From the personalist view of the human being to the psychiatrization of child behaviour
Ever new educational reforms lead to an increase of learning difficulties and mental disorders in children
by Dr Andreas Bau, Hackborn
cc. To understand, assess and be able to classify current events and developments, we need to be capable of surveying social, economic and political developments over a long period and with a keen mind and to assess them with reference to their humaneness. The resulting insights can point the way ahead and will serve the good of all. This also applies to the fields of education and medicine (social sciences), as the following article most impressively illustrates.
Today, children that stand out by some learning problems or conspicuous behaviour, are – as early as in kindergarten and also later in school – being diagnosed with psychiatric disorders such as ADHD, autism, Asperger’s syndrome, etc., and they are often treated with psychiatric drugs such as Ritalin. This has not always been the case. Still in the 60s of the last century such behavioural conspicuities were corrected in the same field in which they had been created: by educational, psychological or educational means. The changes explained below are meant to show the close relation between the paradigm shift in the schools, the no longer personalist view of man and undesirable developments in medical diagnostics that are all running parallel to each other.
Since the 60s of the last century, this change from the personalist view of man to the psychiatrization of child behaviour has – by means of ever new reforms in the education sector – led to an increase in mental disorders of children.
Paediatricians had to deal with this problem, too, and we had to acquire a point of view in accord with our professional ethics.
First school reforms and psychosomatic disorders
In a short time during the late 60s to the early 70s of the last century an unusually large number of children aged from 6 to 8 yearswere referred to the big psychosomatic department of one of Germany’s largest children’s hospitals in Hamburg. These children seemed very nervous and insecure and showed a number of unusual behavioural problems. They all came from the neighbouring state of Schleswig-Holstein and there went to the first and second grade of elementary school. This occurrence attracted the attention of the head of the children’s hospital in Hamburg, Prof K. Seelemann, who was also responsible for the Psychosomatic Department. He investigated the matter and found that, without any transition period, the approved analytical method of teaching reading and writing skills had been replaced by the so-called “whole language” approach. The “whole language” approach, which was at that time praised as progressive, relies on memorizing whole word pictures and prevents the understanding of the structure of our writing.
For this purpose, the analytic-synthetic method is essential, which matches sounds with signs. It was immediately clear to Professor Seelemann that the change of teaching method was the cause of the abnormal behaviour of so many children. He conferred with the head of the children’s psychiatric department of the university hospital. They immediately went to see the authorities responsible for primary schools, presented their suspicions to them and urged the immediate reinstatement of the analytical method of teaching reading and writing. The school officials reacted sensibly to the paediatric authorities’ opposition. They changed the teaching method, and in a short time there were no more children with behavioural problems from the respective primary schools. At that time no psychiatric diagnoses were made and no psychotropic drugs were administered. The cause was found in the educational field and was solved right there, where it had come from! Medical diagnosis was still based on a careful anamnesis, according to the principle: The case history is half of the diagnosis.1 This story should, among other things, teach us a lesson.
Introduction of the set theory – abolition of orthography
In 1975, my daughter attended the first form of primary school in our community. Without notice or explanation the set theory was introduced in mathematics. It was not until the introduction that the parents were informed about the great value and progress the set theory allegedly stood for. In the evening parents often sat with their children trying to understand the set theory and the sense thereof. I could not. I had the feeling that I was busy doing senseless brain-phantom acrobatics. Other parents had the same feeling. We did not hold back with our criticism. We had not been seized by the spirit of the age, but we were oriented towards values.
Some weeks later my daughter’s teacher stopped correcting the children’s spelling mistakes. We parents got together and invited her to a parents-teacher conference.
We requested the teacher to take set theory off the curriculum and to teach the correct spelling of words. We were very clearly expressing our demands. The teacher promised to talk about it to the headmaster of the school and to inform us about the result. After four weeks we had not yet heard anything. Everything continued as before. As a precaution we had developed a plan to be on the safe side and invited the headmaster to the parents’ evening as well as the Hamburg school senator. The headmaster came, but the school senator didn’t. We expressed our astonishment at not having received any message from the teacher nor from the headmaster. Moreover we had not received any excuse by the school senator for his not coming. The parents‘ speaker declared what our demands were: The set theory was to be taken off the curriculum within one week and spelling was to be taught as ever or we parents would take our children off the school, we would engage a teacher of our own and would inform the press. We were ready to take on the legal consequences. We expected from the school – for which we paid our taxes – to instruct our children in such a way that they could train for a good profession later on. Over and out! We were a good collective of indignant and very active parents.
