes of satire. At its most insightful, such interchanges go further to ask whether or

not the suspect final comic is in the spirit of Calvin and Hobbes. While I have already

pointed out ways in which it is not, some fans note that it inspires thought about the “real

world” and the consequences of contemporary attitudes about childhood and its

disciplining by adults – thus, it is in the spirit of Watterson’s Calvin and Hobbes. The

strip is also commonly read as a statement against the medicalization of childhood, which

fans presume would be the stance of Watterson himself.

It is interesting both that the prank is accepted as a genuine comic, and that

sadness is the nearly universal response it elicits. I would argue that this is because it

taps into the same logic that Frank Ahrens spoke of in his article. On the Snopes.com

page dedicated to this hoax strip, it is suggested that Ahrens’s article may be the
inspiration for this anonymous comic strip, though there’s no direct evidence of this.

However, while there is no mention of Ritalin or ADHD in Ahrens’s article, it does

include a nostalgic lament over the breakneck, cyborg-like and commodified pace of

modern life:

13 Another exemplary thread of comments can be seen on the Snopes.com website:

msgboard.snopes.com/message/ultimatebb.php?ubb/get_topic/f/30/t/002612/p/1.html
 250

Much has been written about contemporary society’s

sensory overload, its ability to fracture and disenfranchise people
from their families, their values, their selves. More and more, we
feel naked against a world that goes only faster and harder, louder
and emptier. Outside, everything is too fast, too hyper. Our
reservoir of wonder has been tapped dry. People want to race
snowmobiles, not build snowmen. We grow steroid tomatoes
year-round, reveling in the convenience, diluting the perfection of
a single, smallish tomato plucked right from the vine in late
summer.14
Moreover, the fake comic fits into opinions people already have about Ritalin and

ADHD; namely that ADHD is nothing more or less than a manifestation of an ordinary

(white, male) American childhood, which has been mistaken for a mental disorder. In

other words, to cure Calvin of his ADHD is to bring his childhood to a premature end—

and this is the source of the sadness.

This critique of ADHD is apparent in several other cultural texts. An episode of

The Daily Show that aired on May 17, 2000 (the same month that the first of the Ritalin

lawsuits were being filed in Texas) included a skit featuring Steve Carell, in which he

identified what are clearly normal childhood behaviors as symptoms of ADHD. This skit

avoids becoming too strident or polemical by deteriorating into a gag about Steve Carell
popping any kind of pill he mentions. But before the skit is over, it implies that ADHD is

nothing more than an expression of normal childhood. This claim is challenged by host

Jon Stewart, but he also concedes in his dialogue with Carell that “there is some

overdiagnosing going on, isn’t that true?”

Captain Underpants

Captain Underpants is the most recognized creation of children’s author Dav

Pilkey. Aimed at young, implicitly male, readers, the first of this series of books was

published in 1997. To date, the series consists of ten books and three spinoffs, with two

books currently in production for publication in 2014 and 2015. The series is wildly

14 Frank Ahrens, “So Long, Kid: An Obituary for a Boy, His Tiger and Our Innocence,”
The Washington Post, Nov. 19, 1995.
 251

popular, selling 70 million books worldwide in more than 20 languages and it has been

credited for making readers out of kids who have trouble learning to read. It has also

attracted a significant amount of resistance from parents and organizations who find the

books offensive and inappropriate for the age of their intended audience. The series has

made it onto the “most banned books” list multiple times, and Captain Underpants books

were reported by the American Library Association to be those “most challenged” in

2012.

The books follow the adventures of Harold Hutchins and George Beard, two
fourth grade boys who are riotous troublemakers. The most productive scheme the boys

come up with is drawing their own comic books to sell to their classmates. Their comics

recount the adventures of the titular hero, while lampooning the school’s teachers and

principal. For this, the boys are sent to the principal’s office. While there, however, due

to an unlikely mix-up, their principal becomes hypnotized into believing he is Captain

Underpants. When the principal leaps out of the window in nothing but a cape and his

underpants, Harold and George have to rescue him from hurting himself. This blurring of

boundaries between the world of Harold and George’s comic books, the world of their

school, and the comic book world of Pilkey’s making, is the animating conceit of the

series, and the source of much of the humor. The other primary source of humor:

underpants.

The obvious metatextuality of the books’ narratives is mirrored in the formal

layout of the texts. Most of each book is laid out much like any piece of children’s

literature, with a small amount of type-set text on each page, while the rest of the page is

dominated by an illustration. Within this framework, each book in the Captain

Underpants series contains a reproduction of a comic book by George and Harold, in the

form of a book-within-a-book. All of the images and text on these pages appear to be in

crayon, bounded by roughly drawn boxes. The illustrations in the comic are crude, as if

rendered by a child’s hand, and the text includes misspellings and reversed letters.
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Figure 7: An example of Dav Pilkey’s Captain Underpants book-within-a-book, from

The Adventures of Captain Underpants (1997).

In addition, Pilkey’s books include a number of other novel features. Each book features

a “Flip-o-Rama” section, which instructs the reader to flip particular pages with

sequential images quickly to achieve an animated effect. Each story includes a kind of

anagram game, in which George and Harold rearrange the letters on a school sign to

make crude bathroom humor jokes.

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Figure 8: An example of Dav Pilkey’s use of anagram as a source of humor, from

Captain Underpants and the Invasion of the Incredibly Naughty Cafeteria
Ladies from Outer Space (1999).

Some editions of the books also feature flicker-images on the cover. Taken together, all

these features make these children’s books into unique reading experiences, which is

certainly part of their charm to kids and their success in getting the attention of those who

may not be generally drawn to reading.

Author Dav Pilkey has stated that he designed the books in this way in order to

appeal to kids with ADHD. Their short chapters and embedded activities are classic

strategies for engaging children with attention problems. Pilkey is not shy about the fact

that he was himself diagnosed with ADHD. In fact, Pilkey’s status as a person with

ADHD is used in his promotional materials, and many of the press profiles done on the

author recount Pilkey’s own tales of being punished in grade school for the distraction
 254

caused by his drawings. 15 Pilkey’s identity as ADHD, and his explicit claim to write for

a young ADHD audience, necessitate a close reading of the perspective on ADHD

presented by Captain Underpants.

First, George and Harold are clearly identified as children diagnosed with ADHD,

although this isn’t mentioned explicitly until the fourth book, Captain Underpants and

the Perilous Plot of Professor Poopypants (2000). Their behaviors, however, are typical

of the ADHD profile, which is made clear from the first book, in which they are

identified as being troublemakers. They are also identified as being good kids, though,
and the reader is clearly intended to identify and sympathize with the pair, not in spite of,

but because they are (good) troublemakers. In the fourth book, George and Harold are

finally introduced as having ADHD – even as the concept of ADHD is, then,

fundamentally rejected.

15 Dav Pilkey, “Pilkey Gets Last Laugh with ‘Underpants,’” Interview by Dierdre
Donahue, USA Today 8/21/2011.
 255

Figure 9: Pages 14 and 15 from Captain Underpants and the Perilous Plot of Professor
Poopypants (2000), in which a biodeterminist model of ADHD is dismissed in
favor of social and institutional explanations for the disruptive behavior of
some students.

Summarized adroitly here, Pilkey’s perspective on the diagnosis is fully consistent with

the commonly held view of the disorder, which we also saw expressed in proximity to the

satirized Calvin and Hobbes cartoon, though here it goes a step further to imply an

alternative explanation for the behaviors identified as ADHD – they are the result of the

education system failing students who don’t easily adapt to the school environment. This

message, from someone speaking as a person with ADHD, to young people identified as

ADHD, works to undermine the diagnosis and the authority that endorses it, and in that
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sense is a truly subversive text, to be considered in the same context as the political

activism of groups like Mad Pride, an organization of psychiatric survivors who organize

against the forced medication of the mentally ill. Pilkey’s subversive agenda is further

signaled to the observant reader in the choice of the protagonist’s names. George M.

Beard was, of course, the American physician who, in the mid-1800s, defined

neurasthenia, a nervous condition that was popularly diagnosed among an elite class of

people throughout the 19th Century, and was later discontinued and generally discredited.

This association implies that Pilkey views ADHD as a similar phenomenon – a

culturally-bound condition that is more fad than substantive illness category. George and

Harold aren’t physically different from normal children, in need of behavioral

modification through drugs. They are normal children responding in a predictable way to

circumstances that should be altered to meet their needs. It’s an elegant critique; by using

novel techniques to engage the attention of children – even children with learning

challenges – and successfully writing books that invite non-readers to read, Pilkey

demonstrates the effectiveness of non-chemical responses to children with attentional

limitations.

Similarly, the 1988 John Waters film Pecker includes a character whose primary

function is to articulate a similar critique of ADHD. The main character’s little sister,

Little Chrissy, is depicted as a happy, energetic, and impulsive child from her first

appearance on screen, where she greets her brother cheerily, saying, “I killed a worm!”

She is also shown to crave – even demand – sugary sweets and sodas at all times, a vice

that is generally indulged by the adults in her working class Baltimore neighborhood.

This sugar addiction is memorialized when the protagonist, an aspiring photographer

named Pecker, snaps a photo of Little Chrissy sneaking into the kitchen cupboards to eat

processed sugar by the handful directly out of the two-pound bag, drooling sickly in a

sugar-induced intoxication. After Pecker receives publicity and money for his first

successful art show in New York, which featured the portrait of Little Chrissy among
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others, the family is visited by social services, who inform the family that Little Chrissy

has ADHD and needs to take Ritalin. Pecker protests, “all little kids like candy!” but the

family is convinced and starts her on Ritalin. In subsequent scenes, little Chrissy is

portrayed as lifeless and zombie-like, saying or doing very little apart from pointing

wordlessly at her own tongue when it’s time for her next pill.

This change in Chrissy is one of several changes in Pecker’s household once the

high-class art world of New York collides with Pecker’s blue collar Baltimore family.

Most all of the changes are portrayed as negative (some, comically so; photos of Pecker’s
associates cause his petty-thief friend to abandon theft as a career path and lead to the

closure of an all nude strip club). The film’s resolution is achieved when Pecker rejects

the imposition of New York standards by staging art shows in Baltimore. In the final

scene, Pecker’s successful art opening, little Chrissy looks like herself again, and is

shown cheerfully helping serve refreshments as part of the family endeavor. When

someone comments “She looks so different!” her mother replies “Little Chrissy is off the

drugs. She’s sugar-free and on the road to a balanced diet.”

John Waters delivers the punch line to this joke in the following scene, which

shows Little Chrissy cramming celery in her face with zeal similar to that with which she

earlier devoured candy bars, before moving on to snort peas with a rolled up dollar bill.

This comic tag doesn’t undercut the film’s satire on ADHD, however; to the degree that a

child is unruly, it is most likely the result of something environmental, like sugar, and
beyond that influence, it is merely normal childhood behavior. Waters’ articulation of this

critique further identifies the tendency to medicalize such behaviors as a marker of class,

for it is only when the family’s class status is disrupted that outside forces intrude with

their redefinitions of little Chrissy’s behavior. As blue-collar Baltimore residents, they

were content to ply Little Chrissy with sugar; as upwardly-mobile New York art world

darlings, they adopted the medicalized discourse and practice of ADHD. Finally, after

rejecting the pomposity of the upper classes, they find a happy medium that addresses the
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behaviors of their child through non-medical means. This, of course, reflects non-medical

treatment regimes that, since the 1970s, have sought to explain and treat hyperactivity

and inattention through diet.

Scrutinizing childhood behavior and medicalizing it as deviant is also identified

as the province of the upper class in the Wes Anderson film The Royal Tenenbaums

(2001). The character played by Bill Murray, Raleigh St. Clair, is a neurologist. Having

married into the wealthy and eccentric Tenenbaum family, he is shown to live a

comfortable lifestyle of independent research and publication. His solitary research

subject is a boy identified only as Dwayne. St. Clair observes Swayne in a number of test

situations, marking down any response as significant and unique to Dwayne’s condition.

St. Clair eventually publishes a book on Dwayne’s condition. What becomes clear to the

audience, however, is that this condition is nothing more than an idiosyncratic group of

behaviors unique to Dwayne. Those features have been observed and represented to the

public as a disorder – but that process serves no apparent therapeutic function for

Dwayne, and seems primarily to offer St. Clair a reason to live, and an opportunity to

publish.

Dwayne is also shown to be anticipating the answers to St. Clair’s research

questions, participating in the process in a way that mirrors Foucault’s accounts of

“hysterics” participating in their doctors’ investigations, through which they mutually

construct the diagnosis of a hysterical woman.16 This sort of phenomenon is seen again
in the 1970s and 80s in the notorious cases of multiple personality disorder and ritual

satanic abuse behind bestselling books like Sybil (1973) and Michelle Remembers

(1980).17 The Royal Tenenbaums does not mention ADHD directly, but the character of

16 Foucault, Madness and Civilization.

17 Flora Rheta Schreiber, Sybil (1973); Michelle Smith and Lawrence Pazder, Michelle
Remembers (1980).
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Raleigh St. Clair reminds the audience of fraudulent behavioral diagnoses of the recent

past, and suggests that some behavioral disorders may not be properly considered

illnesses, but simply expressions of childhood individuality, seen through the interested

lens of privilege.

The Gift of ADHD: The Hunter/Gatherer Gene Theory and

The Lightning Thief

The Hunter/Gatherer Gene Theory

In his 1992 book, Attention Deficit Disorder: A Different Perception, Thom

Hartmann, a multifaceted public figure who wears several different hats, proposed an

evolutionary theory of ADHD. 18 Hartmann suggests that ADHD might be best

understood as a genetic adaptation that would have been advantageous to our Hunter-

Gatherer ancestors – a notion now referred to as the Hunter vs. Farmer Theory. The

Hunter v. Farmer theory that Hartmann proposes suggests that the traits associated with

ADHD (e.g., distractibility, lack of focus, etc.), which are currently considered to be

indicative of an undesirable behavioral disorder, are in actuality the very same

constellation of traits that would have been considered desirable in a hunter living in a

hunter-gatherer society, such as existed 10,000 years ago. Conversely, the absence of

ADHD traits, while being maladaptive in a hunter-gatherer society, would be adaptive in

an agrarian society. Those with ADHD, then, should not be considered disabled; rather,

they should view this constellation of traits as the adaptive qualities of a hunter-gatherer.

In this light, the challenges of ADHD are recast from being an intrinsic failing of one’s

biology, into the mismatch between one’s agrarian/industrial environment and one’s

hunter-gatherer heredity.

18 Thom Hartmann, Attention Deficit Disorder: A Different Perception (Nevada City,

CA: Underwood Books, 1997).
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This theory has been widely criticized, most notably by psychologists Sam

Goldstein and Russell A. Barkley. Goldstein and Barkley argue that Hartmann’s

characterization of the traits associated with ADHD as adaptive necessarily distorts and

misrepresents the nature of those very traits. For example, Hartmann recasts what is

commonly called ‘distractibility’ as ‘response-readiness,’ imagining that the skittish

nature of an ADHD child might be appropriate for a hunter scanning the horizon and

latching onto the smallest attention-grabbing detail as a potential meal. Goldstein and

Barkley find this to be misleading, and suggest that Hartmann does not understand the
body of scientific knowledge accumulated around the study of ADHD:

Such data suggest to us that those with ADHD are not more
"response ready;" in fact, they seem more ill-prepared to respond
to forewarned events, and do not effectively use information from
errors to immediately improve their performance as do normal
children or adults. Any advantages such a pattern of behavior may
have for hunting or warfare are not immediately apparent to us.19
Further, Goldstein and Barkley point out that Hartmann fails to consult the

anthropological record regarding the real characteristics of contemporary hunter-gatherer

societies. This suggests that Hartmann’s hunter v. farmer world is one of his imaginary

construction, and not one based in the lived experience of anyone in the real world.

Goldstein and Barkley claim to be concerned about all of this because theories

like Hartmann’s, which they label ‘pop-adaptationism,’ are “finding their way into the

scientific literature.”20 They also turn their critical attention to two other researchers, J.F.

Shelley-Tremblay and L.A. Rosen, and fault them for taking Hartmann’s idea seriously,

in addition to failing to review the anthropological literature before making claims about

hunter-gatherer societies. More importantly, this rhetorical move draws a line between

Thom Hartmann and ‘the scientific literature,’ making sure that Hartmann is perceived as

19 Sam Goldstein and Russell A. Barkley, “ADHD, Hunting, and Evolution: ‘Just So’
Stories,” The ADHD Report, vol. 6, no. 5 (October, 1998).
20 Ibid., 2.
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not scientific. It is true that Hartmann is not an academic scholar, but a popular writer

and entertainer, and a lay historian, and for Goldstein and Hartmann, that is part of the

problem of his argument; he lacks the authoritative position in the scientific community

that would license him to make such arguments.

Were more scientists to take seriously ideas like Hartmann’s, Goldstein and

Barkley predict dire consequences. As can be seen in this passage, they are concerned

about the ‘slippery slope’ of implications they anticipate from Hartmann’s position:

Does this "myth of mental illness" fate await other

psychiatric and developmental disorders as well? Were autism,
depression or psychosis adaptive? Would other disorders, such as
mental retardation and learning disabilities, that fall along a
continuum of normal and represent the lower tails of a distribution
likewise be framed as now outdated, yet previously successful
adaptations? We hope not.21
This use of the phrase, the “myth of mental illness,” is clearly a reference to Thomas

Szasz’s controversial 1960 article and subsequent book of the same name, which, though

not associated with the Strong Programme at all, is representative of the strongest

possible iteration of social constructivism. As he suggests in the title, Szasz argues that

“the notion of mental illness has outlived whatever usefulness it might have had and that

it now functions merely as a convenient myth.”22 Rather, as Szasz sees it, the label of
‘mental illness’ represents little more than “deviation from some clearly defined norm…

in terms of psycho-social, ethical, and legal concepts;”23 thus, it is socially constructed.

