Pursued by Happiness and Beaten Senseless

Prozac and the American Dream Since the publication of Listening to Prozac there have been many debates about how and why Prozac and other similar drugs are prescribed. The articles that follow take up debates about what conditions such drugs can and should address, questions about authenticity in using drugs for psychic well-being, and concerns about what means we morally endorse in projects of self-creation. The contributions from Carl Elliott, Peter Kramer, James Edwards, and David Healy derive from a project supported by the Social Sciences and Humanities Research Council of Canada, Enhancement Technologies and Human Identity. Let us start with cases. These come from an essay by the psychotherapist Maureen O'Hara and Walter Truett Anderson. The names have been changed, but the patients, they tell us, are real. 1) Jerry feels overwhelmed, anxious, fragmented, and confused. He disagrees with people he used to agree with and aligns himself with people he used to argue with. He questions his sense of reality and frequently asks himself what it all means. He has had all kinds of therapeutic and growth experiences: gestalt, rebirthing, Jungian analysis, holotropic breathwork, bioenergetics, the Course in Miracles, twelve-step recovery groups, Zen meditation, Ericksonian hypnosis. He has been to sweat lodges, to the Rajneesh ashram in Poona, to the Wicca festival in Devon. He is in analysis again, this time with a self-psychologist. Although he is endlessly on the lookout for new ideas and experiences, he keeps saying he wishes he could simplify his life. He talks about buying land in Oregon. He loved Dances with Wolves. 2) Alec is forty-two, single, and for most of his life has felt lonely and alienated. He's never cared much about politics, considers himself an agnostic, and has never found a hobby or interest he would want to pursue consistently. He says he doesn't think he really has a self at all. He's had two stints of psychotherapy; both ended inconclusively, leaving him still with chronic, low-grade depression. Nowadays he's feeling a little better about himself. He has started attending a local meeting of Adult Children of Alcoholics. People at the meetings seem to understand and validate his pain; he's making friends there and believes he belongs for the first time since he left the military. But he confesses to his therapist that he feels sort of squirrelly about it because he's not an adult child of an alcoholic. He is faking the pathological label in order to be accepted by the community, and he's not too sure he really buys into their twelve-step ideology either. 3) Beverly comes into therapy torn between two lifestyles and two identities. the California city where she goes to college, she is a radical feminist; on visits to her midwestern home town she is a nice, sweet, square conservative girl. The therapist asks her when she feels most like herself. She says, When I'm on the airplane.[1] Spiritual emptiness, the search for a sense of self, alienation in the midst of abundance: are there traits any more American than these? These are themes that characterize some of the most memorable American art of the middle and late twentieth century: in the poetry of T. S. Eliot and Sylvia Plath, in fiction from West and Salinger through Bellow and DeLillo, from the plays of Tennessee Williams to the documentary films of Ross McElwee, from the songs of Woody Guthrie to those of the Talking Heads. If we are to believe Tocqueville, this kind of spiritual restlessness has been with us since the early days of the republic. In America I saw the freest and most enlightened men, placed in circumstances the happiest to be found in the world; yet it seemed to me as if a cloud habitually hung upon their brow, and I thought them serious and almost sad even in their pleasures.[2] the decade or so since the development of the selective serotonin reuptake inhibitors, many thoughtful (and some not so thoughtful) voices have urged caution, or at least a damper on our enthusiasm for the drugs, most notably in the debate prompted by Peter Kramer's splendid book, Listening to Prozac. …

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