Two weeks later the teacher quietly returned to the conventional methods of calculating. After one year she explained to me that it had turned out that he method was unusable. With some hesitation the teacher started to attach importance to a careful spelling, again. Frequently we parents had to intervene and to give her some warning. Moreover we learned that the teacher had told the children that parents must not correct their children’s spelling mistakes at home. That caused a conflict between our daughter and her parents on the one side and the teacher on the other, a conflict that resulted in our daughter’s insecurity in learning, of course.2
In other schools these false reforms were pushed to the detriment of the children. Thus, it was not surprising that from the beginning to the mid-eighties of the past century certain institutions that dealt with delays in infant development and with handicapped children began to label children, whose behaviour gave offence occasionally or who were just too lively, with the diagnosis Minimal Cerebral Dysfunction (MCD)or just Cerebral Dysfunction (CD). Among these children were also children who showed anomalies because of the above-described school reforms. In Switzerland they spoke of a psycho-organic syndrome (POS). That the same diagnosis turned up in Switzerland at the same time only with a different name certainly perplexed some paediatricians. In the GDR, however, this syndrome, respectively clinical condition did not exist!
In this case you can learn from history as well.
The children were not particularly conspicuous because of their behaviour, neither would any of the paediatricians have thought of treating them with drugs. A slight tendency towards boys being more concerned than girls was noticed. A group of elderly and very experienced paediatricians were of the opinion that those children just needed some more domestic educational guidance. We also raised the question whether this occasionally conspicuous behaviour might be a consequence of the laissez-faire education in the sixties and seventies. Those who propagated the diagnosis of Minimal Cerebral Dysfunction were above all doctors who were active in German paediatric associations and who were working on classifications of delays in child development.
Several of these paediatricians had an own medical practice in Hamburg so that Hamburg was becoming a spearhead of and a stronghold for the changes that I am describing here. (Today Hamburg has the highest Ritalin prescription rate in Germany.) We, the critical paediatricians, were convinced that children with such a diagnosis would have to show anomalies that can be expressed in neurological terms. The inexpert and improper attribution of minimal cerebral dysfunction (brain-based deviance) suggests this conclusion.
A reputed specialist in child neurology working at the Olga Hospital in Stuttgart carried out a big research study to answer this question. He proved conclusively that the children in question were healthy from the point of view of neurology. After that the diagnosis was taken off the scientific agenda, and we felt confirmed. However, our group of critical paediatricians had underestimated the plans pursued by those paediatricians and the general practitioners who were pushing the classification of child behaviour with robust backing by the pharmaceutical industry. At that time we were still lacking the necessary political understanding and foresight.
However, we remained critical, as the sudden appearance of new diagnoses that up to then had been unimaginable had sharpened our ears. The protagonists of the new development did not remain inactive, they started to attribute a multitude of symptoms to a malfunction of the brain. Predominantly they described symptoms in the domain of behaviour. The new superimposed diagnosis was the extremely vague term “perceptual disorder”. You can resume a lot of phenomena under this term. A further step forward towards psychiatrization of human behaviour! Speech therapists, physiotherapists and above all the new professional group of occupational therapists and remedial teachers were supposed to help the children in question correct their perception. The reports I demanded from the ergo-therapists did not answer the questions I had asked.
To me as an academically trained paediatrician the activity of those occupational therapists seemed very unrealistic, quite different from today. While the new diagnoses attached an excessive importance to the corresponding expensive therapies, education and pedagogy were increasingly devalued. With the slogan “Feely-Feely” the most adventurous “therapies” were offered and outsourced from the medical and pedagogic field.
