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Useless Eaters: the Stigmatization of Illness

By   Follow Me on Twitter     Message Dr Stuart Jeanne Bramhall       (Page 1 of 3 pages)     Permalink    (# of views)   15 comments

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As a psychiatrist battling the stigma of mental illness for more than 30 years, I am gratified by growing public awareness that schizophrenia, depression and bipolar disorder run in families and are, at least partly, biologically determined. Thankfully the days when it was socially acceptable to blame depressives for being lazy or not doing enough to help themselves are long gone.

I wish I could say the same of physical illness which, after all, is basic to human existence. The US, unquestionably, has the most reactionary and punitive attitude towards illness in the world. It comes out in all manner of regressive and inhumane government policy: the federal government's absolute refusal to make sick and parental leave mandatory (as it is in all other industrialized societies), the pressure for long term recipients of Social Security disability benefits to undergo continual review and mandatory treatment (which most have no way of paying for, as doctors have stopped accepting Medicare and Medicaid), as well strong pressure on doctors to declare them well enough to work; and now a proposal to change eligibility for Social Security retirement to make the elderly "prove" they are too sick to work.

The Growing Attack on Entitlements

In the growing attack by Republicans and Democrats on entitlements, there are always assertions either direct or implied that sick people are somehow responsible for the problems that make them unable to work. However what troubles me even more is the way so many Americans have internalized these attitudes how ready they are blame people who get sick on eating the wrong food, not exercising or not managing stress properly. Epidemiological studies show clearly this is not the case lifestyle factors only account for 10 percent of what causes us to become ill.

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There is no question that the US has parted company with the rest of the world on this. I think it's important to ask why. Quite frankly I hear a lot of discussion that is ominously reminiscent of Hitler's "useless eaters" initiative. And I think it's time to ask whether this is simply "coincidence" an accident of history or if there are more sinister reasons why this might be.

The Long Shadow of Joseph Goebbels

Hitler's adopted his "useless eaters" policy in the early thirties at the very beginning of his regime. It was a utilitarian approach to social welfare consistent with the role the Nazi state played in serving the German and American corporate elite who put them in power. And Hitler enforced it vigorously, carting tens of thousands of elderly, handicapped, chronically ill and mentally ill and retarded individuals off to execution centers (long before the communists, Jews, gypsies and other undesirables) because of their inability to contribute "productively" to society.

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American attitudes, not just around health, but around all spheres of human activity, are far more reactionary than the rest of the "free" world. And I think it's high time to ask ourselves why. With new information surfacing over some of the Nazi connections of CIA founder Allen Dulles, I am increasingly skeptical this is either coincidental or down to a handful of right wing think tanks. Dulles' high regard for Hitler's chief propagandist Joseph Goebbels is a matter of public record. As is the fact that Dulles incorporated Hitler's entire eastern European spy network into the CIA after World War II. And the long, cozy relationship between the CIA Office of Public Information and many US newspapers, news magazines and publishing houses. (see excellent article by Daniel Brandt at, along with two dozen references, including Carl Bernstein's 1977 Rolling Stone article)

If the CIA, as it appears, has direct influence over media content, I think it's reasonable to ask whether this plays a role in shaping how we think. I believe it does.

What I find most troubling about the reactionary "useless eater" mentality pushed by policy and opinion makers is the way Americans have internalized the belief that it's their own fault if they become ill. In fact much of the US population seems more freaked out about getting sick than dying. I can't say I blame them, as so many American workers have no sick leave and lose a day's pay every time they are ill.

Americans also spend billions of dollars on alternative health care and vitamin supplements and other non-prescription remedies. And many are practically obsessed with healthy eating, only drinking bottled or filtered water, compulsive exercise routines and meditation, yoga and other stress reduction techniques to keep their massive job stress from making them sick (at present those who still have jobs do the work of 1.5 to 2 people on average).

The media compounds the problem by promoting a variety of cough and cold remedies and caffeine and mega B vitamin "boost" drinks to enable people to attend work when they have colds or even quite serious illnesses, such as bronchitis and the "flu."

Medicating Kids

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Parallel to this pressure for adults to be healthy, is immense pressure for children to be "normal." While parents seem to be appropriately skeptical about taking unnecessary drugs themselves, they seem far too eager to and medicate children with behavior problems. As a child and adolescent psychiatrist, I am well aware that ADHD is a genuine disorder affecting 1-2% of children (but not childhood bipolar disorder this is a diagnosis heavily marketed by drug companies and totally unsupported by developmental or epidemiological research).

At the same time I see absolutely no reason why American children should be three times as likely to be diagnosed and treated for ADHD than children in other parts of the world. In my work, I come across psychiatrists from all over the world. Based on their input, I can safely asserted that the eagerness of US doctors (at the behest of drug companies) to prescribe psychotropic medication for children is an international scandal that casts the standard of American pediatric and psychiatric care in a very bad light.

Sending Sick Kids to School and Day Care

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I am a 63 year old American child and adolescent psychiatrist and political refugee in New Zealand. I have just published a young adult novel THE BATTLE FOR TOMORROW (which won a NABE Pinnacle Achievement Award) about a 16 year old girl who (more...)

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