Robert Bennett provides a clear-headed and concise history of the introduction of mood stabilizers in American culture and the complications that have followed in this excellent installment of Bloomsbury's Object Lessons, Pill.
The fact that many of us cannot get through our days without some sort of charmed talisman hanging around our necks or a magic medical suppository swimming through our bloodstreams is not always a subject for general or acceptable discussion. Legal mood regulators produced and promulgated by big pharmacology have made their definite mark over approximately the past quarter century as a means to control depression and maintain attention.
A quarter century before these "magic" cures (primarily Ritalin) infiltrated the marketplace in the late '90s, The Rolling Stones were singing about the wonders of Valium in "Mother's Little Helper". That song shed a light on an older generation that was using any means necessary to enhance the coping skills they felt essential when dealing with their drug curious children. The 1967 film version of writer Jacqueline Susann's Valley of the Dolls extolled the virtues of survival through popping pills of all sorts as if they were a veritable Skittles rainbow of relief. At their best these drugs enhanced, expanded, and redefined our potentials in all areas of life. Once the drugs were released, and potentials made available, the pills were the genie that would never return to the bottle. The pills could not be abolished, so the problem became obvious: would a vulnerable public be able to control themselves in the face of such risky potential?
Robert Bennett's Pill, another volume in Bloomsbury's fine Object Lessons series (Editors Ian Bogost and Christopher Schaberg), effectively looks at all areas of the history, understanding, and application of pills as maintenance tools (or presumed cures) in psychopharmacology. Shame for needing medical help is never considered, nor should it be. The pills are here to stay, one way or another. Bennett looks at five major medications and all their raging implications. There's the revolutionary Thorazine, the seemingly benign yet startlingly singular Valium, the "existential quagmires" of Prozac, and the unbound potential of Adderall. Piece by piece, capsule by capsule, Bennett wants to address a simple yet important question:
"…What are the larger personal and existential implications of these medical interventions?"
Early in his introduction, Bennett includes a pointed quote from novelist Bebe Moore Campbell as a means to demonstrate how the mentally ill are stigmatized as before, during, and after their relationships (consummated or not) with pills that are not always guaranteed to work:
"…we commonly say that a person is bipolar, not that she has bipolar disporder. You are cancer. You are AIDS. Nobody ever said that…"
Bennett notes that such television programs as HBO's The Sopranos (1999-2007) and Showtime's Homeland, and films like David O. Russell's Silver Linings Playbook (2012) have gone far to help remove the stigma of shame involved with surrendering to a regimen of mood stabilizers. The classic Wachowski Brothers' 1999 film The Matrix asked its hero Neo (Keanu Reeves) to choose between two pills (red and blue) that will yield distinctly different destinations: "…Neo's fundamental decision is initially presented in stark pharmacological terms as a simple choice. The story ends if you take the blue pill, but the red pill will offer limitless adventure with likely clear risks."
Who are we to trust in this quest for inner mental stability, emotional clarity, and spiritual fulfillment? For every story like Zach Braff's Garden State (2004), whose plot suggests the inherent rampant dangers of a pharmacological regimen of any sort, there's an equally powerful counterpoint, like Maya Forbes' Infinitely Polar Bear (2014). Both films effectively portray the sluggishly depressed and manically exhaustive characters and manage to make statements against or in favor of pills (respectively) without taking absolute stands. Still, they're strong portrayals of the role pills play in our modern American culture.
Simply put, Bennett seems to be saying that "our pills are literally becoming us." We rely on them, and if not stopped in time we allow that reliance to become an addiction. We are defined by the degree of control we allow this medication to have on our lives. The "Thorazine" chapter argues that its 1950 discovery "…led to a much wider epochal paradigm shift in our understanding of the relationship between chemicals and the human mind…" The "Snake Pit" asylums (as depicted in the eponymously titled 1948 film) were in decline. Some remained, and nothing was miraculously cured, but even the thinnest glimmer of hope (as seen through medication and other means of cure and control, like lobotomies) were enough to maintain that with a little "help", tomorrow might be a better day.
In the "Valium" chapter, Bennett argues (again) that this was a pill (as all would prove to be) ideally suited to its time (the '60s.) A decade before, James Dean was the epitome of an anguished teen in Nicholas Ray's Rebel Without A Cause (1955). That romanticized notion carried through to the mid-'60s and beyond. Anxiety and frayed nerves were more rampant than ever. Bennett expands on Aldous Huxley's 1932 novel Brave New World and Soma, the cure-all drug at the core of that story, the precursor to Valium. In Huxley's novel, Soma cured the sick, maintained the troubled, and prevented future afflictions. Was it all a perfect solution?
"Huxley depicts Soma as a destructive crutch which props up the authoritarian state by [creating]… dehumanized citizens incapable of feeling."