The above-described events resulted in the creation of the term ADHD, (Attention Deficit Hyperactivity Disorder) and in its entry into the DSM-III-R (Diagnostic and Statistic Manual of Mental Disorder) in 1987. The DSM is the American Psychiatric Society’s classification system.3
Report on the further development of paediatric diagnoses
Parallel to the above described events, a group of parents with very lively children, under the direction of a paediatrician, claimed that the alleged abnormal children who lacked concentration were actually suffering from a Phosphate allergy. The paediatrician put a strip of Litmus in the saliva of the affected children and saw that there was an acidic reaction. This was evidence for the diagnosis Phosphate allergy. In the context of a general surge of allergies, the Phosphate Allergy became very popular. The affected children received the diagnosis “Phosphaties”. The paediatrician developed a strict phosphate-free nutrition plan. Many parents in Germany, who believed, their child was affected by the newly discovered allergy, took care that their children were only nourished on a phosphate-free diet. The consumption of Coca-Cola was strictly forbidden. A large part of the children who were fed on this diet surprisingly, to the satisfaction of their parents, behaved in a calmer way, all of a sudden. This is an example which makes us think, and provides an explanation as well:
Professor Schulte, head of the University children’s hospital, Hamburg-Eppendorf, conducted workshops which were regularly held on a four week basis. A paediatrician asked the following question: “A child at my practice, which calmed down due to phosphate-free nutrition, became agitated again after the consumption of Coca-Cola. Can you explain this to me?” He directed his question to the Chief Doctor of the psychosomatic department of the University’s children’s hospital, Professor Dr Wallis. Mrs Wallis thought for a moment and with her clear voice, requested that we, the practising paediatricians, should thoroughly reflect with her. The reason for the affect of the Coca-Cola was very simple, she said. As long as the mother had prepared a careful diet she had been in very close interpersonal relationship to her child. When the child drank Coca-Cola again, the mother was obviously busy with other things instead of the preparation of a carefully planned diet.
Mrs Wallis pondered for a few minutes waiting for some resonance from us. After five minutes of silence, a paediatrician stood up and said correspondingly: “You mean, Professor Wallis, the problem is the missing attention of the mother towards her child? Because the behaviour of her child is the consequence of a child-raising problem?” Mrs Wallis said nothing and looked expectantly at everybody around. Because no further questions arose and no discussions occurred, we were required to come up with our own ideas in order to give her an answer.
Professor Schultz, full professor of the chair for paediatrics, also remained silent.
I know that this, such an easy and at the same time such a clear answer, caused some paediatricians to think things over. I was among them.
At that time I started to attend a comprehensive interdisciplinary post-graduate training with an emphasis on psychology, on the view of the human being as a person and the meaning of interpersonal relationships for the development of the child. This profound perspective brought me to decide to take a position against the general psychiatrization of children. I also learned to understand the political background of those who later led a strong campaign against me and was able to defend myself with every means possible.
In the mid-nineties, as the diagnosis Attention Deficit Syndrome (ADS) of restless children began to increase, I had a long conversation with Professor Dr. Schulte. He was known throughout the world as an expert on the minds of children and was an emeritus professor at the time. I wanted to learn from him what he thought of the appearance and the quickly spreading diagnosis of ADS. He said correspondingly: “The diagnosis is an American invention. They do such things.” He had experience since he had worked a long time in America. He further added, the process was to be compared with the fresh cell therapy with brain cells used to treat mongoloid children. He had held a lecture in the US a few years ago at the North American Society for Children’s Health. He emphasized that a fresh cell therapy for mongoloid children is useless, it merely costs money, doesn’t help and gives the parents false hope. In addition, it is very dangerous. That was what one called fraud.
After the lecture he thought he would be thrown out of the plane on his flight back to Europe. But his lecture had had a great impact. Since his retirement, however, his voice carried not so much weight any more otherwise he would now gladly help to get rid of the ADS diagnosis in two years such as he did with the fresh cell therapy in a few weeks.
He recommended that I write and publish a scientifically researched article. I followed his advice. The Deutsches Ärzteblatt, the monthly Kinderheilkunde and Der Kinderarzt, the traditional publications for German paediatricians, refused publication. Even many paediatricians, authorities in their field, were not prepared to engage themselves in the problem of the psychiatrisation of children’s behaviour.
Currently appearing in different publications, in medical- or lay- journals and heavily supported by the Pharmaceutical industry, is the ADS Diagnosis or, when combined with hyperactivity, propagated as ADHD. A “therapy” with an amphetamine such as Ritalin for example was portrayed as big progress, as magic solution. The regular prescribing of Ritalin became socially acceptable. Today, twenty years later, doctors, teachers, therapists or school psychologists label children with this diagnosis without inhibition. Despite the fact that the discoverer of ADHD admitted, shortly before he died, that he had invented the diagnosis himself.4
More and more neuro-mythology and biologism, these “new sciences” of the brain slopped over across the Atlantic from the United States to Europe. These “new sciences” do away with the personalist view of man which corresponds to human nature! Quote: “According to the personalist conception, man is basically a social being. His personality evolves and blossoms in and through community. He is not simply the product of nature and nurture, but he has a creative and formative self-activity and is capable of reason and ethics. Man is capable of creating culture and setting moral values.”5 Neurobiologists, however, try to reduce the function of the human brain as well as thought processes and emotional processes, to a biologistic level (neuro-reductionism). Felix Hasler describes this change in his book “Neuromythology” as “more of astrology than science”.