In this sense, Goldstein and Barkley are not only responding to Hartmann’s

characterization of ADHD, but to the epistemic threat of an inter-subjective, socially-

constructed reality, as opposed to a physicalist one.

21 Ibid., 4

22 Thomas Szasz, “The Myth of Mental Illness” in American Psychologist (v. 15, 1960,
pg. 113-118), 118.
23 Ibid., 114, emphasis in original.
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In denying the potential adaptivity of the traits associated with ADHD, Goldstein

and Barkley identify those traits as polygenetic. (The very use of this phrase does

rhetorical work in establishing themselves as more versed in scientific literature than

Hartmann.) Such traits, as they rightly point out, are continuously distributed across a

range of iterations. The irony is that this very that necessitates a socially constructed

definition of ADHD. That is, if attention (or inattention) is distributed continuously

across a spectrum, then the point at which its deficit (or surfeit) is considered

pathological is ultimately an arbitrary distinction influenced by social and cultural values.

This point is apparently lost on Goldstein and Barkley, as they actively shun the notion of

social construction even as they talk about a behavioral disorder that is inherently social

in nature.

So why would Hartmann decide to use this Evolutionary Psychology tactic in the

first place? Why try to make the argument that a behavioral disorder was adaptive?

Goldstein and Barkley answer this correctly when they point out that, “Asserting

that ADHD qualities were at one time adaptive sounds intriguing, and may make those

afflicted feel better about themselves.” This is not really a feat of interpretation, though,

as Hartmann is quite upfront about this motivation. In fact, Hartmann’s book might be

best thought of as a self-help book; it only falls under the purview of Goldstein and

Hartmann, both working hard to shore up their own credentials as ‘legitimate’ ADHD

scientists, because Hartmann dresses up his motivational speech with the language of
Evolutionary Psychology (which is arguably its own kind of pop literature, dressed up in

the language of evolutionary theory and cognitive science – which is in turn neurology

dressed up in the language of computers and philosophy). Hartmann’s willingness to

consider alternate constructions of ‘normalcy’ in the definition of one’s abilities no doubt

comes from the proximity of ADHD activists to the disability community – a relationship

that was solidified in the late 80s and early 90s in an effort to get ADHD recognized as a

disability under the Americans with Disabilities Act. What makes Hartmann’s hunter v.
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farmer theory so confounding to scientists and academics, and simultaneously so

compelling for many among the book-buying public, is the intermingling of this

‘differently-abled’ rhetoric with the rhetoric of science.

The Lightning Thief

We see this theory, and the debates surrounding it, in several iterations in popular

culture. Rick Riordan’s novel The Lightning Thief (2005) recounts the adventure of Percy

Jackson, a troubled 12-year-old, who, as we are informed from the beginning, suffers

from ADHD and dyslexia. These problems, along with a disagreeable stepfather and a
regular schedule of mysterious events, have caused Percy to get kicked out of a series of

schools. (“A dyslexic, hyperactive boy with a D+ report card, kicked out of school for the

sixth time in six years.”24) Finally, he is sent to a summer camp called Camp Half-

Blood. There, he discovers that his biological father is actually the Greek God Poseidon,

making him only half-human. The rest of the narrative is a quest that mirrors the Greek

myths of demigod Perseus in a modern-day setting. The modern world is shown to be

consistent with the mythology of ancient Greece, though the divine nature of those godly

actors is hidden to most mortals. Upon discovering his true nature, Percy’s ADHD and

dyslexia are explained in this new context:

The letters float off the page when you read, right? That’s
because your mind is hardwired for ancient Greek. And the
ADHD—you’re impulsive, can’t sit still in the classroom. that’s
your battlefield reflexes. In a real fight, they’d keep you alive. As
for the attention problems, that’s because you see too much, Percy,
not too little. Your senses are better than a regular mortal’s. Of
course the teachers want you medicated. Most of them are
monsters. They don’t want you seeing them for what they are.25

24 Rick Riordan, The Lightning Thief, 38.

25 Ibid., 88
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In Riordan’s world, all demigods (or half-bloods) have ADHD. It is, in fact, a sign of the

divinity in their blood. In this way, ADHD is rewritten, not as a disability but as a mark

of distinction and a sign of some kind of unseen ability.

Riordan was a high school English teacher before becoming a children’s author

and he tells of composing The Lightning Thief originally as a series of bedtime stories for

his own son who is diagnosed with ADHD. The conceit of the story, then, is designed to

provide children diagnosed with ADHD an alternate definition of their condition, one

which is presumably empowering rather than disabling. But, in contrast to Captain

Underpants, Riordan’s view doesn’t question the reality of ADHD. Instead it reifies it.

This view is invested in the physical reality of ADHD – inherited through bloodline and

“hard-wired” into the brain. Rather than a disorder being dismissed as behavior within

the range of normal, the group of behaviors is entrenched as outside the range of normal,

and then re-classified from a disability into a superability.

Riordan has spoken of being inspired by reading Thom Hartmann’s book

Attention Deficit Disorder: A Different Perception, a book that has proven to be widely

influential beyond its fictionalizing by Riordan. A number of things contribute to the

popularity of the ideas espoused by Hartmann. For one, its association with evolutionary

psychology links it to an already popular trend in popular psychology in the late-20th

century.26 Additionally, it serves the function of re-valorizing a stigmatized subjectivity.

This is consistent with other disability tropes in popular culture, what disability scholars

have identified as the “super-crip” stereotype. Ironically, most scholars of disability

studies identify the concept of the super-crip as a condescending and ultimately able-ist

26 This trend is exemplified by the popularity of works such as: David M. Buss, The
Evolution of Desire: Strategies of Human Mating (New York: Basic Books, 1992); V.S.
Ramachandran, “Why Do Gentlemen Prefer Blondes?” Med Hypotheses. Vol. 48, no. 1 (Jan.
1997): 19-20.
 265

notion, though, in this instance, Riordan is employing it credulously. The super-crip

stereotype illustrates the uneasiness of ADHD within a disability context, as well as

tensions about mental illness in general within a disability context. Since the success of

The Lightning Thief, Riordan has continued to write about his son and is ADHD. As it

turns out, he has also written of their struggles with Ritalin and their decision ultimately

to forego drugs in favor of structural changes in his son’s education.

The association of ADHD with creativity – even genius – might cause ADHD to

even seem like a desirable trait – which tests the limits of the Hunter Gatherer argument.
Moreover, historically, the very same dynamic led to the abandonment of the diagnosis of

neurasthenia in the early 20th Century. As Thomas Lutz points out, the diagnosis of

neurasthenia was sought out as a “mark of distinction, of class, of status, of

refinement.”27 His analysis illuminates ways in which those desires drove the diagnosis

more than did any empirical observation. If ADHD truly is a superpower, then should

people be seeking out the diagnosis? While it initially seems well-intentioned and

harmless to redefine a disability as a superpower, doing so fundamentally changes what

ADHD is. Why is it a disability? Why medicate it? Why grant special protections in the

law? The project of redefinition has extended far beyond ADHD. For example, there is a

movement to stop labeling autism a disability, and to stop calling PTSD a disorder.

These claims come out of an effort to de-stigmatize, but they seem to not fully engage

with the ramifications of what they are asking: do they want a fundamental reexamination

of mental disorders? Or a change in the words being used?

27 Thomas Lutz, American Nervousness, 1903 (Ithaca: Cornell University Press, 1991),
6.
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ADHD Culture: The Joker and Kendrick Lamar

The Joker

The Joker is one of the original villains in Batman’s corner of the DC Universe,

first appearing in 1940. The character was introduced as a chilling homicidal maniac,

whose penchant for wearing clown make-up was a source of cognitive dissonance and

inscrutable terror, rather than comic relief. Not long after the Joker’s introduction,

however, social and governmental pressure on the comics industry inspired a new regime

of self-imposed censorship throughout the industry, as embodied in the Comics Code

starting in 1948.28 In this effort to make comic books more appropriate for their

youngest readers, the tone of superhero comics became much more light-hearted.

Accordingly, the Joker became a laughable villain. The campy Batman TV show from

the 1960s further played the Joker as a comic buffoon. In the 1970s, under Bronze-Age

visionaries Dennis O’Neil and Neal Adams, the tone of Batman returned to the noir feel

of the 1940s, and the Joker again became a dark and sinister villain. Among the elements

of realism added to DC Universe in the 1970s was presence of psychiatry, as embodied in

the sinister Arkham Asylum. This “asylum for the criminally insane” quickly became an

important element of Batman’s world, and writers in the 1970s waded into the ethics of

the insanity plea, the ethics of forced medication (a hot issue in the courts during the

1970s), and the sometimes tenuous distinction between sanity and insanity. While many

superhero adversaries were, from time to time, confined within the walls of Arkham

Asylum, the Joker, above all other villains, became so closely associated with the

psychiatric hospital that it effectively doubles as the Joker’s residence and sphere of

special influence. In the 1980s, the Joker became an increasingly central element of the

Batman pantheon, emerging as Batman’s arch-nemesis. Then, in 1986, writer and artist

28 Bradford Wright, Comic Book Nation: The Transformation of Youth Culture in

America (Baltimore, MD: John Hopkins University Press, 2001).
 267

Frank Miller produced the pioneering graphic novel The Dark Knight Returns, which

controversially set a new standard for the darkness and maturity of tone possible in a

Batman comic, clearly marking a turn from children to adults as the primary audience for

comic books.

All of this set the stage for writer Alan Moore and artist Brian Bolland’s graphic

novel The Killing Joke in 1988. In developing the Joker’s origin story in more detail,

Moore and Bollard offer a picture of the Joker that is, if not sympathetic, perhaps

understandable in terms of psychological disorder. The plot opens with the Joker
escaping from Arkham Asylum. After establishing a hideout in an abandoned

amusement park, the Joker and his hired goons invade the home of Police Commissioner

Gordon, Batman’s long-time friend and ally. Gordon is knocked unconscious and

kidnapped, while his daughter Barbara is shot in the spine (rendering her paraplegic) and

raped by the Joker. While the rape of Barbara Gordon isn’t explicitly acknowledged in

Moore’s dialog, artist Brian Bollard shows the Joker’s hand at the edge of the frame

lifting her blouse ominously, unmistakably communicating the Joker’s shocking actions

to the attentive comic reader – a heretofore unprecedented level of darkness, not only in

the Batman franchise, but in mainstream superhero comics in general. As a helpless and

bleeding Barbara Gordon asks, “Why are you doing this?”, the Joker answers, simply,

“To prove a point.”

 268

Figure 10: An example of the dark tone of Alan Moore and Brian Bolland’s Batman: The
Killing Joke (1988).

If the Joker has a point, however, he seems to have a hard time keeping track of it –

perhaps due to his own scattered consciousness. In a series of colorful monologues –

which stand out as the animating elements at the heart of The Killing Joke – the Joker

argues, in one instance, that he is not insane, because insanity is the only rational
response to the real world.
 269

Figure 11: “You’re going mad.” Alan Moore and Brian Bolland’s Batman: The Killing
Joke (1988).

Later he argues that, while he is insane, very little distinguishes the sane from the insane,

perhaps as little as “one bad day.” Both of the arguments of the Joker’s are in turn

employed to prove his ultimate point: that Batman himself is insane. To make his

point(s), the Joker attempts to drive Commissioner Gordon insane by holding him

hostage in his re-purposed amusement park funhouse and torturing him while forcing him

to view photographs of his daughter being raped. In so doing, the Joker hopes to

demonstrate that he is no different from any sane person, given the right circumstances.

It becomes clear that the Joker is primarily concerned with proving this point to Batman

himself, as he uses the amusement park loudspeaker to lecture Batman, even as the
 270

superhero wends his way through the booby-trapped funhouse towards the Joker and the

hostage Gordon.

Figure 12: “All it takes is one bad day.” Alan Moore and Brian Bolland’s Batman: The
Killing Joke (1988).
 271

The care with which the Joker’s dialog is crafted makes clear that Alan Moore finds the

Joker more interesting than he does Batman. In fact, the Joker, rather than Batman,

serves as the primary vehicle for the expression of Moore’s voice. The moments in

which the Joker rhapsodizes about the virtues of insanity over the barbarity of the sane

world articulate conspiratorial half-truths about the military and technological “wiring of

the world.”

Figure 13: “It’s all a joke!” Alan Moore and Brian Bolland’s Batman: The Killing Joke
(1988).
 272

Coupled with Bollard’s disarmingly sincere portrait of the Joker in a melancholy direct

address of the reader, Moore’s version of the villain inspires pathos, if not sympathy.

The mirroring of madness in reality is picked up and taken further by Grant

Morrison and Dave McKean in their graphic novel Arkham Asylum, published in 1989.

The plot opens with Arkham Asylum falling under the control of the Joker himself,

requiring Batman to enter the madhouse to restore order. In the course of undertaking

this task, Batman has the opportunity to speak with the Joker’s psychotherapist, Dr. Ruth

Adams. While explaining her work with the Joker, Dr. Adams makes a similar argument
to the one put forward by Alan Moore’s Joker in The Killing Joke – that the Joker is not

insane, but, rather, is in possession of a kind of super-sanity. In the panels below, Dr.

Adams describes the Joker’s condition in terms that resonate with the ADHD profile:
 273

Figure 14: “Some kind of super-sanity…” Grant Morrison and Dave McKean’s Arkham
Asylum: A Serious House on Serious Earth (1989).
 274

In spite of Batman’s moralistic rejection of Dr. Adams’ empathetic psychologization of

the Joker, her description of a super-adaptive stream-of-consciousness effectively

characterizes Dave McKean’s crowded, multimedia art throughout the graphic novel. As

events in Arkham Asylum unfold, Batman’s self-righteous confidence in his own sanity

falters, recalling Alan Moore’s challenge to the very distinction between Batman and the

Joker – and thus, between sanity and madness. Additionally, Morrison develops the

origin story of Arkham Asylum itself, turning the psychiatric hospital into a character in

its own right. As a character, Arkham Asylum is afflicted with the ghost of its founder,
Amadeus Arkham, and the persistence of his delusional aspirations, suggesting that the

space of Arkham Asylum itself induces a kind of madness.

At the graphic novel’s conclusion, Batman prevails, not by defeating the Joker or

Arkham Asylum, but by embracing his own neuroses. When Batman’s lifelong

obsession with avenging the murder of his parents is identified by Dr. Adams as “insane,”

Batman replies, “Exactly. Arkham was right; sometimes it’s only madness that makes us

what we are.” Batman then breaks down the walls of the Arkham Asylum itself, telling

its residents, “You’re free. You’re all free.” The Joker’s response is to say, “Oh, we

know that already. But what about you?” The Joker elects to stay in Arkham Asylum,

and as Batman walks out into the glare of the police lights outside, the Joker tells him:

“Enjoy yourself out there. In the Asylum. Just don’t forget – if it ever gets too tough…

there’s always a place for you here.”

 275

Figure 15: “Out there, in the asylum.” Grant Morrison and Dave McKean’s Arkham
Asylum: A Serious House on Serious Earth (1989).
 276

Like Moore in The Killing Joke, Morrison and McKean use the madness of the Joker, as

well as chaotic atmosphere of Arkham Asylum itself, as the primary vehicle of artistic

expression.

20 years later, Kevin Smith’s 2009 Batman project, Cacophony, pays homage to

these earlier, super-crip medico-determinist apologists – and builds further on the Joker’s

diagnosis, marked by symptoms of ADHD. Like The Killing Joke and Arkham Asylum,

Cacophony begins in Arkham Asylum, where the Joker is confined. In Smith’s story, the

Joker’s predictable escape is orchestrated by another supervillain, who hopes that the
rekindled obsessive-compulsive rivalry between Batman and the Joker will distract the

titular superhero from discovering his own nefarious plots. In an aside to the reading

audience, and a clear reference to Arkham Asylum’s Dr. Adams, Smith’s Batman recalls:

A doctor at Arkham once described for me the Joker’s state

of mind. “Imagine trying to solve the world’s most difficult math
equation while you’re surrounded by six televisions that sit five
inches from your face, all tuned to different stations, all rapidly
switching channels, all with the volume at full blast.”
Batman goes on to explicitly identify this condition as “off-the-charts attention deficit

disorder.”
 277

Figure 16: “[A] psychopath…with attention deficit disorder.” Kevin Smith and Walt
Flanagan’s Batman: Cacophony (2009).
 278

In this example, Smith identifies and characterizes the Joker through ADHD. In so

doing, Smith simultaneously characterizes ADHD as a response to an oversaturated

media environment. Since the late 1980s, then, the Joker is diagnosed as the insane

criminal he is partly because of ADHD. In other words, he is this way because the world

made him so, which he mirrors in his scrambled funhouse “wiring.” This, in turn, offers

its own implicit understanding of ADHD – as a mirror, itself, of innumerable

informational flows and excessive stimuli characteristic of late-20th century

technoculture.

There are precedents for this trope early-20th Century American Gothic literature.
Perhaps the most obvious comparison would be the work of American horror writer H.P.

Lovecraft. Lovecraft’s unique and highly influential brand of horror fiction was in many

ways a critique of modernism – as a dispassionate, empirical perspective on human life.

Without a religious, or even humanist, perspective to provide a privileged place for

humans in the order of the universe, the role of people in Lovecraft’s cosmos is reduced

to inconsequentiality. While Lovecraft’s tales, on first blush, seem to be full of demons

and monsters from pits of hell (and indeed, many of his own fears were born out of a

barely contained racism), his inscrutable fiends are not motivated by spite, religious

function, or moral vengeance. Instead the beasts of Lovecraft’s nightmares casually

destroy their human victims with cosmic indifference. The ultimate threat is not eternal

damnation or physical torture, but insanity, as the inevitable consequence of being

confronted with the horrible truth of the universe. For a brand of horror provoked by the

moral relativism of evolutionary and techno-military materialism, the ultimate horror is

the relativism of sanity itself, characterized by this blurring of mind and organic reality.

