A psychiatrist on the manufacture of ADHD

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The website Mad In America is serialising the British psychiatrist Sami Timimi’s book 'Insane medicine: How the mental health industry creates damaging treatment traps and how you can escape them'.

So far the first three chapters have appeared. Part 1 of chapter 3 deals with what Timimi calls the 'manufacture' of ADHD (attention-deficit/hyperactivity disorder):

After 1957, the number of medical articles about children with the “symptoms” of ADHD, escalated exponentially in the United States, and later in other countries. In the previous half century, medical literature, particularly that influenced by psychoanalytic ideas, was more concerned with withdrawn, shy, “neurotic” children. The late fifties, then, marked a turning point as interest transferred more to children who exhibited delinquent, violent, and other antisocial behaviours.

What was behind this shift? According to Matthew Smith, it may have been related to fear, following the Soviet launching of the Sputnik satellites in the autumn of 1957, that the US was falling behind the USSR in the race for scientific, technological, and military superiority. There was concern that if changes were not made to the American school system to redress the situation, they might lose the Cold War altogether. This caused a change in classroom structure, teaching methods, and expectations with regard pupil performance.

I am not entirely convinced by this, and think that such events intersected with other changes taking place in the culture of the time, including (but not limited to) the growth of and fear of adolescent culture, changes in family structure and community rootedness, growing size of an aspirational middle class, and greater concern about children both as perpetrators and victims.

The more important point here is recognising that ADHD emerges and gets popularised because there are cultural, not scientific, reasons for it becoming a sellable brand.