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1117509 Soc 312

UNIVERSITY OF BIRMINGHAM
Undergraduate Division School of Government & Society (College of Social Sciences) 1. STUDENT ID No. (srn): 3. YEAR OF STUDY: 4. MODULE TITLE: 1117509 Sociology 3 Technology and Society

2. PROGRAMME OF STUDY:

5. MODULE BANNER CODE: 08 23487 6. MODULE LEADERs NAME: Dr Ross Abbinnett 7. SEMINAR TEACHERS NAME (IF DIFFERENT TO ABOVE): 8. SUBMISSION DATE: 08/01/2013 9. ASSIGNMENT TITLE: Do pharmaceutical solutions to psychological disorders (such as chronic depression and bi-polar syndrome) provide the solution to human unhappiness? 10. EXTENSION: Yes

a. DATE EXTENSION APPROVED: b. STAFF MEMBERS NAME WHO APPROVED THE EXTENSION: Dr Richard Shorten c. NEW ASSIGNMENT DATE DUE: 15/03/2013 (Please Note -Module information required above can be found in your Module Handbook)

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1117509 Soc 312

Do pharmaceutical solutions to psychological disorders (such as chronic depression and bi-polar syndrome) provide the solution to human unhappiness?
Psychological disorders like depression have become increasingly widespread: nations such as the US and UK are experiencing what Schwartz describes as an 'epidemic'. Such phenomena challenge received wisdom concerning the conception of happiness. Moreover, it raises ethical questions concerning what action should be taken. Happiness bureaucrat Richard Layard believes he has the solution. Therefore we will critically engage his endorsement of pharmaceutical drugs, paying attention to his thoughts on artists and creative individuals. We will adopt an Adornian position in criticising his conception of happiness, and his view that as a societal aim, could be a solution to all human suffering. Through combining the aim of happiness with wholesale advocacy of pharmaceutical drugs. Arguably, his perspective bears a totalitarian inclination, and we will draw on literary fiction in identifying the possible emergent dystopia. Beforehand, we will observe what psychological disorder means, focusing on depression, and current pharmaceutical treatments for depression. Klein explains depression "is a natural energy-saving program" (2006:181-2), functioning as a coping mechanism against the vicissitudes of human existence. Though a commonplace experience, severe bouts of depression may require intervention. Prolonged depression can cause lasting neurological damage with largely unknown consequences: in extreme cases pharmaceutical treatment is often considered essential (Ibid.). With depression, neurological serotonin levels are reduced, combatable with the drug group selective serotonin re-uptake inhibitors (SSRIs) (Klein, 2006:190). These work by increasing levels of serotonin in the brain, helping invigorate neural growth and can prevent lasting neurological damage (Ibid.). Whilst found to aid depressive symptoms, SSRIs have little effect on 'normal' people. Moreover, low serotonin levels do not necessarily cause depression; many nondepressives possess low serotonin levels (Klein, 2006:190-1). This suggests medical science cannot identify what constitutes happiness, but have developed ways of treating unhappiness. While Klein (2006:189) suggests over 60% of diagnosed depressives are helped by these treatments, their efficacy has been questioned (Jay et al 2010). Abrahams (2010) and Chalmers (2006) doubt the reliability of some clinical trials, leading to unreliable data informing GP's decisions on treatments for psychological disorders. Moreover, Abrahams (2010) claims normal conditions of human experience are becoming classified as disorders for which drug-treatment is appropriate. This trend most recently included the American Psychological Associations' move to classify grief as a treatable illness, suggesting more than two weeks of grieving is abnormal, corrigible through treatment Page 2 of 11