As the protagonists in Lovecraft’s tales come to true insight and understanding, so they

go insane, begging the question: Am I, who believe myself sane, in reality deluded? And

does the one I dismiss as insane actually perceive reality accurately? The opening
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paragraph of Lovecraft’s 1922 “The Tomb,” practically reads as a first person account of

the Joker’s super-sanity:

In relating the circumstances which have led to my

confinement within this refuge for the demented, I am aware that
my present position will create a natural doubt of the authenticity
of my narrative. It is an unfortunate fact that the bulk of humanity
is too limited in its mental vision to weigh with patience and
intelligence those isolated phenomena, seen and felt only by a
psychologically sensitive few, which lie outside its common
experience. Men of broader intellect know that there is no sharp
distinction betwixt the real and the unreal; that all things appear as
they do only by virtue of the delicate individual physical and
mental media through which we are made conscious of them; but
the prosaic materialism of the majority condemns as madness the
flashes of super-sight which penetrate the common veil of obvious
empiricism.29
The creative team in charge of Batman comics in the 1970s paid homage to Lovecraft’s

influence by naming the institution in which these kinds of questions are asked – Arkham

Asylum – after the fictional town of Arkham, Massachusetts, featured prominently in

Lovecraft’s universe.

A further example of the madness-as-insight trope in comics is the character

Deadpool, who first appeared in Marvel Comics’ New Mutants in 1991.30 Deadpool is

similarly identified as having ADHD, if not formally within the comic, universally

among fans and reviewers. The video game, X Men Legends II: Rise of Apocalypse,

based on the character, includes quips about ADHD. Deadpool is also depicted as having

a unique form of insanity, in which he breaks the fourth wall and addresses the audience.
He is institutionalized because he sees thought balloons over people’s heads. Thus, in

Deadpool’s moments of “insanity,” he is most closely aligned with the experience of the

comic book reader. Because of the centrality of mental health/mental illness in Deadpool

comics, the character is often visually represented in ways that mark him as a psychiatric

29 H.P. Lovecraft, “The Tomb” (1922).

30 Rob Liefield and Fabian Nicieza, New Mutants No. 98. Marvel Comics, February
1991.
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patient – such as being restrained in straight-jackets. In the following image, Deadpool is

depicted in the moment before he jabs a weapon that appears to be a hybrid of a bomb

and a hypodermic needle – simultaneously marked as a medical device by the symbol of

the caduceus – directly into an oversized brain. Adding a further level of meta-

complexity, within the twisting sulci of the brain one can discern the name “Wade,”

which is a reference to Deadpool’s civilian alliterative moniker, Wade Wilson. Thus, the

character identified as Deadpool – who is arguably a delusional identity of the mentally

disturbed Wilson – is shown to be medicating his own mind, even as he inflicts violence
upon himself.
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Figure 17: Marvel Comics’ character Deadpool struggles with his own brain chemistry.
 282

Interestingly, writer Joe Kelly developed this character in response to what he perceived

as a lack of attention from the editorial staff at Marvel. In response to an atmosphere in

which comics would get started and canceled in a matter of months if sales weren’t

immediately impressive, the writers described feeling as if they could get away with

anything. As Joe Kelly explains, “With Deadpool, we could do anything we wanted

because everybody just expected the book to be cancelled every five seconds, so nobody

was paying attention. And we could get away with it.”31 In creating a character with

such a scattered attention, they seemed to have found something that resonated, and this
character has risen to popularity. In flashbacks to Deadpool’s childhood, he is shown to

be a daydreamer, and eventually dropped out of high school. The character himself

comes from the conditions around him – a world which, when reflected back to us

through his personality, is distracted and fast-moving, like the Joker.

This trope is apparent in ADHD literature as well, perhaps most notably in

Richard DeGrandpre’s popular 2000 book, Ritalin Nation: Rapid-Fire Culture and the

Transformation of Human Consciousness. As the title suggests, DeGrandpre—an

academic writer who holds a PhD in psychopharmacology—makes the case that ADHD

is itself only a symptom of a larger phenomenon, which is the transformation of human

consciousness that modern consumer culture has brought about. “Rapid-fire culture gives

rise to a rapid-fire consciousness, an unsettling temporal disturbance of the self that then

motivates an escape from slowness, thus keeping us forever in the grip of the hurried
society.”32 The first chapters of the book make a historical case for the significance of

these changes, recounting several key steps in the industrial revolution (e.g., the

development of clocks and, more importantly, the time-keeping practices that clocks

31 Vaneta Rogers. "2 Great Tastes That Taste Great Together: Joe Kelly/Deadpool"
Newsarama.com (2009-07-16) http://www.newsarama.com/3348-2-great-tastes-that-taste-great-
together-joe-kelly-deadpool.html
32 Richard DeGrandpre, Ritalin Nation, 22-23, italics in original.
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enable). Simultaneously, DeGrandpre makes the case that consciousness itself is not a

timeless, platonic ideal, but an adaptable and historically-contingent entity. Taken

together, DeGrandpre’s point is that these cultural—and, particularly, technological—

developments have changed, fundamentally, the experience of human consciousness such

that we process more stimuli, we process it faster, and we have therefore come to expect

this elevated level of stimulation as normal.

There is nothing wrong with DeGrandpre’s illuminating history of consciousness-

altering moments from the industrial revolution to the 21st Century present. Nor is it

controversial to argue that consciousness is a historically-contingent phenomenon. The

conclusions that DeGrandpre draws, however, are not as obvious. While it is often stated

as common wisdom that the pace of modern life is faster than it used to be, the point is

actually debatable. Certainly transportation and communication have become more

efficient, but for many middle- and upper class Americans, lifestyles have simultaneously

become more sedentary. Television viewing, which DeGrandpre offers as the most

symptomatic expression of rapid-fire modern culture, may offer a series of rapidly

moving images, but it requires no movement on the part of the viewer, and minimal

intellectual engagement. Quite the contrary, the act of television viewing disciplines

attention, as the medium asks the viewer to constrain his or her intake of stimuli to the

limits of a screen. Were this not so, it would not be a medium advertisers clamor to

populate with commercials that seek consumers’ attention.

Even granting DeGrandpre his former point, however, there are more fundamental

problems with his conclusion. After effectively arguing for the plasticity and adaptability

of human consciousness over time, he then characterizes our current state of

consciousness as being somehow problematic, as if out of step with some kind of

“natural” rhythm of human experience. If indeed consciousness has changed along with

culture and technology, why is this necessarily a bad thing? Is it not a further example of

the adaptability of consciousness? Furthermore, if it is true that “rapid-fire culture gives

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rise to rapid-fire consciousness,” that would suggest that the entire country is

characterized by ADHD. At times, it seems that DeGrandpre is making exactly this

argument. But if this argument is taken seriously, it suggests that ADHD is not a

pathological condition, but a normative state of modern consciousness. And if “rapid-fire

consciousness” is the normal state of consciousness, that suggests that ADHD should not

be recognized as a diagnosis. This conclusion, however, is one that DeGrandpre only

half-embraces. While he is critical of the current rates of ADHD diagnosis (stating that it

is overdiagnosed), he stops short of saying that ADHD does not exist. His views are
more carefully modulated for a variety of reasons.

First, as a concept, ADHD is one of the selling points of his book, with a final

chapter pitched as advice for parents of children diagnosed with ADHD. Were he to

argue that the condition was nonexistent, he would be working to undercut the very

audience of his book. Second, the pathological-ness of ADHD is a structural element of

his critique of late-20th century technoculture in the US. As DeGrandpre presents his

argument, the barbarity of rapid-fire culture is apparent both in our practice of

administering stimulant drugs to children in order to control their behavior, as well as in

the behaviors of the same children when they are not medicated. Other critics of the

administration of stimulant drugs to children argue that distractible, undisciplined

children, when not subject to the twin technologies of ADHD and Ritalin, are just “kids

being kids” – as is suggested in “the last” Calvin and Hobbes strip. DeGrandpre, instead,

re-presents ADHD as cultural, not biological, but nonetheless as a malady—what he

describes as a “stimulus addiction.”

In this case, the millenarian teleology of this argument (present=bad; past=better;

future=reckoning) masks a social conservatism that comes out in DeGrandpre’s

suggested alternative for dealing with ADHD children: simply parent better. Indeed,

DeGrandpre goes on to identify the entrance of women into the workforce as part of the

problem: not unlike other examples of ADHD skepticism, Ritalin Nation is, ultimately, as
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much a critique of late-20th century US mass culture and society as it is a critique of

ADHD.

Kendrick Lamar

Similarly drawing a correlation between ADHD and the surrounding culture at

large, rapper Kendrick Lamar presents a narrative about ADHD. His observations,

however, are causally inverted: rather than explaining ADHD by pointing to the ADHD-

like characteristics of the broader culture, Lamar explains the characteristics of a

particular subculture by pointing to ADHD. In his song titled “A.D.H.D.,” Lamar

characterizes his cohort as a lost generation, caught up in substance abuse and nihilism

that he attributes to living through the “ADHD craze.”

The opening lyrics of this song offer a recitation of drug consumption, each line

apparently bragging about increasingly copious amounts of increasingly potent

intoxicants:

Eight doobies to the face, fuck that

Twelve bottles in the case, nigga, fuck that

Two pills and a half weight, nigga, fuck that

This prosaic gauntlet concludes with the poetically opaque line:

“Got a high tolerance when your age don't exist”

The precise meaning of this line is unclear and evocative, mingling two different

meanings of the word “age,” either in reference to one’s relative biological age (e.g.,

youth), or in reference to an epoch or era. Furthermore, in sharp contrast to the apparent

braggadocio of this opening stanza of poetry, Lamar’s tone is melancholy, and his choice

of pronunciation is idiosyncratic – particularly his pronunciation of the repeated phrase,

“fuck that,” which sounds like, “fuck thawt,” as if affecting a New England, W.A.S.P.

accent. In other words, it sounds pointedly uncool. Meanwhile, this opening chorus is

recited over a dreamy keyboard line, notably unaccompanied by any beat. In fact,
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Lamar’s voice is the only percussive element throughout the entire first half of the song,

which is untypical of hip hop. All these elements together bring the listener to question

the sincerity of Lamar’s celebration of drug use. At the very least, they signal that this

song is going to be some kind of introspective meditation upon the subject.

In the first verse, Lamar explains that the conditions of his environment motivate

his peers to escape reality through intoxication. Poverty is made tolerable by drugs such

as Vicodin, marijuana, and the mind-altering side-effects of cough syrup.

Man, I swear, my nigga tripping off that shit again, pick

him up

Then I set him in cold water, then I order someone to bring

him Vicodin

Hope to take the pain away from the feeling that he feel
today

You know, when you part of Section.80, you feel like no

one can relate

Cause you are, you are, a loner, loner

Marijuana endorphins make you stronger, stronger

I'm in the house party tripping off, my generation sipping

cough syrup

Like it's water, never no pancakes in the kitchen, man

No wonder our lives is caught up in the daily superstition

That the world is 'bout to end, who gives a fuck? We never

do listen

'Less it comes with an 808 (A melody and some hoes)

PlayStation and some drank (Technology bought my soul)

Lamar suggests in this verse that “we never do listen ‘less it comes with an 808” drum

machine beat, though this song has in fact had no beat, 808 or otherwise, up until this

point in the song – further creating a cognitive dissonance that inspires the listen to weigh

carefully the meaning of Lamar’s words. Cleverly, as Lamar utters the phrase “808,” the

listener hears the song’s first kick drum sample, identifiably originating from a Roland
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808 drum machine. Even this beat, however, is subdued and slow, relative to other songs

in the genre of hip hop.

After establishing this bleak atmosphere, Lamar concludes the first verse by

describing an encounter with a girl at a party. The first thing the listener is told about this

girl (after identifying her as African-American by means of free-association with

President Barack Obama) is that she has ADHD, which Lamar – as the narrator and

protagonist – deduces from the fact that she is crushing and snorting tablets identifiable

as Adderall by their blue color.

Her president is black, she black too

Purple Label on her back, but that tab is light blue

She take it straight to the head

Then she look at me, she got A.D.H.D

As the “fuck thawt” chorus returns after the first verse, Lamar adds a final couplet that,

while not fully clarifying the opacity of “when your age don’t exist,” nonetheless adds

more context to the assertion of having “a high tolerance”:

Don't got a limit, just give me some more with it

They always told me ADHD did it

As the second verse begins, Lamar employs the unusual technique of intentionally

stammering – typically verboten among MCs who value smooth talk above all else. The

disjuncture of this poetic device initiates a theme of distraction that permeates the verse.
As it continues, Lamar narrates his introduction to the unnamed girl. Upon discovering

that they are both nearly the same age, she states “then we all crack babies.” Lamar’s

character says that he doesn’t understand this statement – just as the listener may not

have. Mysteriously, the girl tells him that she will explain later, as she moves into

another room.

And then she started...

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And then she started feeling herself like no one else in this
apartment

Beg your pardon, oh, I rap, baby, how old are you?

She say 22, I say 23, “Ok, then we all crack babies”

Damn, why you say that? She said “Where my drink at?

Imma tell you later, just tell your neighbors have the police
relax”

I stood up, shut the blinds, closed the screen; jumbotron

Made to the back where she reside, then she said, in

between the lines

Yep, hope that I get close enough, when the lights turn
down

And the fact that she just might open up, when the Nuvo
start to drown

Her body and I know the both of us really deep in the move
now
It would seem that they’re about to get intimate, when another unnamed party-goer walks

into the room with a large amount of marijuana. Distracted from the narrator’s amorous
attentions, the girl reaches for the drugs, and finally explains her earlier pronouncement:

It's nothing we can do now, somebody walked in with a

pound

Of that Bay Area kush, she looked at me then looked

At it, then she grabbed it, then she said “Get it understood

You know why we crack babies

Because we born in the '80s, that ADHD crazy”

As the concluding line of the final verse of poetry, this statement resonates as the most

memorable line in the song.

The third and final chorus is followed by a stanza that is sung, not rapped. Like

the earlier chorus, this stanza is another recitation of gratuitous drug consumption. Along

with cocaine, MDMA, psilocybin mushrooms and hydroponically grown marijuana, the

lyrics specifically reference the practice of mixing two, four, or six ounce bottles of
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cough syrup with a clear soft-drink, such as Sprite, to make a powerfully intoxicating

drink known as “sizzurp.” In contrast to the opening chorus, however, this recitation

sounds less like homosocial machismo and more like heterosexual seduction, partly

because it comes after the boy-meets-girls story in the second verse, and partly because it

is sung in an R&B style. Built into the lyrics is the offer of “whatever you like” to the

imagined recipient of this drug-addled charm offensive:

You can have all my shine, I'll give you the light

Double cup, deuce, four, six, just mix it in Sprite

Ecstasy, shrooms, blow, 'dro, hoes, whatever you like

You can have all my shine, I'll give you the light
The second verse of this song displays a creative narrative structure, in which the basic

event at the heart of the song – that is, a bit of cryptic insight imparted to the narrator by

an acquaintance at a party – is interrupted by other events, just as the characters in the

song are interrupted and distracted by events, creating a disjointed narrative that mimics

the consciousness associated with ADHD. Moreover, by narratively structuring the

central statement of the song as the words of another character – an unnamed, ADHD girl

at a party – Lamar deflects the statement from being identified as the opinion of the

narrator. This allows Lamar to occupy the role of the observer and reporter – a classic

role for a hip hop MC, inaugurated in some of the earliest hip hop classics, such as Melle

Mel’s “The Message” (1982). In this instance, positioning the “crack babies” statement
as the words of one of his peers effectively generalizes the statement, suggesting it is

more than just the opinion of Lamar, but a perspective shared by his entire cohort.

The claim of this song, then, is that the generation Lamar belongs to – those born

in the ‘80s – have a cavalier attitude towards drug use because it’s been normalized

through the preponderance of ADHD diagnoses and corresponding use of stimulant drugs

among children in the 1980s. It’s an interesting flip of the term “crack babies,” as well.

This term originally referred to children born to mothers who were addicted to crack
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cocaine – a site of moral panic in the 1980s, especially among a conservative white

population that feared and scapegoated impoverished black communities. As it’s used in

this song, however, “crack babies” refers to all who were born in the 80s, because of the

saturation of stimulant drugs – related in chemical structure and effect to cocaine and its

illegal derivatives, like crack – in school systems. Additionally, it reverses – or perhaps

neutralizes – the racial connotations of the term “crack babies,” due to the prevalence of

ADHD among white, male children.

This song is not a direct or obvious critique of ADHD as a diagnosis. However,

by ascribing ADHD, or the ripple effects of its existence, to an entire generation, it calls

into question the utility of ADHD as a marker of difference or deficiency. The rhetorical

act of attributing ADHD to a generation of Americans normalizes the label, using it to

name the conditions and circumstances of a culture. In light of this, the phrase “ADHD

crazy” seems to bear a double resonance. In one sense, it suggests that a generation’s

exposure to the drug regimens associated with ADHD has cause a mental unbalance –

driving these individuals “ADHD crazy.” Alternately, Lamar’s explicit positioning of

this critique in a particular historic moment – 1980s US culture – suggests that the

phenomenon of ADHD diagnoses precipitously rising in the 1980s was itself a “craze,”

marking those who lived through it as “ADHD craze-y.”