Biologism culminates in the allocation of operations in the brain by imaging methods. With imaging techniques such as MRI (Magnetic Resonance Imaging) or PET (Proton Emission Tomography) there is the attempt to associate specific emotions such as sadness or anger, but also diseases such as depression to certain areas of the brain. For example, diagnostic imaging examinations detected a “conspicuously large volume” of the right amygdala in conservative voters in the United States. Even in the case of the ADH syndrom, a centre in the human brain is said to exist where the “disease” is supposed to be located. This is fraud in science! At the beginning of the Neuro- inflation Bush sen. said: “I, George Bush, President of the United States of America, hereby declare the decade, beginning on 1 January 1990, the decade of the brain”.6 What kind of brain is required to say such a thing?
Other psychiatric diagnoses such as Asperger syndrome, autism, selective mutism, social anxiety syndrome and bipolar disorder were gradually established. Nowadays, many young children are labelled with such diagnoses. Evaluations are already conducted in the kindergarten, or at school at the latest. This opens the door to an early education program market. Such programs are introduced onto the market mainly by para-stately operating private foundations. The best-known European foundations are the Bertelsmann Foundation (Germany) and the Jacobs Foundation (Switzerland).
DSM-5, published in 2013, contains further “diseases”.7
With the liberalization of economy subsumed under the term “globalization” starting in 1990, people were increasingly looked upon from the perspective of “rate of return”. Social reforms corresponded with this perspective, for example in the health and education sectors. The goal of education was no longer to raise a fellow citizen capable of democracy, but the homo economicus. This is also the basis of “Curriculum 21”, which will lead to a further increase of the mentioned abnormalities in our children. We do not want this. Our children have a right to education. Let us come back to a holistic education and a personalist view of man.8
According to a US Classification, however, the nature of man is reinterpreted!
Because of my own history and my pediatrician’s work, I was outraged from the very beginning at the fact that lively and sometimes a little nervous but otherwise healthy children, were labelled with the psychiatric “disease” ADHD. For many children a psychiatric diagnosis means heavy burden for their whole life. Psychiatrizing children means a violation of a basic principle of psychology and pedagogy, i.e. human dignity. It means a violation of the child’s soul.9
I began to look for allies and inform others about the impact of ADHD.
Soon I learned to what extend this issue was politically charged. The North Elbian Church and other interested circles started a campaign against myself and the professional psychological association “Verein zur Förderung der Psychologischen Menschenkenntnis, VPM” (Association for the promotion of knowledge about man), of which I was a member and in which I had absolved post-graduate training under the professional direction of Dr Annemarie Buchholz-Kaiser. As a result of this campaign I was forced to fight in order to secure my own professional existence for some time. The slander against my person compelled me to build up a new surgery at a new place. An examination of my integrity before a committee of the Hamburger Ärztekammer (local medical association) because of my membership with VPM had a positive result for me and the VPM. Also two lawsuits were completed in favour of myself. A young judge passed a sentence in which the VPM’s concepts and contents were described as very valuable for the youth. The contents were by no means constricting but on the contrary apt to widen their horizon.
The way was now open for me to go on dealing with the drugs problem and to commit myself to informing about the machinations around the ADH-syndrome.
My friends and colleagues encouraged me in my concern and engagement against preposterous diagnoses and medicamentation aiming at creating globalisation-compatible eunuchs. Ritalin results in stagnation of the mental and emotional development, especially during puberty.
At that time teachers used to stay impartial with regard to ADHD, because they had no students with such a diagnosis in their classes. It was difficult for them to imagine the dimension of this problem. Only few hesitantly joined our party. But we were very active. We wrote articles, delivered lectures and conducted interviews. In Bregenz we organized a symposium about the ADH-syndrome.
We gave an interview to the Hamburg news magazine Der Spiegel. Although I had good relations to the Spiegel’s publisher and some of the editors they could not or did not want to comprehend our arguments. An article in the Spiegel which followed our interview did not provide any of our arguments. Still the review was written in a manner that would give some readers food for thought.
The “diagnosis” ADHDS and so on replaced all previous diagnoses. It was based on an increasing number of “symptoms” which mostly must be regarded as normal behaviour of children. For example a distinct sense for justice belongs to the symptoms which are to prove ADHDS today. A solution of the children’s problems in the environment in which they had developed – which is the pedagogical one – had been given up. This way questions concerning parental education or school education like too few or low demands, individualization or the effects of such school-reforms as open lessons, a lack of teaching of knowledge, but also questions about the social environment were no longer integrated anamnestically. Psychological help is declared nearly useless. From now on medical “treatment” became predominant.