1117509 Soc 312 (Dawson, 2012). Chalmers (2006) and Abrahams (2010) both argue that medicalisation of normal conditions is a product of the pharmaceutical industry's huge and largely unregulated politicaleconomic influence, amounting to a "medico-industrial complex" (Chalmers 2006:337). The implication is the industry is operating to maximise economic power, rather than serve public good through treating genuine illnesses, which makes advocating these treatments in providing a 'solution' to human unhappiness a very questionable one. We now turn to happiness as conceived by utilitarians; argued here has achieved hegemonic status, alongside "mans exit from self-incurred immaturity" Kant (1996:58). The question concerning happiness is as old as philosophy; Adorno asserts the ancient Greeks took it for granted happiness 'the good life' - to be the true field of philosophy (Adorno, 2005:15). For Adorno happiness, much like utopia, is an intrinsically evasive notion; like the grape vines which tormented Tantalus - only through a subsequent absence can we be sure of its possibility: To happiness the same applies as to truth: one does not have it but is in it... He who says he is happy lies, and in invoking happiness sins against it. He alone keeps faith who says: I was happy. Adorno, 2005:112 As we have seen, medical knowledge does not appear to refute this perspective. However, for Layard, "[happiness] is an objective dimension ... And it can be measured." (Layard, 2006a:224). Before we turn to Layard however, we must consider the origins of his neo-utilitarian position Bentham. With the rise of modernity and technocracy, a paradigmatic concept of happiness has dogged western society. Erich Fromm labels this The Great Promise of Unlimited Progress: the promise of domination of nature, of material abundance, of the greatest happiness for the greatest number, and of unimpeded personal freedom has sustained the hopes and faith of the generations since the beginning of the industrial age. Fromm, 1997:22 From this, we can ascertain that the promise's crux lies in two strands of liberal thought utilitarianism and an individuated concept of freedom, or negative liberty, which we will return to below. Bentham's utilitarian philosophy was inspired by the phrase "the greatest happiness for the greatest number" (Warnock, 1974:7). He felt happiness was attainable through avoidance of pain and indulgence of pleasure, outlining a litany of these (Bentham, 1974.:68-77). Despite recognising the importance of others in a limited number of instances (described as 'extra-regarding'), he locates Page 3 of 11

1117509 Soc 312 pleasure in terms of the enjoyment one may derive from another. Such a view of others appears overly instrumental, contravening Kant's (2012) categorical imperative by not considering others as an end in themselves. Moreover friendship for Aristotle (1976:261-311), in its highest form, was not based upon pleasure or utility, but on care and responsibility - as ends in themselves. It is important to note the pluralism in which pleasure is conceived meant there were no higher pleasures for Bentham - push-pin was as good as poetry (Mill, 1974:123). Such a pluralistic approach to pleasures may appeal, but it contains a self-destructive potentiality: a failure to recognise the impact that some pleasures can have, and Fromm argues resulted in a culture of "radical hedonism" (1997:23). Aristotle (1976:325-342), on the other hand, felt the reflective act of theoria to be the highest form of pleasure, and through a balanced and virtuous approach to private pleasures and civic responsibility, we could lead the most desirable life, itself conducive (but not the guarantor) for happiness. Considering these objections, we can see Bentham has an overly individuated, instrumental conception of others in the realisation of happiness, and an ambivalence to the different values of such pleasures. He simply holds all pleasures essentially good and all pains fundamentally bad. The private manner in which happiness is seen is consistent with liberal individualism generally, which calls for a minimal state and free-market capitalism in maximising freedom, utilities and therefore happiness (Wientraub, 1997). For Bentham, happiness could be quantified through use of his utilitarian calculus, believing it offered a route to the greatest happiness through legislation. However, implicit in this doctrine was the notion the free-market could provide happiness, in turn making a more productive workforce, thus greater wealth and therefore greater happiness; a 'virtuous circle'. Bentham committed his life to legal and educational reform in order to realise his maxim (Warnock, 1974). However, as Berlin argued, were alternatives available, such as: pills to swallow, techniques of subliminal suggestion or other means of conditioning human beings ... [Bentham] might well have accepted this as a better, because more effective and perhaps less costly, alternative Berlin, 2002b:222 Berlin was little more than speculating as no such technologies existed during Bentham's lifetime, yet Layard's work confirms suspicion. Happiness... (2006a) reads like a conversation with Bentham's ghost. Rather than detailing all of Layard's contentions, we will consider two arguments: 1) that we should make happiness the common aim of society; 2) his advocacy of pharmaceutical drugs in treating psychological disorders, focusing specifically on his view on suffering in relation to creativity.

