By Craig Newnes, Clinical Psychologist
Marilyn Wedge’s piece on diagnosing rates of ADHD is a curious mixture of generalizations and truths bound to appeal to lovers of the notion of discipline. It is no accident that Michel Foucault first hit the intellectual scene with his work “Discipline and Punish.” Foucault was one of a cadre of Marxist French philosophers who rose to prominence in the wave of post-structuralist thought dominating the last third of the 20th century. “Discipline and Punish” begins with a description of the gruesome execution of a regicide, according to Foucault, one of the first public executions in France where, previously, such matters were dealt with behind closed prison doors. The aim was to make crystal clear what would happen to those who threatened the established order. That one scene, for Foucault, encapsulated the oppression of the people – from peasant to bourgeoisie, all were effectively cannon fodder to be kept in their place. For the more thoughtful professional classes of the 21st century it is not difficult to see that discipline, in its various guises, is ubiquitous. As Foucault explicated – in Madness and Civilization – the obvious external discipline of the Factory owner (against factory workers), the Land-owner (against labourers) and Alienist (against those deemed mad and incarcerated in mad-houses) was gradually internalized by the oppressed. Thus, from school onwards, people were forced (through the threat of punishment) to be “responsible,” “conscientious” and “mindful of others” – anything rather than being free to play, enjoy a non-timetabled life and keep under the radar of those in charge.
Today, Foucault’s insights are regarded with suspicion by many and simply unheard of by the majority, though any adult in a decent job who works 70 hours per week for the dubious pleasure of going to Disneyland for a two-week break from toil might occasionally wonder how they found themselves in this fix. What has all this to do with ADHD rates in France? Marilyn Wedge claims a kind of right-wing Utopian view of French child-hood where children play, study hard, eat their meals around the family dining table and - no doubt – grow up to be self-disciplined, hardworking adults. It is certainly true that the French diagnostic system is less liberal than the DSM’s all-encompassing pathologization of every known behaviour but, it is equally true that France has the highest per capita use of psycho-active medication anywhere in Europe. It may be true that some French families eat meals together in some kind of I Love Lucy/Brady Kids harmony but it is equally true that in the tiny village (population 108) where I live in Southern France I know of two families where the children eat in front of the TV and the fathers are simply absent until long after the sun goes down. It is easy to make a point by appealing to the prejudices of readers for whom France is some paradise redolent of fabulous wine, marvellous cooking and communal family life but, for the people I know, the men prefer cheap Pastis, a trip to McDonald’s (there are more than twenty in the Corbieres alone) is a treat and “family life” is unknowable (unless, like me you live close enough to a parent who screams at his children daily and drives his wife to the local doctor so she can pick up her anti-depressants).
And after this bucolic existence? Despite the difference in the diagnostic systems, why is it that so many French adults are on medication (of all types; the French Government paid a ransom for mass inoculation against the SARS virus – an “epidemic” that, like so many other drug-industry sponsored global panics killed fewer people than die by accidental electrocution at home via faulty wiring)? It is because physicians don’t require a diagnosis before prescribing drugs – just a chat and the gift of some pills and that’s it. Whether the French actually take the medication (it would go against their disciplined “politesse” to say, “Merci, non!”) is entirely unknown though I can see that something to dull the pain may be useful in McDonald’s.