Bennett notes that Huxley's antagonism towards pharmacology would change in the '50s with The Doors of Perception, which would "…optimistically celebrate how 'chemistry and physiology are capable nowadays of practically anything.' "His 1962 novel Island would "…embrace psychopharmacology without reserve." His miraculous pills became the "reality revealer" and "the truth-and-beauty pill". It was just in time for other doors to be opened by different generations through alternate means. Bennet knows the easily portable form of this Object Lessons volume can't make room for Jim Morrison, Allen Ginsberg, Timothy Leary, and the seemingly irresistible mantra of tuning in, turning on, and dropping out.
The "Lithium" chapter follows, with discussions of Erik Skjoldbjærg's Prozac Nation, (2001) James Mangold's Girl Interrupted (1999), and One Flew Over the Cuckoo's Nest (Milos Forman, 1975). Bennett properly credits Showtime's Homeland as a series that has regularly demonstrated "…how recent mental health narratives have begun to depict realistic, and less stigmatized, portrayals of mental illness." He cites star Claire Danes's skills in portraying the difficulties of balancing a "normal" life that disguises and suppresses the mania of a bipolar condition through Lithium. Mania is never quiet for long. Witness hip hop star Kanye West's "twitter meltdowns". West provides another picture of how some artists have understandably exploited their condition for the sake of their art (taking or avoiding their medication.) Bennett concludes, as he should, that life with and without these medications is a work in progress:
"More a lengthy journey than simple destination, psychotropic medications… mirror nothing so much as the convoluted illnesses they are designed to cure."
It's this careful, methodical journey Bennett takes through these medications and their effects as manifested through popular culture that makes Pill an effective, compelling book. These medications have made a profound mark on society as much through their rampant complications as through their little miracles.
The "Prozac" chapter effectively brings us to a more recent history, one in which neuroses are no less intense and the means by which they are regulated have become more mainstream. The Sopranos contains a psychoanalytic narrative which "…is itself shadowed by a second… one that represents mental illnesses and their treatments in an increasingly realistic… manner." Bennett convincingly argues that the series concurrently explored Tony Soprano's psychoanalytical issues via therapy with Dr. Melfi while also examining the medicine in his cabinet. No matter how some may perceive Prozac as the blessing that saved their troubled lives, a core message inherent within The Sopranos was that the journey towards recovery had no choice but to be complex, circuitous, and messy.
There are real-life pioneers in Prozac narratives. Lauren Slater's Prozac Diary (Random House, 1995) "…redefine[d] health itself as an ambivalent, Janus-faced, double-edged sword." Prozac provided the liberation to open newer experimental technologies. Elizabeth Wurtzel's 1994 memoir, Prozac Nation (Houghton Mifflin) connects her father's daily Valium use with her own proclivities for drugs. Bennett seems to be concluding that Wurtzel's narrative is tougher, more realistic. She imagines the dialogue between Tony Soprano and Dr. Melfi. The former has less faith in the medication than the latter:
"In this never-ending battle between mental illness and medicine cabinets, Wurtzel sides more with Tony than Dr. Melfi…' There is a sense that at long last there is a chemical answer…' Her faith in Prozac is more ironic than sincere."
Bennett judiciously balances his narrative between the two camps. Slater is saved by Prozac while Wurtzel feels more damned by it. In the "Adderall" chapter, Bennett notes that Wurtzel's perspective on the dangers of mood stabilizers changed with her 2002 follow-up memoir More, New, Again: A Memoir of Addiction (Deckle Edge, 2001). Ritalin was now the drug of choice, and it was the focus for a generation of young people at the dawn of the new millennium who were looking for ways to suppress and perhaps exploit their attention deficit disorder.
Pill ends with a brief, pointed coda (cleverly titled "Waiting for Brad Pitt", referring to a role Fight Club plays in a manic episode) in which Bennett gives details about his bipolar condition. Pages from his notebooks at the time of his most extreme manic episodes, reproduced here, betray a frantic, desperate attempt to control and contain his thoughts. "When taken to its extreme," he writes, "this kind of unmedicated manic thinking can lead to disaster…" He continues, offering another variation on the thesis he'd introduced at the start of this book:
"Pill… is a philosophical exploration of how psychotropic medications… are used to treat mental illnesses and the larger philosophical implications of [their] abilities (and inabilities) to reconstruct the neurocircuitry of the human brain."
Bennett leaves ends this work wise enough to know his readers aren't demanding absolute answers. He asks if there's a sense of a "real 'me'" outside of the "cures" his medications offer. He suggests that the modern variation of Hamlet's "To be or not to me" soliloquy is contained within the easy temptations of surrendering to better living through chemistry. Pill succinctly and comprehensively charts the enigmatic relationship humanity has had with wonder drugs of all sorts, particularly here Thorazine through Adderall. He suggests, carefully, and with touching immediacy (especially through the final personal chapter), that there's still work to be done as we understand both the blessings and the curses of these drugs.