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1117509 Soc 312 Layard's central position is government policy should be aimed towards providing the greatest good for the greatest number, yet he identifies a flaw in the classical utilitarian viewpoint: that it can be achieved through maximising wealth. Historically, government policy has attempted to maximise citizen-utility through economic growth (Klein, 2006:236), yet Layard (2006a; 2006b:25) demonstrates that increased wealth has not been matched by increases in happiness. Consequently, happiness should be the objective of public policy (and private ethics), and this will achieve the greatest good. Implicit in this assumption however, is the view happiness really is the right aim for society, as opposed to justice, equality, environmentalism, or a plurality of values: "We desperately need a concept of the common good. I can think of no nobler goal than to pursue the greatest happiness of all" (Layard, 2006a:234). Certainly, Beck (1992) would disagree, arguing environmental sustainability more desirable for achieving the utilitarian objective, as it could reduce the iatrogenic risks that civilization increasingly faces. Furthermore, Layard appears unconcerned that many citizens might have a different normative viewpoint on what we ought aim for, appearing somewhat authoritarian as public policy would not reflect the desires of its citizens. He rationalizes this aim as "self evidently good" (Layard, 2006a:113), which is unconvincing. This unconcern with value subjectivity is also found in Bentham (see Warnock, 1974:19). We will return to this issue below. Having outlined Layard's happiness objective, we now turn to those who this appears hardest to achieve - sufferers of psychological disorders, such as depression. Layard (2006a:205-21) believes it humane to medicalise such conditions. While we have seen that this is palatable in instances where permanent neurological atrophy is possible, he appears incautious in advocating their use wholesale. Before explaining why exercising caution in medicalising such disorders is advocated here, we will focus on Layard's justification for advocacy regarding artists. In doing so we will draw on Adorno and Horkheimer's (1997) culture industry thesis, applying its framework to the pharmaceutical industry. Layard (2006a:205-21), suggests psychological illnesses such as depression, schizophrenia, and bi-polar disorder should be treated through drugs such as Chlorpromazine, lithium and SSRIs. In making his argument, he discusses the possibility that mental turmoil may contribute to the creative process of great artists such as Van Gogh and Munch. He holds when provided with appropriate drugs, evidence suggests artistic output does not suffer quantitatively, declaring: "we should use our expanding knowledge to control the misery that comes from awkward genes and destructive upbringings" (Layard 2005:220). However, the argument is weak, as it fails to recognise how the content or style of artists might be affected. Edvard Munch is a great example, because his most famous painting Scream recounts his experience of psychological attack (Bischoff, 2000:10). Munch's

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1117509 Soc 312 struggle with depression was fundamental to his being, informing his art: "without fear and illness, my life would have been a boat without a rudder" (quoted in Bischoff, 2000:10). This sentiment implies an important formative element to turmoil. It can inform our lives in positive ways - the phrase res severa verum gaudium contains a truism we should not overlook, as Layard does. The importance of unhappiness will be returned to later. In the case of art, Adorno argued that great art should act as a register for the barbarism of civilization that is airbrushed out of history, acting as a "negative truth" (Adorno and Horkheimer, 1997:130) which counters the positivity of ideology, enabling culture to be a site of resistance and possible agent of social transformation. However, the capacity for the realm of culture to provide an index for suffering became undermined with the rise of the culture industry's (hereafter CI) massproduced products, whose aim was to reconcile the internal contradictions of capitalism's flaw of overproduction through the manufacturing of 'need' and the repression of demonstrations of negative truth (Ibid; Adorno, 1991:98-107). The administered 'needs' that arose, and the ideological influence of mass culture incarcerate individuals within the "iron system" (Adorno and Horkheimer, 1997:120) of capital, reinforcing it. The mentality of the public is subsumed under "the rationality of domination" (Ibid:95), which vitiates the possibility of resistance under its totalitarian imperialism. The capacity for critical art in this context becomes undermined, as the objects of CI (the masses) experience a reification of consciousness, impairing capacities to counter the positive ideology reverberating within its every product. Moreover, all it offers is an ersatz promise of happiness that it cannot fulfil: The culture industry perpetually cheats its consumers of what it perpetually promises ... the promise, which is actually all the spectacle consists of, is illusory: all it actually confirms is that the real point will never be reached, that the diner must be satisfied with the menu Adorno and Horkheimer, 1997:139. Through conning us with inauthentic happiness, one could understand why levels of depression have risen to heights Schwartz (2005) argues 'epidemic'. Worse still, the images it conveys can have a significant impact on mental wellbeing. Schwartz shows cultures which deify ultra thin feminine ideals, (e.g. Sweden, USA, UK) have higher rates of eating disorders. Significantly, "in cultures that adopt the ultrathin ideal, the rate of depression in women is twice that of men. In cultures that adopt a more reasonable ideal, sex differences in rates of depression are smaller" (Schwartz, 2004:213). Furthermore Schwartz (2005:104) demonstrates that endless choices (a staple of CI) actually cause psychological harm - choice 'overload' can lead to anxiety when making decisions, and self-blame when left dissatisfied. Examples such as this intimate a systemic, social pathology as