Reconsidering the opaque lyric, “Got a high tolerance when your age don’t exist”

in light of this criticism suggests two possible interpretations. Perhaps “age don’t exist”
when children are made to grow up too quickly – such as when the start a regimen of

stimulant drugs at a very young age. Alternatively, but not mutually exclusively, this line

could describe the perceived invisibility or insignificance of a cohort of individuals – a

“lost generation,” caught in a cycle of chemical dependence since grade school. Notably,

there have been a number of studies that support Lamar’s core observation in “A.D.H.D.”
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Individuals diagnosed with ADHD as children tend to develop substance abuse problems

later in life at a higher rate than those never diagnosed with ADHD. 33

ADHD as Brand Identity

In 2013, Fox Networks launched a new programming block called Animation

Domination High Definition, or ADHD. It is clear that ADHD was the desired brand

identity, the longer moniker clearer engineered in order to produce this acronym. This

block of programming features animation shorts by a number of different creators. These

shorts are also contained in a website and several apps, through which they can be

accessed at any time. The content is varied, fast moving, irreverent—all characteristics

associated with Attention Deficit Disorder. The name of the diagnosis helps Fox

communicate what they consider to be the most salient and marketable characteristics of

their visual commodity: it’s ADHD-ness. Furthermore, doing so is clearly founded on

the belief that these characteristics are sought by their audience—behavior that would be

considered indicative of ADHD. This instance of corporate branding implicitly argues

that ADHD now characterizes an entire demographic of mass media consumers, across

multiple textual and visual genres, in analog as well as digital formats, and beyond the

white, middle-brow (but not necessarily the masculinist) identity of young technoculture

consumers.

The logic behind Fox’s branding decision and the social critique of Kendrick

Lamar have implications for the ontological status of ADHD as a diagnosis. Ostensibly,

both seem to take the diagnosis of ADHD for granted. After all, ADHD works as a

means of characterizing a generation or a target audience because it already exists in

33 TE Wilens, The nature of the relationship between attention-deficit/hyperactivity

disorder and substance use. J Clin Psychiatry. 2007; 68 (suppl 11):4-8. See more at:
http://www.psychiatrictimes.com/adhd/adhd-and-comorbid-substance-use-
disorder/page/0/4#sthash.ts83dDYd.dpuf
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culture as a marker of particular behaviors and characteristics. However, in applying a

medical diagnosis to a group, as opposed to an individual, the diagnosis also begins to

lose its meaning. For if the characteristics associated with a disorder can be applied to

broad sectors of the population, they cease to be pathological, and become normative

behavior. Beyond the issue of numbers, these populations characterized by ADHD are

arbitrarily identified by social forces, rather than by the probable tendencies of a medical

pathology. In the case of Lamar, ADHD is generational, making the argument that

diagnoses come and go in “crazes,” subject to the whims of fashion and politics. Fox’s
marketing similarly constructs an ADHD-like population as generational. Many of the

“ADHD” shorts feature pop culture references catering to young-adults born in the 80s—

Power Rangers, Pokémon, etc.—and a remarkable amount of humor at the expense of

“older” people. (e.g., “The Power Rangers and An Old Guy”) In addition to using

ADHD to signal a new youth generation, Fox also uses it to signal a particular aesthetic

and taste in animation. Disease categories are generally not bound by such

considerations, and Fox thereby implies that these characteristics are dispositional, rather

than medical. Ultimately, Fox, Lamar, and even DeGrandpre use ADHD to characterize

a generation and a population. They thereby imply an essentially social definition of

ADHD, rather than a biological one, and they don’t characterize it as a disability. Lamar

doesn’t present it as an entirely positive trait, but for him, too, it is nonetheless a

normative one. Fox, on the other hand, by marketing towards an ADHD-identified

audience, explicitly caters to and rewards “ADHD” characteristics, making the diagnosis

a consumer as well as generational identity, rather than a disease category.

While these texts retool ADHD as a social condition and a consumer disposition,

another mass media normative has emerged that draws on the futurism and imminent

timeframe inherent in ADHD since the 1980s. This is epitomized by the “reality science

fiction” narratives of the Smart Drug.

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CHAPTER 5

EMERGING IDENTITIES: SMART DRUGS, CYBORG

SUBJECTIVITY, AND SELF-IMPROVEMENT

Perennially, headlines in the popular press tout the imminent development and

availability of a new wave of pharmaceutical drugs designed to boost mental function and

cognitive capacity – to be available without prescription. While it is true that

pharmaceutical companies are constantly producing new drugs, and recent research into
conditions such as Alzheimer’s disease have produced promising new leads into further

understanding particular cognitive functions, stories about hypothetical Smart Drugs – in

literature, film, and popular science journalism – proliferate independently of any

particular scientific developments. This popular narrative trope of the Smart Drug is the

focus of this chapter, as the previous chapter featured popular narratives about Ritalin and

individuals diagnosed with ADHD. As the Smart Drug narrative is typically mobilized, it

directly anticipates the emergence of an entirely new subjectivity and consciousness –

that of the cyborg. Though we are told scientists are on the verge of this ultimate

technological advance, this kind of cognitive enhancement remains, elusively, just one

breakthrough away – inevitable, yet perpetually imminent, like The Future itself.

Upon closer observation, the hypothetical Smart Drugs of the imminent future are
functionally indistinguishable from the amphetamines and amphetamine derivatives so

widely used today. The cyborg subjectivity so eagerly anticipated by the Smart Drug

narrative, then, is a reality now, not a reality which will come to be sometime in the

future. I argue that what keeps this transformation of subjectivity from being recognized

as such is not a technological development or laboratory discovery, but the social

institutions that govern the distribution of controlled substances, in concert with wider

social beliefs about disability and the integrity of the liberal humanist subject. In other
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words, Ritalin is not considered more widely to be a Smart Drug because of our legal and

philosophical dispositions toward disability, drug use, and the liberal humanist subject.

To illustrate these points, I will look first at a 2009 article by freelance journalist Sherry

Baker that appeared in Discover magazine, along with the genre of popular science

journalism more generally. Second, I will discuss the 2001 novel The Dark Fields by

Alan Glynn, and its subsequent adaptation into the 2011 film Limitless, adapted for

screen and produced by Leslie Dixon, and directed by Neil Burger.

Imminent Futurism
An issue of Discover magazine (April, 2009) bears a teaser across the top of the

front cover, which reads "BRAIN BOOST," followed by the provocative question,

"Should everyone be on Ritalin?" This consideration is posed in an easy, almost flippant

manner, but this casual question has profound legal and ethical ramifications. Notably,

this teaser presents Ritalin as a brain-booster, apart from any mention of ADHD. In spite

of the fact that Ritalin is a Schedule II controlled substance (legally available only with a

doctor’s prescription), and is associated almost exclusively with ADHD, this teaser is

specifically not asking, ‘Does everyone have ADHD?’ Rather than making a statement

about the rate of ADHD diagnosis, the teaser is evoking a cultural shift in attitudes

towards enhancement technology. Though such a cultural shift would have a significant

impact on our experiences of our selves in the world, the episteme-shaking potential of

this idea is tempered by its presentation in the sensationalistic context of a particular sub-

genre of popular science journalism, in which all social changes are thought to be marked

and made possible by the advent of new and improved technological products.

Inside, on a full color splash page across pages 54 and 55, the article’s main

headline reads "Building a Better Brain," followed by a stinger:

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Today's mind-altering drugs can already improve your

memory, increase your alertness, and smooth your mood. Just wait
until you see what tomorrow's drugs can do.1
The use of the pronoun “your” directs the statements about the efficacy of drugs directly

at the reader. Again, it would be wrong to presume that Discover magazine is targeting

an audience composed entirely of people with diagnoses that would make them legally-

and medically-sanctioned subjects of such statements; rather, this stinger implies that

pharmaceutical drugs can affect one’s cognition in these ways regardless of one’s

diagnostic status. While this statement may be true, insofar as it goes, it is not

uncontroversial to state it so boldly. In fact, the inverse of this position – that behavior

modifying drugs only modify the behaviors of individuals diagnosed with the

corresponding behavioral disorders – continues to be a commonly cited criterion in

establishing the legitimacy of behavioral disorders such as ADHD, in spite of the lack of

evidence supporting this circular logic.

The image on the splash page is a photograph of a miniature display depicting an

oversized human brain under construction. The brain is color-coded into several

segments, which presumably correspond to regional functionality, as one might see on a

neuroanatomical model. Around, under, and on top of this brain are a collection of small

construction worker figures, apparently doing the work of "Building a Better Brain," as if
it were a matter of architecture and masonry. One of the construction workers pushes a

wheelbarrow full of prescription pills, the shape and size (relative to the miniature

worker) of bricks.

1 Sherry Baker, “Building a Better Brain,” Discover Magazine, April 2009, 54-5.
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Figure 18: “Building a Better Brain.” Discover Magazine April 2009, p.55.
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It's an image evocative of Artificial Intelligence (AI), recalling the positronic brain

engineering imagined by science fiction writer Isaac Asimov.2 The image implies that

we have the tools and knowledge to literally build a brain – or perhaps its mechanical

equivalent – from basic, raw materials. Not only does the image convey this optimistic

estimation of the state of cognitive neuroscience, it simultaneously asserts an ontological

and phenomenological claim that the mind is a structure composed of simpler, more basic

materials. While the image is an overly literal depiction of such a notion, it is a legible

metaphor for the reductionist model of consciousness.3 This view hold that states of

consciousness we experience can, like all other biological and natural processes, be

understood in terms of simpler, more fundamental processes – the reactions of neurons to

electrical charges and changes in neurochemistry. While this position is not universally

endorsed – it is, in fact, only one position in what has remained a heated debate for

centuries among philosophers of the mind – it is a position that is familiar to Discover

readers for its co-constitutive association with the project of artificial intelligence, both in

science fiction and in AI laboratories.

In combination, this headline and image together conjure something akin to

Aldous Huxley's Brave New World, or the future worlds imagined by science fiction

writer Phillip K. Dick, in which psychoactive chemicals are widely available and used

routinely to enhance or regulate human cognition and mood. Discover magazine cannily

mobilizes this spectacular imagery and rhetoric in this instance to speak to its target

2 Issac Asimov, The Positronic Man (New York: Doubleday, 1992).

3 Although the title uses the word ‘brain’ rather than ‘mind,’ it is clear that this is an
informal slippage – most likely indulged for the resulting alliteration. The discussion of cognitive
states in the stinger (alertness, memory, mood) and the fact that the article is about technologies
(primarily chemical ones) that affect cognition, further make it clear that the article is not about
creating ‘better’ physical organs in a laboratory, but creating ‘better’ states of consciousness. A
less alliterative but more accurate headline would be “Optimizing Consciousness.”
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audience by fulfilling well-established genre expectations of popular science journalism.4

Such magazines and columns often appeal to the technophiles and futurists in US culture,

those who are invested in the idea of uninterrupted technological progress and

development, and hold faith in both the capacity and the inevitability of technology to

solve any and all human problems. Within this genre, the concept of The Future is loaded

with extra-chronological significance, and made to carry the metaphorical weight of what

is Possible, what is Desirable, what is Inexorable. Essentially, The Future in this context

functions much like the notions of Progress and Manifest Destiny functioned in popular

culture and political discourse in the US before the project of Westward expansion had

reached its furthest geographical conclusion. This is evident in Discover magazine’s tag

line, which appears on the cover of each issue, just below the title: “Science, Technology,

and The Future.” The capitalized definite article emphasizes the extra, ideological

meaning packed into this concept of The Future.

While “futurism” might be a characteristic ascribable to a wide range of science

fiction, I would further distinguish the form that finds its expression in magazines such as

Discover as “imminent futurism,” as it is perpetually preoccupied with what is “just

around the corner.” Often, and not coincidentally, these near future eventualities are

described as a series of consumer products. Thus, headlines promise a sneak preview not

only into the world of tomorrow, but into the marketplace of tomorrow, granting

privileged information to those elite consumers who fancy themselves early adopters of

new technology. ‘Just wait until you see what tomorrow’s [drugs; cars; robots; etc.] can

do!’ As a result, the objects of interest in this narrative mode exist in a perpetual state of

4 Other examples of this genre include the popular magazines Omni, Mental Floss, and
Wired.
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nearly-existing. They are essentially imaginary objects, the speculation of which

facilitates discussion of “cutting-edge research” and the institutions that underwrite it.5

This rhetorical strategy has been in circulation in the US for well over a century,

having roots in the marketing and hucksterism that accompanied the popularization of

electricity in the US, and perhaps first coming into its own with the World's Fairs at the

beginning of the 20th century.6 This strategy normalizes and makes accessible the

potentially obscure complexities of scientific research by presenting it in a capitalist

context with which readers are already familiar: the sales pitch; or, in its print form, the

catalog. Simultaneously, it perpetuates a popular technofuturist and scientistic cultural

narrative, in which scientific discoveries in laboratories lead seamlessly to commercial

products, thereby disseminating scientific knowledge in the form of technology through

the ostensibly democratic mechanism of the free market. There is, of course, some

precedent for this notion in the post-WWII rise to prominence of Big Science, whereby

research and resources formerly mobilized by the war effort were repurposed for the

production of a series of consumer products – from televisions, to plastic, to M&Ms –

and none would argue with the obvious fact that many scientific discoveries have

followed this general path. However, in the majority of instances, this trajectory is

neither that direct nor that inevitable, and such a simplified narrative obscures the role of

a range of historical and political contingencies that factor into the process of mobilizing

science.7 In fact, I would argue that the generic expectations of imminent futurism, like

5 My personal favorite example of this is the flying car, which imminent futurists have
been promising is only a year away for the past 50 years. Technofuturist author Warren Ellis has
parodied this trope in his graphic novel Doktor Sleepless (with Ivan Rodriguez, Avatar press,
2008), in which frustrated citizens take to spray-painting indignant demands on city walls,
including ‘WHERE’S MY FUCKING JET PACK,’ and ‘YOU OWE ME A FLYING CAR.’
6 Carolyn de la Pena, The Body Electric: How Strange Machines Built the Modern
American (New York: NYU Press, 2003).
7 Latour and Woolgar, Laboratory Life.
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many of the conventions of popular science journalism, tend to mystify more than

illuminate, thereby bearing more similarity to the tradition of American exhibition (a la

P.T. Barnum) than to serious inquiry.

The imaginary object of imminent futurism being pitched in this instance is the

Smart Drug – a perennial favorite in popular science journalism. While multiple forms of

chemical cognitive enhancement have been conceptualized and pursued throughout the

modern era, the idea of Smart Drugs continues to evoke The Future. Cognition-

enhancement has been positioned in the popular imagination as the furthest iteration of an
emerging cyborg subjectivity. That is, the consciousness of a cybernetic organism, the

point at which the co-mingling of human bodies and technology has reached the level of

cognition itself. Such a subjectivity has potentially profound ramifications for the

epistemological basis of Western thought and institutional practice, as it would

compromise some of the foundational conceits of traditional liberal humanist subjectivity

– namely the discreet boundaries of autonomous, rational, and self-directing subjects that

can be distinguished from animals and objects in the material world. For some

technofuturists, such a subjectivity is almost inevitable – the logical conclusion of the

evolution of human beings and the technologies they create. From this perspective, this

exciting new world of tomorrow will be available as soon as this next wave of chemical

technology is perfected and brought to market.

Posthumanism v. Transhumanism

While technofuturists and Discover magazine in this instance embrace the

imagery of cybernetic organisms for the sense of futurism it communicates, cyborg

theory scholars (most famously Donna Haraway) have embraced the image of the cyborg

both as a critique and a disruption of liberal humanist pretenses that have enabled

oppression and exploitation in the modern era. While it is true that the episteme of liberal

humanism, as a key aspect of the Enlightenment, is foundational to our current legal

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institutions and our conception of human rights – neither of which I would suggest

reflexively dismissing altogether – the humanist perspective also perpetuates a rather

problematic notion of ‘human nature.’ This view dismisses the cultural and individual

differences between people as inconsequential, reducing the human experience down to

an essential and universal human nature that is uniquely and exclusively rational. Thus, a

hierarchal binary relationship is constructed, in which human beings are positioned as

separate from and superior to all other animals, and the natural world in general.8 Such a

view of the world apparently legitimates approaching our environment as a quantity of

resources awaiting human exploitation. In turn, this perspective also affects one’s view

of human beings by obscuring our perceptions of the continuity between ourselves and

other life forms, especially in terms of cognition and consciousness.

Further, the human/nature dichotomy upon which liberal humanism is established

entails a series of additional binaries, most of which are inherently exploitative and

oppressive (e.g. man/woman; white/black; ‘first world’/’third world’; non-

disabled/disabled), and each of which significantly structures our experiences.

Simultaneously, humanism’s appeal to an essential ‘human nature’ obscures the social

and constructed nature of those dichotomies, suggesting instead that they are ‘natural’

qualities that reside within the discrete, biological make-up of isolated individuals.

Finally, as Foucault has demonstrated, liberal humanism, rather than being a description

of our unchanging, essential nature, is a contingent notion that is mutually implicated

with particular, historic regimes of power and political economy.9 Capitalist market

theory is dependent on the idea of the autonomous, self-contained agent acting in his/her

8 The rhetorics that construct the “natural world” are culture-bound and contingent. See
Akira Mizut Lippit, Electric Animal: Toward a Rhetoric of Wildlife (Minneapolis: University of
Minnesota Press, 2000).
9 Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason
(New York: Pantheon, 1965).
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own self-interest; in turn, of course, the apparent ‘success’ of market theory is often

touted as support for the validity of liberal humanism. By claiming to be ahistorical,

universal and essential, liberal humanism naturalizes the systems of power that uphold it,

rendering those systems invisible and thereby enabling their continuing dominance. With

this focus on individual autonomy, the social and constructed nature of human experience

in general is obscured.

