Turning childhood into a mental illness
The therapy industry is in danger of screwing up our kids.
Since I started studying childhood and parenting a few years back, I have noticed a proliferation of alarmist reports about the allegedly distressing state of young people’s mental health. Every year, the number of psychological problems afflicting the young seems to expand. Typically, these reports assert that ‘the problem is greater than we thought’ and is likely to get worse. More and more young people will succumb to mental ill-health, apparently.
This week it was the turn of advocacy group Childline to raise the alarm. Childline says growing distress among young people is ‘fuelling record numbers of counselling sessions’. It says the number of children having therapy for anxiety rose by 60 per cent over the past two years. Predictably, following the ‘it will get worse’ pattern, Peter Wanless of the NSPCC declared that ‘anxiety is a growing problem in young people’s lives today, and it is not going away’.
It is far from clear how Wanless has quantified the growth in anxiety. Anxiety is an intrinsic part of the human experience. Since the rise of modernity, commentators in every era have described theirs as an Age of Anxiety. Anxiety refers to the concerns and worries people have about the future, and about uncertainty. For centuries, theologians, philosophers and healers have discussed the debilitating effects of anxiety. At times, what we now know as anxiety was referred to as melancholia, or even a kind of hysteria. From the late 19th century onwards, extreme forms of anxiety started to be diagnosed as psychological conditions.
Until the latter part of the 20th century, this medicalisation of anxiety remained relatively restrained. Doctors focused their attention on pronounced, debilitating instances of neurosis. Then, in 1980, the American Psychiatric Association invented the term ‘anxiety disorder’, and from that point onwards the distress and pain associated with anxiety came to be thoroughly medicalised. We have witnessed a serious example of diagnosis creep, which has led to a widening definition of anxiety, and to more and more people being diagnosed with a kind of illness.
The growing trend for redefining the problems of life as issues of mental health has had a particularly pernicious effect on children and child development. Since the late 1970s, there has been a creeping tendency to portray children as uniquely vulnerable to emotional damage. Before then, it was commonly believed that children could recover their strength and resilience in the aftermath of an emotionally difficult experience. But in the late 20th century, in line with the expanding medicalisation of everyday life, society became preoccupied with the apparent fragility of childhood.
It was at this point that the idea that mental illness is a common feature of childhood started to gain resonance. In the decades that followed, more and more children came to be diagnosed with a psychiatric illness. This trend was particularly striking in the US, where an estimated 575,000 children were diagnosed with anxiety disorders in the year ending March 2002 – 136,000 of them under the age of 10.
By the turn of the 21st century, Britain was catching up with the US when it came to the medicalisation of children. Back in 1999, Dr Jennifer Cunningham, a community paediatrician from Glasgow, informed me that ‘mental health is defined so widely that any child who has a normal reaction to adverse circumstances [in their life] is now assumed to have mental-health problems’. The tendency for interpreting the troubles and anxieties of childhood through the prism of mental health has now become a dogma, and worse, it is a dogma through which the young are socialised.
Children’s mental health is frequently talked about as if it were a condition that needs to be ‘improved’ in to order to save the child from psychiatric problems later in life. Consequently, the normal apprehensions of school pupils are now regularly viewed as medical or mental-health problems.
The manufacture of child-related mental-health problems has become a growth industry. Report after report claims that mental illness among children is on the rise. Such reports insist that children are more anxious, stressed and depressed than ever before. Confused and insecure children are likely to be diagnosed as depressed or traumatised. Energetic or disruptive youngsters are said to be suffering from attention deficit hyperactivity disorder (ADHD). Kids who give their teachers a hard time or argue with adults might even find themselves labelled victims of ‘oppositional defiant disorder’.
This proliferation of medicalised categories for children tells us far more about the inventive powers of the therapeutic industry than it does about childhood today. So schoolkids who are shy are offered the diagnosis of social phobia. Children who really hate going to school might have ‘school phobia’. Pupils worried about exams are diagnosed as suffering from ‘exam stress’. Everyone who has been a child or who understands children will know that they are often concerned about how they will perform in exams, of course; but what is different today is that this is rebranded in the therapeutic language of ‘exam stress’.
The relationship between this new narrative of illness and its impact on young people is a dialectical one. The narrative doesn’t only frame the way children are expected to experience everyday problems – it also acts as an invitation to infirmity.
Children who are socialised to see their experiences through the prism of mental health will internalise this narrative. Unlike children who went to school 30 or 40 years ago, today’s schoolchildren readily communicate their problems in a psychological vocabulary, using words like stress, trauma and depression to describe their feelings.
In 2000, a survey in the UK discovered that children as young as eight were describing themselves as ‘stressed’ by relationships and school. The study found ‘unprecedented levels of stress’ in Britons of all ages, with ‘worryingly’ high levels among children. Professor Stephen Palmer of City University, who led the study, said he was ‘surprised by the extent of the problem’. He said that ‘if you had asked eight-year-olds about stress 20 years ago, they would have looked blank’, but ‘now they understand the concept and a significant number report experiencing it’.
The fact that 20 years ago eight-year-olds would not have understood the term ‘stress’ but today they do is testimony to the impact of the diseasing of childhood. The use of psychological vocabulary to understand and describe children’s lives inexorably leads to a situation where young people will start to make sense of their lives and experiences through such vocabulary. The medicalisation of children’s emotional struggles means young people are now trained to see troublesome experiences as a source of illness, for which help must be found. And when normal anxiety or emotional difficulty is viewed as a psychological condition, young people will find themselves less able to cope with the disappointment and pain that are actually a fairly common feature of young life.
Young people will start to see the challenges that are integral to growing up as a source of psychological distress. Well-intentioned campaigners demanding more mental-health resources for schools and other places are, despite their best intentions, inviting children to feel ill. And this cultivation of vulnerability, of mythical illness, has serious implications for children who are genuinely ill. The medicalisation of childhood doesn’t only disorient young people in general – it also diverts precious resources away from children with serious psychological conditions by counting everyone as being in need of such assistance.
What children need from adults is not a diagnosis but inspiration and leadership. Instead of obsessing over children’s vulnerability and fragility, we should be cultivating their resilience, and encouraging them to develop a real sense of independence and selfhood.
Frank Furedi is a sociologist and commentator. His latest book, Populism And The Culture Wars In Europe: The Conflict Of Values Between Hungary and the EU, is published by Routledge. (Buy this book from Amazon(UK).)