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1117509 Soc 312 possible cause of psychological disorder - the psychological effects of culture are a by-product of capital's totalising dominion. We have seen how for Adorno, the 'rationality of domination' has colonised culture, and subsumed its previous role (as a site of expressive resistance and agent of social transformation), under the exigencies of the 'iron system'. This view held that the inception of CI amounted to an adaptive strategy by capital, to maintain its potential immortality. If we consider its tenets - an instrumental rationality underpins the capitalist system and amounts to expansion and continued supremacy of an elite group, we observe similar tendencies within the pharmaceutical industry. Above we observed the notion of a 'medico-industrial complex', which reductively objectifies individuals as a means of capital expansion. We could consider that medicalisation of normal human conditions (such as grief) appear an example of the instrumental rationality observable in CI - a commodification of human emotions, exacerbating reification. Just as CI was an adaptive strategy reinforcing capitals supremacy, it is argued here, the pharmaceutical industry is an adaptive strategy - responding to the iatrogenic human impact of capital's adaptation. It can be understood as a corrective means to continue the utilitarian virtuous circle - by stimulating a commodified form of 'happiness' in depressed workforces, productivity can be raised, thus reinforcing the 'iron system'. Moreover, just as products of CI drown out the cries of negativity that exist in society because of its flaws, there is a potential for suffering to be silenced in similar ways by use of pharmaceuticals. This for Adorno amounts to tragedy; "the need to lend a voice to suffering is a condition of all truth" (2004:352); to eradicate suffering but not the conditions which create it, amounts to a lie and is an act of violence upon happiness. For Adorno, the role of critical theory was to ceaselessly reveal the Janus face of modern civilization, to refute the triumphalism of its teleology of progress: "[B]eneath the known history of Europe there runs a subterranean one. It consists of the fate of the human instincts and passions repressed and distorted by civilization." (Adorno and Horkheimer, 1997:192). Only through pressing positive affirmations of history (and present) into tension with the silenced suffering of those who experience it, could truth be approached.

We observed Layard's argument for a social common good - the universal goal of happiness. One could describe this as an attempt to forge a general will among a nation, as Rousseau proposed. Jacob Talmon (1952:38-49) suggests Rousseaus desire to impose upon citizens *A+ fixed, rigid and universal pattern of feeling and behaviour (Ibid:39), reveals a totalitarian persuasion in his personality and political aims. However, does Layard not also propose we adopt an inflexible and prescribed pattern of behaviour and feeling? Does Layard not also appear a valid target for this line of criticism? There is an implicit suggestion in Layards thought that happiness Page 7 of 11