New “therapy”-methods sprang up like mushrooms and infiltrated the training in all psychological healthcare professions. Based on such professional education some people arrogated to make grave diagnosis themselves. Over and again crying parents saw me in my medical practice. They told me of trespasses into their personal affairs. For example a young mother was told by an ergo-therapist: “Since you had such an authoritative father your relationship to your son will always be disturbed.”
In Hamburg an ADHDS-group of paediatricians and psychiatrists was created with the money of the pharmaceutic company Hoffmann la Roche in order to establish ADHDS even more and to achieve that the diagnosis was made by solely “experts”. A group around the chairman of the pediatric society, Dr Gritz from Hamburg who was no unknown to me, increasingly became a circle of rigid ADH-syndrome proponents. I received a telephone-call by Mr Gritz. The gist of this call was: “Mr Bau, why do you stab in our back? Don’t go out on a limb again; otherwise another campaign will be started against you.” I answered: “So far it is not forbidden in Germany to express a scientifically based opinion, is it?”
(Today the dosage of Ritalin is calculated by the degree of severity of the so called symptoms!) The prescription rate of this very controversial ADHDS drug is highest in Hamburg. The overall rate in Hamburg is nearly 50 per cent higher than the average of whole Germany.10
The human reason has more staying power
Increasingly in several European countries, but also in the US – the ADH-syndrome’s origin – parents, doctors, pedagogues and psychologists began to oppose the psychiatrization of underage children and the magic bullet Ritalin.
The Italian association “Giu le mani dai bambini” had a great impact.11
The described consequences of the changed pedagogy, paediatrics and psychiatry are that today that opposition obviously origins from many different quarters (for example “Lernmethode Lesen durch Schreiben” [Learning method learning to read by writing], Spiegel online from 19 June 2013). The time has come to send these harming diagnostic mistakes back to sender: to its origin, the USA. This master plan à la USA does not make sense for Europe and the rest of the world. After World War Two people in Germany shouted: “Ami go home!” The whole world today could shout the same!
Thanks to a long standing interdisciplinary discussion we are today able to see through these political processes and the paradigm change, to raise our voices in an understandable manner and to cause a reversion. An awareness of European values offers a scientific base for our actions. •
1 cf. “Kölner Stadt-Anzeiger” from 11.6.2013, “Schtrait ums Schraibenlärn”
2 cf. „Mengenlehre – das ist Zeitverschwendung.“ Der Spiegel 36/1974. “Die phonetische Schreibung als abschreckendes Beispiel.” Heike Schmoll in Current Concerns 31/32, 31 October 2013
3 see Special Supplement Zeit-Fragen from 22 April 2002; Current Concerns No 8 from 27.2.2012. Inventor of ADHD Leon Eisenberg: “ADHS ist eine fabrizierte Erkrankung”; M. Nestor, “Frankfurter Allgemeine Zeitung” 2013
“Neue Zürcher Zeitung” from 30.4.2012, “Gewisse Diagnosen sind Ausdruck des Kulturwechsels”
Wikipedia: DSM Diagnostic and Statistical Manual of Mental Disorders (Diagnostisches und
Statistisches Handbuch Psychiatrischer Störungen)
„Schweizer Ethikkommssion“ warns against “Ritalin – gegen den Missbrauch von Psychopharmaka”, 26 December 2012
4 cf. “Ritalin gegen ADHS – Wo die wilden Kerle wohnten. ADHS, die erfundene Krankheit”, in: “Frankfurter Allgemeine Zeitung” from 16.2.2012
5 Cooperatives – the alternative to the construct of homo oeconomicus, Current Concerns No 17, 13 May 2013
6 “Neuromythologie”, Felix Hasler, ISBN 978-3-8376-1580-7
7 “Normal”, Allen Frances, ISBN 978-3-8321-9700-1
8 “Die Bildungsreformen und die Psychiatrisierung hängen eng zusammen”, cf. Current Concerns No 34/35 2013, Special Supplement on Education
9 Basic principles from the perspective of a personalist psychology, Current Concerns No 20/21, 29 June 2013
10 cf. Infoportal Nordfriesland www.infoportal-nordfriesland.de/index.php/news/aufreger-der-woche
11 Zeit-Fragen No 30 from 21.7.2008 - Special Supplement Zeit-Fragen 22. April 2002