In contrast, the constructed and heterogeneous nature of cyborgs highlights the

constructed and social nature of subject positions in human society. Just as cybernetic
theory considers human beings functionally interchangeable with other information

processing systems, cyborg theory considers human beings in a continuum with other

living creatures and objects. The perspective, then, is decidedly more ecological,

understanding human beings as life forms among other (more or less) similar life forms

in an ecosystem that must find balance in order to achieve sustainability. Because this

deployment of cyborg theory is fundamentally a critique of these failures of liberal

humanism, many scholars subscribing to this position identify as posthumanists.10

The term ‘posthuman,’ however, is occasionally employed by very different

groups of thinkers. For example, Robert Pepperell’s The Post-Human Condition bears

only a superficial resemblance to the theory associated with Haraway, and is in fact more

representative of what is also known as transhumanism (the nomenclature I will use

heretofore, for clarity). Transhumanists seek to extend the boundaries of human power

through technological modifications to human bodies, ultimately creating a new race of

beings for whom the limitations and quotidian concerns of corporeality as we know it are

10 Alternately, Bruno Latour identifies this critique of liberal humanism as ‘non-

modernism,’ as a further rejection of the teleologic chronology of liberal humanism, which
artificially divides time (and cultures) into the ‘primitive’ past and the ‘modern’ present.
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inconsequential.11 However, in spite of a shared celebration of the image of the cyborg,

transhumanism is philosophically at odds with posthumanism. Where posthumanism is a

critique of the tendency of liberal humanism to elevate and privilege human beings over

the natural world, transhumanism fully embraces the central tenets of liberal humanism,

seeking to extend further the privileged position of human beings over nature.

Transhumanism and posthumanism also differ in their dispositions towards

futurity. Transhumanism promotes a kind of faith in technological progress to achieve

the ultimate extension of human power sometime in the near future, culminating in a

rapture-like moment of transcendence transhumanists refer to as ‘The Singularity.’ In

contrast to this millenarian teleology, posthumanism rejects the liberal humanist notion of

‘progress’ altogether. Instead of concerning itself with a future condition of

transcendence, posthumanism examines heterogeneous networks of human beings,

animals, and machines as they have existed throughout the modern era, in order to

articulate a critique as a polemical call to action in the present moment. Transhumanism,

however, by organizing its principles around the concept of The Singularity, establishes

itself not so much as a theoretical or critical apparatus, but as a belief system that

retrospectively vindicates established structures of power (white, male, Western, able-ist,

and heteronormative) as the necessary antecedent to the next stage of human evolution.

However, what transhumanists in general, and the copy writer(s) responsible for

this Discover headline in particular, fail to recognize is this: if this Brave New World of

cognitive enhancement is to come about, it will be the result of legal, institutional,

rhetorical and social changes, and will have little to do with new scientific discoveries or

the development of new technology. In fact, the current network of pharmaceutical

manufacturers and regulators effectively works to discourage the development of truly

11 Ray Kurzweil, The Singularity is Near: When Humans Transcend Biology (New
York: Viking, 2005); Vernor Vinge, “Singularity 101 with Vernor Vinge,” interview by Doug
Wolens, H+Magazine, http://hplusmagazine.com/2009/04/22/singularity-101-vernor-vinge/.
 304

novel drugs. Rather, the largest profits are found in creating minutely different look-alike

drugs that closely replicate the functionality of drugs that have already succeeded on the

market, and in finding new cross-indications for existing drugs, allowing them to be re-

released with renewed patent privileges of exclusivity.12 Any drugs of the future are very

likely to be subtle variations or re-combinations of the drugs of today – drugs which, as

even the Discover article concedes – can already "improve your memory, increase your

alertness, and smooth your mood."

This concession, then, begs the question: why is the moment of transhumanist

consciousness—cyborg subjectivity—constructed as a perpetually imminent future? In

other words, why does the headline "Building a Better Brain" still carry the future-shock

impact that the Discover editorial staff is leveraging for attention? Why are the mind-

altering drugs of today not popularly perceived to have already ushered in the Brave New

World of cyborg subjectivity?

The transhumanist vision of cognitive enhancement—and the cyborg subjectivity

this would instantiate—is held at bay, not by the state of pharmacology, but by the

popular investment in the application of pharmacy as a prosthetic, compensating

technology, mediated by discourses of disability, as well as the social injunction against

enhancement technology and a popular fear of cyborgs.

Enhancement vs. Prosthesis

In spite of the techno-futurist appeal of the cyborgs to Discover readers, in wider

culture the incorporation of technology into human bodies, or conversely, the

incorporation of living material into machines, is still most often constructed as a site of

ambivalence at least, unease and danger at worst. N. Katherine Hayles, in How We

Became Posthuman (1999), explores several articulations of the anxiety aroused by

12 Healy, The Creation of Psychopharmacology, 371-390.

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‘cyborgs’ (cybernetic-organisms) in science fiction literature. In the novels of Phillip K.

Dick, for example, the blurred boundaries between human beings and technologies are

the site of both attraction and repulsion in these novels, erotically charged yet ultimately

threatening to notions of autonomy and free-will, as Hayles points out. Popular culture

offers many more examples of dystopian views of cyborg subjectivity. The Sci-Fi

Channel’s popular series Battlestar Galactica (2003-2009), for example, consistently

negotiates this tension, presenting cyborg characters that are capable of seducing human

beings, yet ultimately threaten the very existence of humanity. Similarly, the series of
films in the Terminator franchise present an ongoing time travel narrative in which the

downfall of human civilization is the consequence of surrendering a uniquely human

subject position to a hybrid interdependence with artificial intelligence systems. As

Hayles explains, such reactions are rooted in the fear that the presence of cyborgs

threatens human dignity by unsettling the privileged position that humanity enjoys in

relation to other objects, a position justified (according to the tenets of liberal humanism),

by the essentially human traits of rationality, individuality, autonomy and agency. From

the perspective of many of those who value these traits, as well as those who are invested

in the power structures complicit in the liberal humanist project, any disruption of these

basic truths is tyranny.

There are two important exceptions to this social injunction against incorporating

technology into human subjectivity: the military, and disability.

It was in the military, during the course of WWII, that our modern conception of

cybernetics was first formulated, as automated systems in aircraft and artillery

configurations placed human beings and machines into complicated relationships of

interdependence.13 Notably, the use of amphetamines and amphetamine derivatives to

sustain attention over long periods of time was implemented by the US military during

13 Weiner, Cybernetics.
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the same war, well before the same types of drugs would be regularly used to treat

children diagnosed with Attention Deficit Hyperactivity Disorder. Why did these uses of

chemical technology and cybernetic systems not meet with the same ambivalence within

the military as they seem to in wider society? The total mobilization that is modern

warfare simply overrides such concerns. That is, the imperative to win at all costs simply

obviates such concerns, in the same way that the sanctity of human life is pushed aside in

the name of achieving military victory. Further, the liberal humanist subjectivity of

soldiers was already compromised, as a result of their strategic deployment in military

operations that transcend the will or subjectivity of any individual soldier. Soldiers in the

military resign many of their rights as citizens and are subsequently positioned as parts of

a larger machine, collectively comprising their own kind of Leviathan. Thus, we speak

less of individual soldiers than of groups of soldiers. It is this partial subjectivity that

excuses individual soldiers of the responsibility of what would otherwise be considered

murder, were the soldiers not acting on the orders of senior officers, themselves acting in

turn on orders from officers more senior yet. 14

The other important exception to the injunction against the incorporation of

technology into human subjectivity is the case of disability. For a long time now,

technologies have been used to compensate for what have been perceived as disabling

deviations from physically normal bodies.15 While recognizing that the presence of

disability is still the source of unease for many people in a fundamentally able-ist society,

the use of biotechnologies by disabled individuals, even their incorporation into the

bodies of disabled people, is rarely questioned. In fact, there is a history of disabled

14 According to Time Magazine’s June 2008 cover story, Prozac is now “The Military’s
New Secret Weapon.”
15 This is also tied to the military, as war veterans were the first disabled population to be
addressed in legislation. See David Serlin, Replaceable You: Engineering the Body in Postwar
America (Chicago: University of Chicago Press, 2002).
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individuals being coerced into the incorporation of biotechnologies into their own bodies,

irrespective of their desires.16 Such instances escape social opprobrium largely because

this use of technology works to re-inscribe the accepted limits of what is constructed as

the "normal" body. By relocating the use of such technology to bodies that are already

identified as deviant, "normal" bodies are inversely marked by their lack of technological

intervention, enforcing the boundaries of traditional subjectivity.17

Herein lies a key distinction. From a liberal humanist perspective, technologies

that are installed in the bodies of people constructed as disabled serve a compensatory

function, implicitly returning a body to the level of functionality that is presumed

necessary to act as an autonomous agent within a social field organized around self-

possession in the capitalist marketplace. This compensatory use of technology, however,

is perceived as different from the use of technology to enhance what is constructed as a

"normal" body. It is the enhancement of the body then, beyond a socially constructed

range of "normal" capacities, that might be considered a kind of cyborg subjectivity, in

contrast to the compensation of a disability due to some physical impairment, which is

perceived to merely repair and re-inscribe traditional liberal individualism.

These arguments are not simply abstract definitions of augmented consciousness

inferred from the subtext of movies and science fiction novels; rather, these

enhancements are materially instantiated, inscribed into legal and institutional policy and

practice, as well as technological treatments. In the case of cognition-affecting or

behavior-modifying pharmaceutical drugs, this is realized through the approval process

of the Food and Drug Administration. The FDA will only approve drugs that are

indicated for remedying particular illnesses or conditions. Thus, one cannot get approval

16 For example, controversial practices such as cochlear implants and involuntary

medication.
17 Serlin, Replaceable You.
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for a drug – in fact, one cannot even legally begin the process of testing the safety of a

drug – that is intended for healthy people.

This definition became official policy as a result of the Kefauver-Harris

Amendment to the Food, Drug and Cosmetics Act of 1962, which strengthened FDA

controls over new drugs in the wake of the Thalidomide scare (chapter 1). The Kefauver-

Harris amendment changed several aspects of the drug approval process, including the

creation of an additional initial step in the process, which required drug developers to

submit an approval form before new chemical compounds were synthesized or obtained
for testing. This approval form requires drug developers to specify the medical indication

to which the drug is to be tested. This gave the FDA more control over experimental

substances, and built in a test of efficacy, as well as safety, into the approval process.

A presumably unintended consequence of this change in FDA practice was the

effective stifling of psychiatric and pharmaceutical research into the effects of

psychoactive drugs on “healthy” consciousness. For example, this change in practice

shut down all research into the cognition-enhancing drug LSD, more than four years

before it was declared a Schedule I Controlled Substance or become a popular sacrament

of the 1960s counterculture. This research was halted not because it was perceived as

dangerous, necessarily; those associations with LSD would not solidify until later in the

decade. Rather, the research came to a halt because its design failed to meet the

emerging standards of the regulatory system recognized by US law.

This same amendment also wrote into law the use of the large-scale clinical trial

as the gold standard of proving safety and efficacy. In this, the Kefauver-Harris

amendment can be seen as only one more step in a continuing trend towards

standardization and the adoption of industrial science in the medical industry. This same

trend continued to put pressure on the psychiatric industry throughout the 1960s and 70s,

precipitating a dramatic epistemic break in US psychiatry – and, I would argue, US

culture as a whole – marked by the publication of the third edition of the Diagnostic and
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Statistical Manual of Mental Disorders (DSM-III), in 1980. As opposed to previous

editions of the DSM, the DSM-III presented an entirely new model of diagnostic

psychiatry, as opposed to dynamic psychiatry. This was a move away from Freudianism,

and a move towards an allopathic model of disease, which presumed all mental disorders

to be discreet entities, rooted in brain illness. This shift brought psychiatry more in line

with larger trends in the medical industry as a whole, made psychiatry more amenable to

the billing practices of insurance companies, and created literally hundreds of new

clinical indications that could be cited by drug producers in seeking FDA approval.
ADHD is a result of this emerging biotechnological treatment regime. Since the

1950s, there had been a fair amount of research done on attentional disorders, and

amphetamines had been known to increase the intensity and duration of attention in

subjects since the 1930s. With the release of the DSM-III, however, there was now an

official diagnosis, to which a pharmaceutical drug could be matched, and insurance

companies could be billed. As a result, ADHD (at the time still called ADD) diagnoses

and sales of Ritalin increased dramatically throughout the 80s.

Since then, thousands of children have installed cognition-enhancing chemical

technology into their bodies on a daily basis, each pill being only the last instance of a

larger pharmaceutical machine into which their subjectivity is integrated. In this sense, I

would argue that those diagnosed with ADHD and prescribed amphetamine-based drugs

are certainly experiencing something like a cyborg subjectivity. However, the perception
of this as a compensatory augmentation for what has been rhetorically positioned as a

disability has continued to keep this practice solidly within a medical model. Thus, the

construction of ADHD as a mental disorder prevents the cyborg subjectivity it

instantiates from being recognized as such.

It is this chemical cyborg that displaces the futurist dreams of cognitive

enhancement. The transhumanist utopia exists in an imagined world of perfect scientific

instrumentalization, apparently naive about the marketing and profits involved in “big”
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science, which do not merely distribute medical information and treatment technology,

but exploit it for profit, distributing it only within channels that are conducive to

commercialization.

The current regime of knowledge and its authorship constructs the use of Ritalin

as a reconstitution of the liberal humanist subject, rather than what it is, a challenge to it.

In this light, the popular misconception that Ritalin only affects those with ADHD can be

seen not only as a justification for the biological basis of the disorder, but as a defense of

an episteme that defends the integrity of the liberal humanist subject – even if that
requires flatly denying empirical evidence that challenges the defense.

What keeps the Brave New World of bio-techno-futurist fantasy perpetually a day

away, then, is not the limitation of present technology, but a regulatory institution that

controls the legal distribution of cognition-enhancing drugs in a manner concordant with

its investment in the preservation of the liberal humanist subject that predicates and

justifies the consumer capitalist marketplace.

Brain Boosterism

In accordance with generic expectations, the headline of Sherry Baker’s article in

Discover promises to give the reader a sneak peek at the mythical Smart Drug that the

near future will bring. Through this commoditized conceit, Baker presents a modest

amount of contemporary neurocognitive research, a few quotes from a handful of

scholars and industry insiders, a large amount of transhumanist rhetoric, and almost no

substantive discussion of any Smart Drug that is significantly different from the drugs

with which we have been managing the attensity of children for decades.

Baker, a freelance technology journalist, perhaps unwittingly reveals the position

of privilege from which she writes in the opening paragraph of this article. Placing

herself at a party in a “million-dollar Victorian mansion,” among “lawyers, musicians and

businesspeople,” she speaks off-handedly of recreational marijuana use among a class of

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people who have apparently little fear of incarceration for the same activities that have

landed an extraordinarily large (and disproportionately non-white) portion of the US

population behind bars.18 In this context, she discusses the casual trading of prescription

medications among members of the professional class. In particular, she identifies the

use of modafinil (marketed in the US as Provigil) as a performance-enhancer and

attention-sustainer among the jet-set crowd.

Though Baker identifies modafinil as “the latest and most touted of a growing

number of pharmaceuticals used to enhance cognition and mental performance in people

without a diagnosis, disorder or disease,” it is in fact a drug that has been in use since the

late 1970s; it has been prescribed for a number of conditions and diagnoses, including

ADHD, but is most commonly prescribed for narcolepsy. The US company Cephalon

Incorporated only recently acquired the rights to market it in the US, and, because of

patent disputes, generic versions have only been available since 2012. To whatever

degree Baker’s observations reflect real trends, they are undoubtedly a result of these

developments, which are matters of politics, patents and marketing, rather than

developments in pharmacy.

In addition, Baker’s observations reflect the drug consumption practices of her

cohort, more so than any changes in production or distribution of drugs. Modafinil is not

being prescribed as a performance enhancer, and a close look at Baker’s rhetoric shows

she is making no such claim. Rather, she carefully states that modafinil is “used to

enhance cognition and mental performance” by the pill-trading professionals with whom

she parties. Baker offers no acknowledgment that this is an option only available to those

with easy, regular access to medical resources for anything outside of emergency care,

nor does she even hint that this practice constitutes the possession and distribution of a

controlled substance. The nonplused manner in which she addresses these issues reveals

18 Baker, “Building a Better Brain,” 54.

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not only her own class position, but the presumed class position of the Discover audience,

as well.

If her opening anecdote fails to connect through common experience, by the third

paragraph Baker extends her observations to a wider (though still privileged) population,

citing research that identified as much as 18% of some college populations are electively

using Ritalin and/or Adderall as a “study drug,” irrespective of any ADHD diagnosis.19

Continuing along this line, she opens her argument even further, addressing the conscious

experience of an entire culture – including the reader, directly addressed with the pronoun

“you”:

In a world of information overload and increasing multi-

multitasking, you do not have to suffer from ADHD to have
trouble focusing. You need no diagnosis to benefit from drugs that
cut through the chaos and help you get things done.20
In this statement, Baker establishes the source of ADHD behaviors as contemporary US

culture – particularly the media landscape and productivity expectations. In the same

sentence, she ascribes these behaviors to anyone (potentially everyone) within that

culture.

This claim – that ADHD is a rational response to cultural (over)stimulus – has

been made by some as a way to humanize a behavioral disorder, by others as a way of

discrediting the behavioral disorder altogether, and by others as a means of critiquing

modern culture (which, in turn, is used by some as a means of establishing their own

class position in response to modern culture.) In this instance, Baker uses this line of

reasoning to justify a discussion of enhancement technology. As Baker has it, the fact

that contemporary US culture induces ADHD behaviors demonstrates the widespread

need for cognition enhancement of the kind administered to those diagnosed with ADHD.

19 Ibid., 56; Baker cites a study conducted at the University of Maryland, published in
Pharmacotherapy in 2008.
20 Ibid.
 313

While this may seem reasonable to many Discover readers, the logical conclusions it

entails are complicated and run counter to the very argument Baker puts forward.

Behavioral disorders are defined and diagnosed by the display of non-normative

behaviors. If “trouble focusing” is a widespread enough condition that one need not be

identified as non-normative for displaying such behaviors, then those behaviors, by

definition, are normative. While Baker states “You need no diagnosis to benefit from

drugs that cut through the chaos and help you get things done,” intending it to be a self-

evident claim about the demand for cognitive enhancement, it is also, read literally, a
precise misreading of the current state of affairs in the US. In fact, one does need a

diagnosis to (legally obtain and) benefit from drugs that help one focus.