1117509 Soc 312 could be a panacea for all human ills, and pharmaceutical drugs could aid in the objective's realisation. In doing so, Layard (like Bentham) overlooks the particularity of normative goals, ignoring other values possibly favoured ahead of happiness. His objective appears to resonate with what Berlin, (2002a) termed positive liberty. Outlining two concepts of liberty, Berlin favours a negative conception. Positive liberty, for Berlin, amounts to a doctrine proclaiming possession of a solution to all human ills, and can justify any action in its name, leading to tyranny. This is an open possibility in Layard's thought. For example, Layard holds criticising the hedonism of the 'Greatest Happiness Principle' is unimportant, suggesting if we could organise a society around this, "the miserable millions ... would consider it a blessed delivery" (Layard, 2006a:114). Such paternalism intimates a latent totalitarian mindset. Huxleys (2007) literary classic Brave New World (hereafter BNW) offers insight into what a society adopting greatest good principle could look like. Inhabitants of BNW live in a totally administered society, where the cult of capitalism has replaced religion. When feeling unhappy, BNWs citizens simply take soma and forget their troubles. In BNW, the mechanical repetition of the phrase Everybodys happy now, becomes the most e xtreme accusation (Adorno 1997:109); the happiness based upon the satisfaction of false needs is truly bad (Ibid), whereby individuals no longer stand in dialectical opposition to society, but adsorbed within its totality Finally, we will address Adorno's position more closely on happiness and the importance of a negative stance in dialectical opposition to society. Earlier we observed the importance of 'negative truth' that autonomous art could possess. Adorno's approach insists the need for a negative dialectical engagement with society: "to lend a voice to suffering is the condition of all truth" (Adorno, 2004:17-8). Pain and negativity were crucial, the driving forces of dialectical opposition to what is, and unless a state of societal nirvana is realised in actuality (rather than through chemicallyinduced bliss), there would always exist a need for its function, as a beacon for hope for emancipation. Adorno is similarly dubious to the naive utopian pretensions of positive liberty, which he labels a 'fiction'. Freedom, "can be defined in negation only, corresponding to the concrete form of a specific unfreedom" (Adorno, 2004:231). Applying this negative dialectic to happiness, it is clear why Adorno is concerned with melancholy: happiness, like freedom, can only be understood through a tension with its antithesis. Layard, in seeking to eradicate suffering, according to our dialectical approach, would eradicate happiness also: "happiness is not invariant; to be always the same is the essence of unhappiness alone" (Adorno, 2004:352). A society which overcomes unhappiness through chemically-induced bliss while maintaining miserable conditions, amounts to a false negation of the negative.

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1117509 Soc 312 In conclusion, we have observed the shortcomings of pharmaceutical solutions to psychological disorder - their efficacy is not necessarily established, and not all treatable 'disorders' serve to improve mental wellbeing but rather medicalise conditions typical to human existence (such as grief). We also considered how systemic social conditions may contribute to psychological illness in an individual. This led us onto the importance of suffering as an agent of social transformation and onto an Adornian dialectical consideration of the role of negative thought in critically highlighting social conditions which contribute to suffering. From these considerations, we are forced to challenge Layard's advocacy of pharmaceutical solutions to human unhappiness, and in doing so, have questioned the desirability of his core thesis - the universalising objective. In conjunction with the vitiating capacity for subaltern emancipation/amelioration, we have also considered the totalitarian elements in Layard's prescription, and drawn on popular literature in order to offer a potential telos of his aims, if implemented. For these reasons, we reject Layard's suggestion, we must not inoculate ourselves against all unhappiness, it plays an important role both on an individual and social level. To eradicate human unhappiness without attempting to alter social conditions which contribute to it undermines the possibility for positive social change, and could inadvertently eradicate the possibility of being 'in' happiness.

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1117509 Soc 312 _____ (2006b) 'Happiness and Public Policy: A Challenge to the Profession'. The Economic Journal, 116, (pp.24-33). Schwartz, B. (2004) The Paradox of Choice. Harper Collins: New York. Mill, JS. (1974) 'On Liberty' in Warnock, M. (ed) Utilitarianism (pp.126-250). Collins: Glasgow. Talmon, J. (1952) On the Origins of Totalitarian Democracy. Secker and Warburg: London Weintraub (1997) 'The Theory and Politics of the Public/Private Distinction' in Weintraub, J. and Kumar, K. (eds) Public and Private in Thought and Practice (pp.1-42). University of Chicago Press: Chicago. Warnock, M. (1974) 'Introduction' in Warnock, M. (ed) Utilitarianism (pp.7-32). Collins: Glasgow.

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