Baker’s perspective suggests that she believes that, were a behavior or state of

consciousness to become increasingly widespread, addressing that behavior or state of

consciousness through mind-altering drugs would become increasingly normalized,

whereas, under the current system, the more widespread a behavior, the more the

condition is normal, thereby removing it from the category of legal sanction.

Furthermore, arguing for the essentially cultural nature of ADHD is an argument

against the reductionist model of consciousness. (Or at least against the notion that

ADHD counts as a disorder that can be understood in reductionist terms.) Reductionism

would have it that states of consciousness are the result of simpler, more basic

interactions, rather than something that arises out of social interactions. This view of
consciousness is not only favored by AI research and transhumanists in general, it is the

epistemic justification of the diagnostic turn in modern psychiatry. Behavioral Disorders

can be treated with neurochemical manipulation because – according to the working

hypothesis of diagnostic psychiatry – they are, at their root, neurochemical imbalances.

If, however, the same behaviors are attributable to social factors, then one would not be

necessarily addressing a chemical imbalance through medication, but modifying

behaviors in order to bring them into accord with social expectations – a practice which is
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closer to elective enhancement than medical treatment. If this is the case, it describes a

state of cyborg consciousness. To be clear, that ADHD behaviors are the result of

cultural influence is a defensible position – though, in its logical conclusions, it is a

position one would expect to be adopted by critics of diagnostic psychiatry and

reductionist views of consciousness, and not a technofuturist publication like Discover.

Within the main body of the article (after the million-dollar mansion anecdote, the

breathless expectations raised by the article’s headline are quickly moderated.

Immediately apparent is the move away from talking about Smart Drugs, more generally,
in favor of talking about drugs that modify three discrete subsets of cognition: alertness,

memory, and creativity – each of which is discussed in turn under its own respective

subheading. Each of these cognitive functions is certainly a part of being ‘smart,’ but

boosting any one of them individually seems to fall short of the promise of being made

‘smarter.’ This potentially disappointing de-escalation of scope is not the result of

Baker’s journalism, per se, but a constitutive shortcoming of the very concept of Smart

Drugs. This is because ‘intelligence’ is, itself, an amorphous and culturally constructed

concept, with no simple definition and no clear means of assessment. In fact, the very

notion of a ‘global intelligence’ is called into question by many researchers.21 It is both

practically and logically impossible to chemically boost something that we cannot define,

measure, or even establish as ontologically significant. Instead of a ‘global intelligence,’

then, psychopharmacology addresses a series of cognitive functions, each of which seem

to have something to do with ‘intelligence’ or ‘consciousness,’ but none of which

convincingly comprise the category as a whole. Ironically, this approach of rationalizing

21 The robotics research of Rodney Brooks, for example, eschews the notion of an
‘executive brain’ altogether, in favor of a collection of smaller, discrete functions working in
concert. Just as the notion of autonomous, rational individual is a constitutive fiction of liberal
humanism, ‘global intelligence’ may also be a convenient fiction that falls away upon serious
inquiry. It is ironic that distributive intelligence, as it has come to function in robotics, is an
acknowledged element of transhumanist thought in general, yet the Smart Drug narrative relies on
the romantic ideal of a central, executive intelligence.
 315

consciousness into a series of discreet functions, a project at least as old as Wundt###, is

itself a challenge to liberal humanist subjectivity, while the Smart Drug narrative

necessitates relying on a liberal humanist – even Romantic – view of the indivisible and

inherently rational subject.

The expectations raised by the article’s headlines are further moderated as it

becomes clear that, rather than discussing any ‘drugs of tomorrow,’ the article almost

exclusively addresses the effects of drugs that have been well-documented for years. For

instance, the primary examples Baker cites as creativity-boosting drugs are LSD and
marijuana. Both substances are described as being effective for this purpose, but less

than ideal candidates for cognitive enhancement because of their more dramatic

intoxicating effects. (Baker fails to make the connection between the history of LSD and

the legal sanction against drugs as enhancement technology.)

The creativity-boosting alternative to these well-established psychotropic drugs

that Baker outlines is transcranial magnetic brain stimulation (TMS) – the only non-

chemical intervention mentioned in the article. Proponents of TMS claim that exposure

to powerful magnets and/or low levels of electrical current along the outside of the skull

can affect brain activity in predictable, therapeutic, and non-invasive ways. Baker’s

juxtaposition of TMS and LSD suggests that TMS may boost creativity without the

hallucinations or disorientation of LSD. Baker speaks to Allan Snyder, the director of

Sydney, Australia’s Centre for the Mind – a “mind laboratory” dedicated (as their website
advertises) to finding “scientific ways to enhance creativity...to investigate the mind’s

hidden skills...and to instill the champion mindset.”22 The “champion mindset” is a

reference to the inspirational (and punctuationally-challenged) self-help book What

Makes a Champion! (2002), edited by Snyder and promoted by the Centre for the

22 Centre for the Mind website, “Current Research.”

http://www.centreforthemind.com/research/currentresearch.cfm; Centre for the Mind website,
“Who We Are.” http://www.centreforthemind.com/whoweare/index.htm.
 316

Mind.23 This particular brand of self-help literature is predicated upon the notion that

one can acquire access to latent, untapped mental resources (as will be discussed further

in the following section of this chapter), and Snyder presents TMS research as evidence

to this central conceit. Baker and Snyder, then, are both invested in presenting TMS as

cutting-edge research. This is done at the expense of mentioning that Snyder’s research

is only the most recent iteration of the recurring theme of attempting to use magnetism

and electricity as a tool of cognitive manipulation – a project that dates back to the latter

half of the 19th century, often associated with mesmerism exhibitions and medicine

shows.24 Neither do Baker or Snyder mention that TMS has been met with multiple
repudiations from the FDA. The FDA has finally conceded TMS to be safe, but

continues to dispute its efficacy.25

Similarly, under the subheading ‘The Attention Edge,’ Baker speaks primarily of

the drugs already available – amphetamines – and ultimately concedes that the ‘drugs of

tomorrow’ will most likely be “revised versions of existing drugs.”26 This is perhaps the

most true statement in the article, as institutional practices, patent law and marketing

principles all contribute to the perpetuation of an industry that discourages innovation and

rewards imitation.27 Even this significantly modified prediction, though, is backed up

with little more than an assertion of technofuturist faith: “As scientists learn more about

23 Snyder, Allan, What Makes a Champion! Fifty Extraordinary Individuals Share Their
Insights (Victoria: Penguin Group Australia, 2002).
24 De la Pena, The Body Electric.

25 TMS was eventually approved by the FDA in 2011, but only under the provisional
Class II designation of medical devices, for which safety, but not efficacy, has been established.
This move was controversial and met with public criticism for its lack of evidential basis.
26 Baker, “Building a Better Brain,” 56.

27 Healy, The Creation of Psychopharmacology.

 317

how the brain manages attention, drugs will become even more powerful, nuanced, and

precise.”28

The research Baker presents on the chemical components of memory formation is

the most interesting and informative science discussed in the article. Recent clinical

research into Alzheimer’s disease, as well as the experiences of military veterans

diagnosed with post-traumatic stress disorder (PTSD), has led to several new findings

genuinely worthy of science journalism. Ironically, in an article purporting to celebrate

applied pharmacy, the scientific substance of this subsection seems to exist in a negative

ratio to practical application, of which there appears to be comparatively little. Baker

concedes that only “some [of the] existing memory enhancers appear to work, to a

degree,” but “in normal people, the results are mixed.”29 This state of affairs does not
keep Baker from reporting, however, that “better memory boosters now in clinical trials

should be here in four to five years,”30 a prediction apparently based on little more than

technofuturist faith. In fact, the moments of imminent futurism in this section are among

the most awestruck – and inscrutable – in this article. In paraphrasing New York Times

columnist David Brooks, Baker opaquely asserts that “memory enhancers could be the

new Viagra, and memory could be the new sex.” This statement makes very little sense

apart from referencing the ever-recognizable brand Viagra as a highly successful

prescription medication widely used as an enhancement drug. Nonetheless, the Discover

editors elevated this quotation to the mystifying title of this subsection of the article:

“Memory: The New Sex.”

Baker’s article is equally breathless in the space that it gives to discussing

transhumanists and their expectations for cognitive enhancement. Baker introduces

28 Baker, “Building a Better Brain,” 56-7.

29 Ibid., 57.

30 Ibid.
 318

transhumanists as “technology boosters” with the goal of promoting the “voluntary,

ethical use of technology to create humans with biological capacities far beyond those of

people today.”31 Predictably, the transhumanist perspective presented as The Future of

cognitive enhancement is: Perfection! After Baker momentarily concedes that there are

chemical enhancement technologies with which we are already familiar – steroid use in

sports is the example she cites in this instance – she questions if new smart drugs will be

subject to the same problems we currently associate with this more mundane form of

drug use:

Will cognitive tweaking have unexpected and even

dangerous effects? Will it spawn a new drug culture? And is it
fair for the wealthy to access a new generation of costly, off-label
smart drugs while the rest of us do without?32
(In this instance Baker separates herself from the same class in which she implicated

herself in the opening paragraph, adopting the populist position of “the rest of of.”) Each

of these valid concerns is dismissed in turn by Baker’s citation of transhumanist

neuroethicist Wrye Sententia, who is confident that in 20 years drugs will have developed

to the point where unexpected side-effects will be eliminated (because: The Future!).

Sententia, via Baker, also re-assures the reader that enhancement drugs “are used to

enhance your performance as a worker” – an ominous statement that is apparently

intended to displace any concerns of developing a complacent ‘drug culture.’33 In

response to the question about class privilege, Sententia offers no rejoinder, but dismisses

the concern as irrelevant, since technological advances typically cater to the upper classes

before eventually trickling down to the masses. This uneven distribution of resources,

then, is defended and presented as part of the natural way of the world. In fairness, Baker

31 Ibid., 59.

32 Ibid.

33 Ibid.
 319

offers some space to dissenting opinions. In the discussion of creativity, Baker quotes

experimental pharmacologist Stefano Govoni at length, as he observers:

...classic ADHD traits, such as impulsivity and a

disorganized life, have also been described in several thinkers,
such as Albert Einstein, Salvador Dali, Winston Churchill. What if
Einstein or Churchill had taken ADHD drugs?34
Here, Govoni rightly points out the contradiction in the rhetoric of ADHD self-help

authors such as Hallowell and Ratey, quick to identify celebrities and famous thinkers as

ADHD. The critique echoes that which is expressed in the Calvin and Hobbes hoax: that

altering cognitive function may be tantamount to altering someone’s unique and essential

nature, which may not be desirable. Along these lines, Baker also quotes professor of

psychiatry Julio Licinio, who wonders, in a world where the consumption of cognitive

enhancers becomes increasingly common, “will you be at a competitive disadvantage if

you don’t take them?” 35

In this instance, peer pressure and the competitive disadvantage visited upon those

not using smart drugs is identified as a potential drawback to the pursuit of cognitive

enhancement as a whole. But at several other points in the article, the same sentiment is

used as a justification for the accelerated adoption of cognitive enhancement as a national

priority. The Discover article explicitly mentions economic competition on a global

scale, employing the notion of smart drugs in a kind of economic total war. Early in the

article Baker cites neurotechnologist Zach Lynch as saying, “neurotechnology holds the

promise of...accelerating economic growth for entire countries.”36 He goes on to pose

this scenario:

Think of millions of workers in India or China cognitively

enhanced with neuropharmaceuticals that boost productivity. Will

34 Ibid.

35 Ibid.

36 Ibid.
 320

the United States be able to place these drugs off-limits and

compete?37
Notably, this statement is elevated to the level of a pull quote in bold red letters on page

56. As the first pull quote the reader sees after turning the splash page, it is the second

most visible text after the headline itself. Similarly, at the article’s conclusion, Baker

quotes transhumanist Nick Bostrom, speculating that once Singapore and China “start to

promote cognitive enhancers to their own populations...other countries may follow suit

for fear of falling behind.”38

It is significant that the doomsday scenarios offered by the white men in both

examples involve the populations of India, Singapore, or China (named twice) using

cognitive enhancement. Not only are these groups currently feared, economic

competitors: racist, U.S. stereotypes of Asian people already grant them intelligence

potentially superior to that of White people. Since WWII, one racist subtext to this has

been that we need to enhance our cognition with the chemical technology that is our

domain as a White nation, in order to compete with these super-smart, hard-working,

family-oriented Asians. This view represents Asian populations as dehumanized

exemplars of mere productivity, a horde of beings who exist not as autonomous, rational

individuals, but as interchangeable elements within a techno-corporate economic engine.

In the case of racist fears of the “Pacific Rim” as a monolithic economic sector, this

discourse demonstrates that the de-centering of the individual can be mobilized to

contrasting political purposes – either as a means of moving beyond exploitation, as

Haraway-inspired posthuman cyborg theory would have it, or as a means of increasing

exploitation, as the capitalist, transhumanist model would have it. These concerns about

Global Economic Competition lay bare the transhumanist investment in capitalist markets

and the ability of cybernetic technologies – including chemical ones – to generate profits

37 Ibid.

38 Ibid.
 321

and power in the continued exploitation of resources. It further places Baker’s article

within the genre confines of imminent futurism, where speculative inquiry is ultimately

re-directed to a series of consumption choices within a competitive field.

Perhaps most telling, though, are the further reflections of transhumanist Nick

Bostrom, who suggests that the near-future of cognitive enhancement consists of “the

stretching of diagnostic categories...increasingly profligate off-label use...[and] people

seeking their own medicines from online pharmacies.”39 It is through the continued

application of these already-established subversive tactics that Bostrom claims the

moment of cognitive singularity will be realized. In other contexts, the stretching of

diagnostic categories has been identified as the basic problem with the ADHD diagnosis.

In the Ritalin lawsuits, it was presented as one of the mechanisms of fraud. Off-label use

of prescriptions – or bypassing the diagnostic/prescriptive process altogether by

purchasing drugs on-line – in most contexts constitutes a crime. But in this instance,

Bostrom posits both as mechanisms of social change. Ironically, by positing that these

subversive tactics are already in active deployment, Bostrom’s claim effectively

challenges the diagnostic regime, including ADHD. The full implications of this rather

radical suggestion are not fully entertained by Baker, perhaps because Bostrom’s

statement is presented as a forecast of near-future events, rather than as a polemical call

to action.

Baker’s article concludes with a gesture towards a half-hearted embrace of the de-

centered logic of cyborg subjectivity. Baker challenges her own knee-jerk repugnance at

the notion of cognition-enhancement; after all, why should one cognitive state be

considered inauthentic because it was inspired by a chemical change, when all cognitive

39 Ibid.
 322

states can really be thought of as chemical states and, further, that "everything we

experience has an impact on our neurobiology."40

Baker questions the ethical distinction between using chemicals to sustain

attention and using other technologies, such as airplanes, to extend human power into

realms otherwise beyond our physical limitations. While this consideration is perhaps the

closest Baker gets to insightful in this article, it unfortunately recirculates the topic of air-

travel, prompting Baker to once again perform her own privileged class position by

complaining of the ignominy of flying coach, revealingly in medicalized terms, as she

informs the reader of her own name for it.

These considerations move towards a displacement of some of the central tenants

of liberal humanism, almost posthumanist. However, on the balance, Baker’s

presentation is decidedly transhumanist, and is perhaps best summed up by her simple

quotation from Neuroscientist Earl Miller. When asked about the ethical implications of

cognitive enhancement, Miller responds, “I would love to have drugs that enhance my

cognition.”41Therein lies this article’s inability to accurately perceive the state of

cognitive enhancement -- it suggests rather naively that brain boosters are just a

pharmaceutical discovery away, laying bare the presumptions of a kind of techno-

teleology, itself invested in the inevitability of technological progress. In keeping with the

consumerist tradition of popular science journalism, the article’s headline promise to sell

you, the reader, the ‘drugs of tomorrow’ before any of the other kids on your block.

Predictably, the Smart Drug, like the Flying Car, turns out to be an imaginary object of

imminent futurism, which serves to structure the presentation of however much actual

science the article happens to hold.

40 Ibid.

41 Ibid.
 323

Instead, the Discover magazine article advocates black market distribution and

illegal consumption of controlled substances as a subversive means of accelerating the

transcendence of the upper class from humanity itself, into an evolved state of

consciousness, from when they will be vastly more efficient at and effective in exploiting

value from other human beings by pitting them against each other in an amphetamine-

fueled race to the bottom. This transhumanist fantasy and popular science journalism

share in common an investment in futurity that impedes the accurate perception of the

current state of affairs.

Some questions this raises for further consideration are: Why the recent surge in

interest in cognition-enhancement? Could the surge in brain boosting interest be related

to a growing call to reconsider the war on drugs in the US? Is it perhaps a response to

our current military engagements, in which the notion of routine performance

enhancement is being normalized for a growing number of US citizens and their

families? Or perhaps ADHD itself has functioned as a kind of incubator for cyborg

subjectivity, a demarcated space in which children have served as de facto guinea pigs for

an emerging social environment in which we construct our subjectivity as dependent

upon cognition-enhancing technology in order to be able to deal with the complex

vicissitudes of a technologically saturated environment.

Becoming Limitless

The 2001 film Limitless purports to weave a tale about a futurist smart drug, but

essentially describes amphetamines as we know them – and therefore fits into our

discussion of ADHD. How can a movie so closely describe the effects of Ritalin and yet

still maintain an imminent futurist treatment of the subject?

The 2001 novel The Dark Fields, by Alan Glynn, is the story of Eddie Spinola, a

frustrated writer, working as a copy editor, who serendipitously comes into possession of

an experimental new smart drug called MDT-48. Written as a cautionary memoir from
 324

Eddie’s perspective, in the final hours of his life, the story is a Faustian tale in which the

acquisition of knowledge beyond the bounds of normal human cognition eventually leads

to the protagonist’s destruction. When Eddie first takes the drug, he is immediately

inspired to finish the book project he’d been working on for years. He quickly realizes

that his boosted cognition – which manifests itself in heightened attention, focus, and

energy, along with increased memory recall and synthesis – allows him to process the

flow of information around him with greater efficiency and comprehension. Eddie

applies this discovery to the stock market, and works his way into the upper echelons of
high finance practically overnight, reinventing himself in the process.

But then the drug’s side effects become increasingly apparent. Eddie starts to

experience black outs, only to regain consciousness in compromising situations for which

he cannot account, including the scene of an apparent murder at his own hands.

Additionally, he discovers that others who have taken the drug have died from

withdrawal when forced to quit, which is especially concerning to Eddie, as he has only a

limited supply of the drug. When Eddie learns of an impending lawsuit against the

pharmaceutical company that covertly produces and distributes MDT-48 on the black

market, he attempts to blackmail the company for a lifetime supply. In spite of his newly

acquired social power, this attempt at blackmail proves to be a step too far; it is revealed

that the pharmaceutical company has been surveilling him for the duration of his self-

administration of MDT-48, effectively using him as an unwitting guinea pig. With their
own evidence of Eddie’s involvement in the murder of a foreign ambassador’s wife, the

company blackmails Eddie before he can make any of his own demands. Realizing he

has been outmaneuvered, Eddie makes a final gesture towards salvation by leaving all of

his money with his ex-wife, and chronicling his tale for posterity as he waits for the

inevitable death that accompanies MDT-48 withdrawal. As Eddie lays on his deathbed,

he sees live footage of the president on television, and recognizes in his expression the

signs of MDT-48 use, suggesting a bleak and dangerous future in which corporations
 325

hold political sway over governments by managing the consciousness of people in

positions of power.

The novel is far from hard science fiction, and reads more like a page-turning

thriller a la John Grisham. The wonkiest moments in the novel are concerned with the

details of stock markets, day trading, and international finance, rather than cognitive

neuropsychology. There are a few key moments, however, in which consciousness is

directly addressed. The most notable of these is a moment of reflection after Eddie’s first

big success in day-trading stocks, where he describes his newfound perception in

distinctly cyborg terms:

...maybe it was superior information, or heightened instinct,

or brain chemistry, or some kind of mysterious synergy between
the organic and the technological – but as I sat there at my table,
staring vacantly at the screen, these ruminations slowly coalesced
into an overwhelming vision of the vastness and beauty of the
stock market itself. Grappling for understanding, I soon realized
that despite its susceptibility to predictable metaphor – it was an
ocean, a celestial firmament, a numerical representation of the will
of God – the stock market was nevertheless something more than
just a market for stocks. In its complexity and ceaseless motion
the twenty-four-hour global network of trading systems was
nothing less than a template for human consciousness, with the
electronic marketplace perhaps forming humanity’s first tentative
version of a collective nervous system, a global brain. Moreover,
whatever interactive combination of wires and microchips and
circuits and cells and receptors and synapses was required to
achieve this grand convergence of band-width and brain-tissue, it
seemed to me in that moment that I had tumbled upon it – I was
jacked in and booted up...my mind was a living fractal, a mirrored
part of the greater functioning whole.42
The use of the term ‘jacked in’ near the end of this passage harkens to the science fiction

subgenre of cyberpunk, particularly William Gibson’s Neuromancer (1984), in which

‘jacking in’ describes the process of entering into a virtual world of information that

exists alongside the physical world. The allusion would seem to place the novel more

solidly in a class of speculative fiction investigating cyborg subjectivity. The description

42 Alan Glynn, The Dark Fields (New York: Little, Brown & Co., 2001), 123.
 326

of an organism that extends beyond the reach of a single subject, beyond the range of

human rationality alone, is suggestive of the distributive consciousness expounded by

Haraway.

In contrast to Haraway’s progressive vision of ecological and social justice,

however, Eddie instrumentalizes his cyborg insight, exploiting it to gain a competitive

edge in the capitalist marketplace. This would seem to suggest that Glynn’s

understanding of cyborg subjectivity is more similar to a transhumanist vision of mastery

than it is to posthumanism. Complicating this further, however, is the temporality that

Glynn attributes to this flash of cyborg subjectivity. Rather than presenting this cyborg

subjectivity as a new mode of being the protagonist inhabits, it is shown to be only a brief

moment of insight. In this sense, The Dark Fields is perhaps more of a psychedelic text

than a cyborg or transhumanist one, as those moments of insight into the nature of

consciousness are presented as a kind of gnosis, and the taking of MDT-48 as a kind of

vision quest. The moment of enlightenment is the deeper truth of the universe, which

represents a kind of consciousness that can’t be occupied – only respectfully and

cautiously approached, like a holy sacrament.

In fact, the influence of psychedelic culture in The Dark Fields is apparent

throughout the text, in a number of ways. For example Eddie’s book, which he

completes upon first taking MDT-48, is an historical account of the influence of LSD on

the birth of the internet, making the connection between late-20th century counter-culture

and early-21st century cyberculture. Glynn, through Eddie, informs the reader of the

evidence for this thesis, demonstrating his knowledge of the CIA’s LSD experiments.

Notably, Glynn has cited Jay Steven’s Storming Heaven: LSD and the American Dream

(1987), as a book that informed his writing of the novel.43

43 Alan Glynn, “Author Interview: Alan Glynn (‘Limitless’).” Interview by John Robert
Marlow (Aug. 17, 2011). http://makeyourbookamovie.com/author-interview-alan-glynn-
limitless/495/
 327

This psychedelic influence is also manifest in Glynn’s juxtaposition of contrasting

perceptions of time – both in narrative events and in the philosophical perspectives

different characters espouse. This debate over temporality recapitulates the

colonial/indigenous binary inscribed in popular psychedelic texts of the 1960s, such as

Carlos Castañeda’s The Teachings of Don Juan: A Yaqui Way of Knowledge (Berkeley:

University of California Press, 1968). For example, after “losing time” in an MDT-48-

inspired blackout, Eddie unexpectedly returns to consciousness in the midst of having a

conversation with the wife of the Mexican ambassador to the United States, in which they
are discussing the essentially cultural nature of perceptions of time:

... I heard myself saying...‘If you don’t choose your future,

who the hell’s going to do it for you?’

‘Well,’ said Donatella Alvarez, smiling across the table

– and smiling directly at me – ‘that is the North American way,
isn’t it, Mr. Cole?’

‘I beg your pardon?’ I said, a little taken aback.

‘Time,’ she said calmly. ‘for you it is in a straight line.

You look back at the past, and can disregard it if you so wish. You
look towards the future...and, if you so wish, can choose it to be a
better future. You can choose to become perfect...’

She was still smiling, and all I could say was, ‘So?’

‘For us, in Mexico,’ she said very deliberately, as

though explaining something to a small child, ‘the past and the
present and the future...they co-exist.’44
It is telling here that the character Donatella Alvarez links a Western obsession with the
future to a quest for self-perfection, which together comprise the appeal of the

transhumanist sales pitch for the Smart Drugs of tomorrow. In this instance, Glynn

seems to offer a critique of a transhumanist position, even as the protagonist blindly

moves forward with his own transhumanist agenda of “better living through chemistry.”

44 Glynn, The Dark Fields. 154.

 328

And of course, this dream is ultimately cut short by the financially-interested

machinations of a transhumanist corporation, exploiting Eddie for their own competitive

advantage in the marketplace.

The final plot point of the book, significantly, revolves around a class action

lawsuit of a pharmaceutical company. The lawsuit involves a plaintiff who committed

murder while taking an anti-depressant produced by the defendant. Eddie’s information

about the company’s clandestine production of smart drugs without any disclosure of the

deadly side-effects could play into the plaintiff’s case that the company regularly
suppressed information about side-effects in order to increase profits. Glynn was

finishing this novel in 1999-2000, just as the Ritalin lawsuits, which included some of the

same claims, were taking place. It is in the process of considering this course of action

(testifying against the pharmaceutical company) that Eddie is confronted with the

paradox of contributing evidence to a legal claim based on a model of consciousness that

apparently disavows his own agency:

Maybe the reductionist view of human behavior...was right,

maybe it was all down to molecular interaction, maybe we were
just machines.45
Glynn does not resolve this conundrum. This argument never makes it to court in the

space of the novel, as Eddie meets his demise before having the opportunity to see a jury

grapple with such questions.

Though Glynn claims he did not write the book as a movie, its potential for film
was apparent from the start.46 Glynn, through his literary agent, began shopping the

book to film production companies in 1999, before the final draft had made it to print. 47

In an interview, Glynn recalled wanting to shop the script with a three word pitch: “A

45 Ibid., 314.

46 Alan Glynn, “Author Interview.”

47 Ibid.
 329

pharmaceutical Faust.” His suggestion was overruled by his agent’s pitch: “Viagra for

your brain.” While this phrase never made it to the official advertising copy for the film,

it is significant for several reasons. First of all, it predictably confirms that brand-name

erectile dysfunction drugs are a more recognizable element of popular culture than classic

literature. The fact that this pitch was ultimately effective speaks to the fact that

pharmaceutical products already walk a line between prosthesis and enhancement in

popular culture, as Viagra itself is widely perceived as a drug that functions wholly apart

from the diagnosis that ostensibly controls its distribution. Furthermore, it speaks to an
inherently heteronormative and masculinist perspective characteristic of both the film that

eventually gets made and technofuturist culture in general.48 It also speaks to the power

of the Smart Drug narrative that in this instance, in order to sell a film script, the literary

agent sold the fictional drug represented there-in. As far as this pitch goes, whatever plot

the script contains functions primarily as a delivery mechanism for the Smart Drug trope.

The book was quickly optioned, and the rights to adapt the screenplay were

acquired by veteran Hollywood writer and producer Leslie Dixon. The project soon

stalled, however, as often happens in Hollywood. While Dixon’s screenplay continued to

be optioned, there were a number of changes in production, direction, and casting before

the film finally came out in 2011 as the more optimistically-titled Limitless, over a

decade after the project first started. In the meantime, The Dark Fields went out of print

in 2006, and did not come back into print until it was re-released under the title Limitless,
to coincide with the release of the film.

In an interview featured in promotional materials for the release of Limitless,

Leslie Dixon talks about her eagerness to produce the film upon being presented with the

novel:

48 Joel Dinnerstein, “Technology and its Discontents: On the Verge of the Posthuman,”
in de la Pena and Vaidhyanathan, eds. Rewiring the ‘Nation.’
 330

I thought it was a provocative idea. Just verging on science

fiction but not really, kind of realistic. And a timely idea ‘cause
everybody’s in labs right now trying to make the ultimate smart
drug and everybody would like to take that drug if it existed and
get access to the other 80% of your brain that scientists say we
cannot achieve in our normal lives and improve memories,
cognitive function, have ultimate bullshit detectors, better reflexes,
and just generally become an uber-person. I thought, that kind of
technology is probably around the corner and it would be
interesting to see a story come to life about somebody that gets a
hold of it before any of the rest of us ever do.49
Ironically, Dixon speaks of the timeliness of the idea as easily in 2011 as she apparently

did in 1999. That she characterizes both moments, over a decade apart, as “just around

the corner” from this technological breakthrough is characteristic of the Smart Drug

narrative, recalling the perpetual imminence so often expressed in popular science

journalism.

More significant, however, is Dixon’s allusion to “the other 80% of your brain.”

She asserts this statistic in passing as if its truth was so self-evident and widely

acknowledged that it needs no explication or evidence. To clarify Dixon’s casually

expressed allusion, she is referring to the popular notion that human beings only use a
small percentage (in this case, 20 percent, in other instances, 10 percent, 11 percent, etc.)

of our brain. Dixon included this sentiment in her adapted screenplay, when Eddie first

encounters the drug it is described in these terms:

They’ve identified these receptors in the brain that activate

specific circuits, and you know how they say we can only access
20 percent of our brain? Well what this does, it lets you access all
of it.50
This line was subsequently used in theatrical trailers and television commercials for the

film, demonstrating the perception among the film’s producers and marketing team that

this narrative is widely recognized and understood by a US audience. Notably, the line

does not appear in The Dark Fields at all. MDT-48 is described as a “smart drug,” but

49 Leslie Dixon, Interview. http://www.youtube.com/watch?v=ESgXYei9p60.

50 Limitless.
 331

there is no reference at any point to a 20/80 ratio of brain accessibility. Rather, this ratio

is an American narrative that preceded and influenced Dixon’s first reading of Glynn’s

text.

The notion that we only use 20 percent of our brain is, of course, demonstrably

false. MRI results, as well as the consensus of modern neuroanatomy, refute this. Even

before the development of technologies like MRI, which enable the visualization of

neural activity in real time, this notion of fractional brain accessibility was never

seriously entertained by science. While the belief is widely acknowledged in US culture

– in this form or something close to it – it did not come out of scientific discourse at all.

It is something closer to an urban legend that has arisen from – and continues to be

perpetuated by – the self-help movement in the US.

Among the earliest places this idea shows up in print is in 1939, in Thomas

Lowell’s introduction to Dale Carnegie’s widely-popular and genre-defining self-help

book How to Win Friends and Influence People. In this instance, Lowell claimed we

only use ten percent of our “latent mental ability,” and he attributed the statement to the

turn-of-the-century American psychologist William James.51 While James did not utter

this statement precisely, he was fond of claiming that most people only achieve a fraction

of their potential in the course of their lifetime. Bearing the influence of William James,

language that echoed this was common among those in the self-help movement

throughout the early part of the 20th century. This is also thematically close to the

popular appeal of phrenology in the 19th century, which promised to reveal to its disciples

the heretofore undiscovered capacities of their own minds through the analysis of the

protrusions the various regions of the brain impressed upon the outward shape of the

skull. Of course, phrenological readings also reinforced inherently racist and biologically

51 Barry Beyerstein, “Whence cometh the myth that we only use ten percent of our
brains?” In Mind-myths: Exploring Everyday Mysteries of the Mind and Brain, Sergio Della Sala,
ed. (New York: John Wiley and Sons, 1999).
 332

deterministic ideas about the heritability of behavioral traits, which partly explains the

persistence of the practice in spite of the rational flaws in the theory. But even more

importantly, phrenology’s participation in a program of self-improvement explains the

popularity of the contested science. And this program of self-improvement is predicated

on the popularization of the notion that most people achieve only a fraction of their

potential in the course of their lifetime.

The articulation of this notion in terms of a percentage of brain-mass utilization

lends a whiff of scientism to the myth, which no doubt contributed to its apparently
credulous repetition throughout culture. In addition to its prevalence in self-help

literature, this notion is commonly invoked by mentalists, magicians, and psychics as an

explanation for supernatural cognitive powers. Famous spoon-bender Uri Geller, for

example, cites this as an apparent fact in the introduction to Uri Geller’s Mind-Power

Book.52

As a relic of the American tradition and industry of self-improvement, the 80/20

conceit is representative of the other differences between Glynn’s novel and the film it

inspired. Together, these differences effectively change a tragic morality tale into a

hero’s journey of self-discovery through biotechnology. The change in title makes this

almost immediately apparent. Glynn’s title is a reference to the melancholy closing

paragraphs of F. Scott Fitzgerald’s The Great Gatsby, calling to mind the ultimate futility

of aspiring to self-perfection53; the title ‘Limitless’ summarizes in a single word that very
aspiration and reasserts its viability as an object of desire.

52 Uri Geller and Jane Struthers, Uri Geller’s Mind-power Kit (London: Virgin Books.
1996).
53 The passage reads, “And as I sat there brooding on the old, unknown world, I thought
of Gatsby’s wonder when he first picked out the green light at the end of Daisy’s dock. He had
come a long way to this blue lawn, and his dream must have seemed so close that he could hardly
fail to grasp it. He did not know that it was already behind him, somewhere back in that vast
obscurity beyond the city, where the dark fields of the republic rolled on under the night.” F.
Scott Fitzgerald, The Great Gatsby (New York: Scribner, 2004), 180.
 333

In an interview about the process of adapting literature to film, Dixon has

described some of the further additions she made to Glynn’s original story:

I knew I was going to have to invent more plot. Movie

audiences are more ADD-ish than book readers, and there were
going to have to be some extra twists and turns... I didn’t want to
use [Glynn’s] ending — Faustian as Eddie’s bargain is, I had a
feeling the audience would still want to see him win.54
It is significant that Dixon uses “ADD-ish” as an adjective in this instance, particularly

because she applies this adjective to the entire US movie-going public. This usage of

ADD or ADHD as an adjective is not unique to Dixon; rather, it has become a common

expression in US popular culture since the mid-1990s. The expression’s ubiquity,

however, does not lend any clarity to precisely what ADD means to those who use it. In

this instance, Dixon clearly employs it to communicate a desire for more events, more

action, more chase scenes, more fight scenes, and more sex scenes (all of which Limitless

holds of The Dark Fields). But all of these things are entirely typical of most Hollywood

movies. So, rather than using “ADD-ish” to describe something that is abnormally

lacking in attention, Dixon is referencing a behavioral disorder to describe the normal

conditions of 21st century consumer culture.

In the above quote, Dixon also identifies the most salient difference between The

Dark Fields and Limitless: the ending. Rather than concluding tragically, Eddie in

Limitless achieves his full potential. While it is left strategically unclear whether or not

Eddie is still consuming NZT (he claims to have quit, though the final scene reveals that

he has apparently just picked up the ability to speak Mandarin overnight – wink, wink),

he has gained mastering over either the drug’s side-effects or its withdrawal symptoms.

His book is published (titled Illuminating the Dark Fields, as a nod to Glynn). He wins

back his love interest. He outwits all of his rivals (unlike The Dark Fields, in which

54 http://www.mulhollandbooks.com/2011/03/17/a-conversation-with-the-dark-fields-
author-alan-glynn/.
 334

corporations represent an unfathomable, Lovecraftian kind of omnipotence). And in a

final tweak of Glynn’s ending, Eddie himself runs for political office. As a narrative of

(white, male) mastery, then, Limitless is a decidedly more transhumanist text than is the

psychedelically-influenced The Dark Fields.

While Limitless was generally received as science fiction, as opposed to a thinly

veiled allegory for a burgeoning cyborg subjectivity within 21st century US

technoculture, the similarities between MDT-48/NZT and stimulant drugs like Ritalin has

been noted. Glynn addressed this in an interview following the release of the film, in

which the final question posed by the interviewer was, “Where can I score some NZT—or
MDT, as it’s called in the book?” Glynn responded:

At a reading I did at Partners & Crime in New York

when the book first came out someone asked me this question and
I said that I would be filling out prescriptions after the Q&A.
Which got a laugh. But I do get the question a lot, and I wish I had
a satisfactory answer.
On the IMDB discussion board for the movie there are
endless debates about what NZT might really be, Adderall, Ritalin,
Provigil, ecstasy, caffeine, whatever. I chose the name MDT-48
quite carefully, to reflect or subtly suggest MDA, MDMA, DMT
and LSD-25.

I chose the 48 because of Bach’s well-tempered

Clavier, the 48, to suggest complexity, structure and beauty. But
it’s obviously made-up shit. Custom made for the story.
I did do a lot of research—a great book I read was
Storming Heaven: LSD and the American Dream by Jay Stevens—
but when it came to it the drug was purely a product of my
imagination.

So where can you score some? I’ll be selling vials of

my blood after the interview…55

55 Glynn, Alan, “Author Interview: Alan Glynn (‘Limitless’),” Interview by John Robert
Marlow (Aug. 17, 2011). http://makeyourbookamovie.com/author-interview-alan-glynn-
limitless/495/
 335

As this interview demonstrates, a common response to this film is, “Where can I get this

drug?” A feedback loop emerges: when trying to sell the script of Limitless to Hollywood

producers, Glynn’s agent sold the idea of the Smart Drug; in turn, the film has had the

effect of selling the idea of a Smart Drug to its audience.

While Glynn’s invention of MDT-48 in The Dark Fields was originally inspired

by psychedelic drugs, Limitless describes NZT in terms that accord closely with Ritalin

and other stimulant drugs commonly administered to individuals diagnosed with ADHD.

Throughout the film, the effects of the drug are explained in terms familiar to anyone so
diagnosed. Rather than using terms like cognitive enhancement, the effects of the drug

are typically described in terms of attention, recall, motivation – all effects that can

already be achieved with amphetamines. In contrast to the notion of a chemical that can

“make you smarter” or impart knowledge in some kind of “Keanu-Reeves-in-The-Matrix-

I-know-Kung-Fu” way, it is explicitly stated that the drug works better if you’re “already

smart”—further bringing into the realm of plausible what was initially described in

magical terms. All of the side-effects are also similar to amphetamines when abused—

losing time from lack of sleep, lack of appetite, increased sex drive. When a character

describes going off of the drug, all of her symptoms are those associated with ADHD.

Even the cinematography reflects this, as the film is bright whenever the protagonist is on

the drug, and dark and moody when he’s not.

Cyborg consciousness is addressed in The Dark Fields, though it’s approached as

a psychedelic vision: a glimpse into the face of something greater or god-like, at the

expense of one’s soul; a thing beyond our everyday knowing; accessible, but only briefly;

in another word – sacred. In Limitless, this sense of the spiritual and psychedelic is

subsumed entirely by the cinematography. To the film’s credit (specifically, to the credit

of director Neil Burger and cinematographer Jo Willems), the artistically shot scenes

under the influence of NZT are perhaps the greatest pleasures Limitless offers.

Narratively, however, this sense of the sacred or enlightening aspects of cyborg

 336

subjectivity are sidelined to the utility of that consciousness to manipulate resources

(including women) in a capitalist market, in line with the vision of transhumanists and

imminent futurists. Ironically, this demonstrates the degree to which these positions

(transhumanism and imminent futurism), both infatuated with futurity, are actually

invested in the status quo of white, male, hegemonic power. This investment, in turn,

contributes to the failure to perceive the realities of cyborg consciousness already extant.

Rather than being genuinely interested in revolutionary social change, these perspectives

are more interested in the future, they are more interested in the present and the strategic
advantage that the technology of the near future will help them exploit. It behooves

transhumanists and imminent futurists to continue to believe that the chemical technology

of cyborg subjectivity and the instrumentalization of consciousness are “just around the

corner,” as this predicates the exclusive access to technology that perpetuates power. By

not identifying NZT as Ritalin or any other drug available in the US, the film maintains

its status as fantasy, while unfortunately avoiding the most interesting philosophical

questions its subject matter prompts. This leaves us with a paradox: the reality of now is

more science fiction than the futures imagined in science fiction.

Conclusion

Discover magazine, like many popular science magazines, presents a

transhumanist vision of cyborg subjectivity through consumer-driven cognitive

enhancement in the imminent future. Limitless transforms an arguably posthumanist

vision (The Dark Fields) into a transhumanist fantasy of self-improvement and mastery

through cognitive enhancement, again, in the imminent future. In the process of doing

so, both Discover and Limitless describe psychostimulant use and cognitive experiences

widely understood as co-constituting ADHD. However, neither of these sources identify

their subject as such, as a result of the structural fetishization of futurity fundamental to

their entrenched ideological positions.

 337

A posthumanist, cybernetic, ANT-inspired perspective maintains that cyborg

subjectivity isn’t a state of the future but an accurate assessment of the present. As

follows, cognitive enhancement via Ritalin is a kind of cyborg subjectivity – bringing the

brain state of an individual into an established accord between several non-human

actants, including educational institutions, pharmaceutical companies, government

policies, legal codes, methylphenidate itself, physical distribution networks, and

information flows. Transhumanists fail to see this because of their common investment

in futurity. Others fail to see it as such because of the discourse that both fears cyborg
subjectivity and normalizes cyborg subjectivity as instances of disability.

Seeing ADHD from a posthumanist cyborg perspective is key to getting beyond

the dualistic question of ADHD’s ontological status as either “real” or a “fraud.”

Understanding it as technology – not just Ritalin, but the ADHD diagnosis itself – allows

us to more clearly address the social and ethical issues at hand. Addressing such issues is

essential because the current regime, now 35 years old, exercises coercive power of its

subjects – by virtue of the vulnerability their status as minors entails – even while

appealing to their guardians’ best intentions and desires. The ethical problem lies in

using categories of disability and the language of medicine to deploy new bio-

technologies, because medicalized discourse carries an authority that often precludes

skeptical inquiry. It can make a significant difference to a parent, when confronting the

prospect of an ADHD diagnosis for their child, whether the administration of Ritalin
amounts to modifying behavior, enhancing cognition, or “medicating” an organic disease.

The test subjects in this longitudinal, population-wide experiment – whose informed

consent is rarely sought – are those individuals for whom the idea of cognitive

enhancement through chemical technology has been made as mundane and simple as off-

handedly suggesting that they “take a chill pill.”

 338

CONCLUSION

In spite of the contentious public debate over whether Attention

Deficit/Hyperactivity Disorder is a “real” or “manufactured” condition, this dissertation

has not directly concerned itself with ADHD’s status as an objective reality. Instead, by

looking at the technologies and practices that constitute ADHD, as well as the broader

cultural trends that make these practices intelligible, this dissertation has approached

ADHD as a sociotechnological practice. The result, therefore, is not a natural history – as

one might expect of any organic entity – but a cultural history. Further, this dissertation

argues that this cultural history does not merely supplement existing narratives that

purport to be natural histories of ADHD; rather, this cultural history fully supplants

existing narratives in its explanatory capacity. This method of inquiry is particularly

well-suited to the study ADHD because the condition of ADHD is only recognized by the

expression of a range of social behaviors. Similarly, the diagnostic process associated

with ADHD is entirely comprised of cultural and intersubjective events. Just as attention

itself is a relational attribute, describing the quality of interaction between subjects, so,
too, is ADHD a manifestation of the interaction between an individual and his or her
social environment. Moreover, the rise of ADHD diagnoses throughout the 1980s and

90s is not linked to an increased incidence of distractible behaviors, nor is it directly

inspired by a scientific or medical breakthrough. Rather, the advent of the ADHD

diagnosis codifies an emerging cultural practice – that of discursively constructing

distractible behaviors in problematic students as the result of a “chemical imbalance,”

and subsequently administering stimulant drugs as a means of managing the attensity of

select individuals.
 339

This cultural history of ADHD as a sociotechnical practice produces a

multifaceted analysis that contributes to the understanding of ADHD in several important

ways:

1. It complicates the divisive and misleadingly reductive debate of whether or not

ADHD is “real.”

2. It accomplishes this by situating ADHD within specific historical moments and

technocultural practices.

3. The cultural history of ADHD, thus reconstructed, stands in stark contrast to the

popular “origin story” of ADHD, thereby revealing the ideological function of

this ADHD narrative.

4. Taken together, this enables a more thoughtful and nuanced consideration of the

skepticism of ADHD frequently expressed in popular media and observable

through events such as the Ritalin lawsuits of 2000.

5. Finally, this discussion expands the range of ethical considerations at stake as this

diagnosis proliferates within American culture.

Considered in this light, the creation of the ADHD diagnosis marks a significant moment

in the ongoing history of the cultural and scientific efforts to instrumentalize

consciousness – that is, the ongoing pursuit of a reductive and materialist model of

consciousness, in which the human mind is understood as a collection of basic and

discrete cognitive functions, ultimately enabling the selective manipulation and

productive management of conscious experience. With roots in the 19th century, this

historical trend significantly precedes the advent of ADHD. Indeed, by the mid-20th

century, most of the technologies fundamental to the instrumentalization of

consciousness had been developed and, in proscribed circumstances, were being routinely

deployed. For example, pharmaceutical stimulants – many of the same ones later

administered to children diagnosed with ADHD – were administered within the military

to sustain the vigilance of U.S. soldiers throughout WWII.

 340

However, military and commercial deployment of attention-sustaining

technologies in the mid-20th century occurred independently of the notion that these

chemicals corrected a pre-existing deficit in one’s capacity to pay attention, apart from

any history of brain damage. These chemicals only came to be regularly employed to this

purpose in the 1970s, when the increasing incorporation of mental health professionals

within educational institutions brought psychiatric practice into closer and more regular

contact with educational discourse. The influence of this relationship inspired many

educators to a renewed interest in medical interventions as a means of managing sub-

populations of problematic students, while psychiatric researchers increasingly addressed

the concerns of educators by re-hypothesizing diagnostic categories previously

formulated as dysfunctions (e.g., Minimal Brain Dysfunction) or excesses (e.g.,

hyperkineticism) as deficits of attention. Doing so allowed the already-existing

technology of attention-sustaining stimulant drugs to be brought to bear on this

population, and provided a practical means of realizing what some educators had already

envisioned: effective tools with which to address educational difficulties thought to arise

from somatic disturbances within the brains of problematic students.

Equally crucial to the development and subsequent proliferation of the ADHD

diagnosis in the late-20th century is the diagnostic turn within the profession of

psychiatry. The American Psychiatric Association marked this precipitous change in

psychiatric practice with the publication of the third edition of the Diagnostic and

Statistical Manual of Mental Disorders in 1980. Inspired by the desire to bring

psychiatry more in line with medical practice and insurance billing procedures, as well as

a general repudiation of Neo-Freudian model of therapy, the editors of the DSM-III re-

formulated mental illnesses as discrete and somatic entities, inherently receptive to

medical interventions, such as pharmaceutical drugs. The fact that “attention deficits,” as

researchers had constructed them in the 1970s, were receptive to manipulation by

stimulant drugs, then, made the new diagnostic category of ADHD a fit candidate for
 341

inclusion in the DSM-III. In turn, as the DSM-III became widely accepted by insurance

companies and governmental institutions as authoritative, and the existing structure of

educational institutions provided a mechanism for the wide-spread and relatively fast

implementation of the these sociotechnical practices, ADHD itself has extended the

instrumentation of consciousness to a much broader, more diffuse, and younger

population.

In contrast to many previous instantiations of the instrumentation of

consciousness – such as its application in the military to extend human capacities beyond

normal – the sociotechnical practices of ADHD employ this technology, instead, as a

means of establishing and enforcing a cognitive norm. This use is in further contrast to

the allopathic model of medical intervention, which seeks to cure an illness. Instead, the

sociotechnical practice of ADHD is an ongoing regimen meant to discipline the body, as

would a prosthesis.

The advent of the ADHD diagnosis expanded the category of disability both

discursively – introducing a new category of disability – and demographically – creating

a new population of individuals identified as disabled. This occurred at a time when law

makers and school administrators were re-evaluating the protocols regulating institutional

responses to individuals with disabilities – including economic flows of recompense for

institutions providing access to disabled individuals. The expansion of disability entailed

in the creation of ADHD, then, brought revenue sources to both pharmaceutical

companies and schools, while granting those diagnosed with ADHD access to otherwise

restricted biotechnologies of self-regulation. As ADHD was written into education

policy and legislation such as the Americans with Disabilities Act, it became more solidly

established in U.S. culture. The “reality” of the diagnosis becomes a moot issue; the

reality of the diagnosis, and the social practices authorized by the diagnosis, have become

widely recognized elements of U.S. custom and law.

 342

This cultural history of ADHD contrasts sharply with the “origin story” of ADHD

presented in most ADHD literature. As it is commonly presented, the origin story

focuses on the medical research of a handful of individual physicians through the 20th

century, narratively linked through the presumption of a common physical reality

standing behind each inquiry. This origin story of ADHD is inherently invested in the

physicality of ADHD, not because of any evidence for its physicality, but because of the

ideological investment in materiality that underwrites the entire paradigm of diagnostic

psychiatry. Research into physical indicators or causes, and the histories that dutifully

recapitulate only these research interests, can, at best, retrospectively justify

developments in psychiatric practice that grew directly out of conditions external to these

kinds of research. At their worst, such research and histories obfuscate the overlapping

social and institutional conditions that produced and continue to perpetuate ADHD as a

diagnosis and practice.

Uncovering the debate about chemical interventions in the classroom

demonstrates that skepticism to such intervention precedes the popularization of the

practice. As the examination of education literature in this dissertation has demonstrated,

“attention” has long been identified as a key concept in education, and a particularly

important consideration in the education of problematic students. Moreover, “attention”

was recognized as a relational quality, involving both the student and the educational

environment. Before the 1970s, this discourse was more commonly focused on

maximizing the attention-promoting elements of the educational environment, as that half

of the attentional relationship was more readily manipulated by educators. Manipulation

of the brain chemistry that constitutes an individual student’s inclination (or

disinclination) to pay attention was acknowledged as a hypothetical alternative means of

managing problem students. While some educators embraced the idea, most often this

was dismissed as impractical and unethical when contrasted against manipulating the

educational environment to promote attention (or discourage inattention). As education

 343

institutions incorporated psychiatric practice into their structure throughout the 1960s and

70s, this disposition began to shift. By the 1990s, after the development of the ADHD

diagnosis, manipulating the increasingly contested structure of the educational

environment had become widely perceived as impractical, in contrast to the relative ease

with which the inclination towards attention could be chemically stimulated in the

conscious experience of individual students. Acknowledging the shifting terms of this

debate in education is an important contribution to understanding ADHD in U.S. culture,

as it complicates the common characterization of resistance to the administration of

stimulant drugs to struggling students as “backlash” to medical and scientific advances.

Similarly, the widespread skepticism of ADHD, increasingly apparent throughout

popular culture by the end of the 20th century, cannot be reduced to a single point or
dismissed as anti-scientific backlash, either. Rather, the popular critiques of ADHD fall

into a range of distinct (if not necessarily logically cohesive) critiques, informed by and

connected to broader cultural dialogs about childhood, disability, and the use of chemical

technology to manipulate consciousness. ADHD, then, in addition to being a

sociotechnical practice, is also a narrative practice, and popular narratives of ADHD are

key elements of this cultural history.

The use of a mental disorder such as ADHD to characterize the current state of

U.S. culture is a rhetorical trope that hearkens back to now-outmoded categories of

mental illness, such as neurasthenia. Notably, both proponents and skeptics of ADHD

participate in this practice. Some dismiss ADHD as merely an expression of

contemporary culture, and therefore not a legitimate disorder; others point to the

influential effect of cultural pressures as validation of ADHD’s legitimacy. This slippage

is not only a symptom of culture using a diagnosis as a metaphor; this vagueness is

written into the diagnosis itself, because the diagnosis is a cultural response to cultural

pressures within cultural institutions. To identify ADHD as a social construct, however,

is not to dismiss it as immaterial – or even to equate it to neurasthenia; reducing ADHD

 344

to a modern reincarnation of neurasthenia would be an oversimplification, erasing the

historical specificity this project endeavors to restore to the conditions giving rise to

ADHD. However, the tendency to use ADHD as a vehicle for critiquing the advancing

speed of culture is a tendency common to the phenomenon of neurasthenia as well as

ADHD.

The examination of popular cultural texts, such as Batman, illustrates ways in

which ADHD fits into these longstanding cultural tropes. Beyond simply noting that

Batman’s nemesis, the Joker, has recently been characterized as having ADHD, this

dissertation has sought to demonstrate that this depiction of the Joker draws on and

contributes to pre-existing narratives about madness, insight, and the increasing speed of

culture. The same narratives contribute to our understanding of ADHD itself. In other

words, the Joker – as an instantiation of the narrative of madness as insight – prefigures

and makes possible the reception of ADHD as an intelligible concept. Beyond just

dismissing ADHD as a fraud, the multiple critical perspectives observable in popular

culture place ADHD within a larger discourse of consciousness and the ethical

ramifications of its instrumentalization. These popular narratives, in turn, shape how

these sociotechnological practices will be applied to our own consciousness in the future.
 345

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