The New Eugenics: Why Genetic Theories of Mental Illness and Addiction Are a Damaging Dead End

May 08 2016

The New Eugenics: Why Genetic Theories of Mental Illness and Addiction Are a Damaging Dead End

May 9th, 2016

Modern genetics doesn’t forcibly sterilize people. But fashionable theories around it put us in boxes just as eugenics once did, harmfully ignoring cultural and social differences and individual change.

Adam Cohen’s book, Imbeciles: The Supreme Court, American Eugenics, and the Sterilization of Carrie Buck, chronicles the horrors of the eugenics movement. It focuses on the 1927 Supreme Court decision in Buck v. Bell, in which an 8-1 majority upheld forced sterilization. Oliver Wendell Holmes wrote in the decision: “It is better for the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind.”

We all scorn eugenics today, recognizing its unscientific roots and its substitution of scientific terminology for prejudice. But we now kowtow to a virtually equivalent philosophy, one with no greater grounding in science—that is, the idea that mental illness and addiction are determined by our genes.

Of course, we don’t today allow forced sterilization based on genetics. But the implications of genetically-focused, biological psychiatry, for society and for individuals and families, are colossal.

 

Disbelief in Cultural and Social-Class Differences

Immigrants and poor people bore the brunt of eugenics and sterilization. Testifying against Buck, biologist Harry Laughlin submitted an affidavit to the court that she had a “record during life of immorality, prostitution, and untruthfulness” due to her belonging to “the shiftless, ignorant, and worthless class of anti-social whites of the South.” The same discounting of the impact of social forces was apparent in Laughlin’s sponsorship of legislation limiting immigration for Jews and other types who seemed distastefully unlike us.

What ignoramuses these leading scientists were, along with the unwashed masses who followed their legal and public health commandments! Our superior, evolved society now recognizes this as a facade for age-old bigotry. Of course, the Nazis’ endorsement of eugenics permanently killed the idea in the US. This anti-eugenics movement here was led by anthropologists Franz Boaz, Margaret Mead and Ruth Benedict, who emphasized instead that culture determines individual personality and outlook.

And yet, we don’t believe that today.

Instead, the American biological/genetic mental illness and addiction movement trawls the globe for signs that all people share the same DSM disorders. The most thoroughgoing treatment of how ubiquitous and misguided is this global assault on cultural differences is Ethan Watters’ remarkable Crazy Like Us: The Globalization of the American Psyche. As Watters has written: “We have for many years been busily engaged in a grand project of Americanizing the world’s understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad.”

How crazy is that? The internationally biologized human psyche Watters describes is force-fed by the pharmaceutical industry, piggy-backing on American and international psychiatry, in every corner of the world, however ill the fit. In place of this homogenization, Watters argues, “researchers have amassed an impressive body of evidence suggesting that mental illnesses have never been the same the world over (either in prevalence or in form) but are inevitably sparked and shaped by the ethos of particular times and places.”

But we move farther from this culturally aware alternative with every passing year. In 2001, the US Surgeon General’s office authored a supplement: “Culture Counts: The Influence of Culture and Society on Mental Health,” which “reveals the diverse effects of culture and society on mental health, mental illness, and mental health services.” No government office would issue such a declaration today (one that has been cited only once since then, according to the National Institutes of Health counter).

Watters notes that an “unfortunate relationship has popped up in numerous studies around the world. It turns out that those who adopted biomedical/genetic beliefs about mental disorders were the same people who wanted less contact with the mentally ill and thought of them as more dangerous and unpredictable.” Meanwhile, “the most perplexing finding in the cross-cultural study of mental illness: People with schizophrenia in developing countries appear to fare better over time than those living in industrialized nations”—and this despite our advanced biomedical techniques!

A demonstration of cross-cultural imperialism regarding addiction was performed in 1999 by a committee of epidemiologists. The World Health Organization’s Cross-Cultural Applicability study was convened to judge the consistency of symptoms of alcohol dependence across cultures. Dividing symptoms of dependence into psychological and physical categories, they found, “Contrary to expectation, descriptions of physical dependence criteria appeared to vary across sites as much as the more subjective symptoms of psychological dependence.” Just as Watters describes with mental illness, the fundamental form that addiction takes, whether it occurs at all, is essentially determined by cultural factors.

Along with the denial of the impact of culture, how many times have we been lectured that addiction and mental illness don’t read income tax returns, that we are all equally susceptible to these maladies? But this isn’t true. Consider, as just one example, the undeniable data with the most prevalent form of drug addiction, smoking: “Today in Britain and the United States, smokers tend to be poor, less educated, or mentally ill.”

The struggle between biologic and social status factors is evident in efforts to explain all addictions. Maia Szalavitz, my fellow columnist for The Influence, has tried to tease out biological sources for addiction and mental disorders, problems she describes coping with herself in her brilliant new book, Unbroken Brain.

Elsewhere, however, Maia notes, “Addiction rates are higher in poor people—not because they are less moral or have greater access to drugs, but because they are more likely to experience childhood trauma, chronic stress, high school dropout, mental illness and unemployment, all of which raise the odds of getting and staying hooked.” Maia holds out the hope that big data assaults on mental illness and addiction will resolve these—see below for the chances of that.

Addiction therapist Adi Jaffe has described Carl Hart, Bruce Alexander and myself as “radical environmentalists,” by which he doesn’t mean that we blow up power plants. Rather, we three believe that addiction is culturally, situationally and experientially caused.

Bruce created the seminal Rat Park experiment, where animals previously habituated (“addicted”) to morphine solution simply switched to drinking water when allowed to roam free with other rats of both sexes.

Carl, another Influence columnist, makes clear—based on both his personal experience in Miami’s ghetto, and on his research showing that “addicts” can be dissuaded from taking methamphetamine by simply paying them enough—that drugs do not create drug addiction.

Addiction is instead caused by people’s environmental and situational motivations, which frequently change. This truth—and its denial—is evident in the genetic idea that mental illness and addiction are permanent, which answers the question Szalavitz poses in her cogent piece: “Most People With Addiction Simply Grow Out of It: Why Is This Widely Denied?”

The reason, Maia, is widespread belief in biological, genetic causation—along with trauma theory. (If addiction-causing trauma is permanent, how can people overcome addiction?)

 

The Reification of Biological Conceptions

Today, people widely, but vaguely, assume that addiction and mental illness have been shown to be genetically based. The reverse is true.

In, 2003, scientists completed compiling the three billion letters of genetic code that comprise the human genome. The initial Human Genome Project (HGP) cost $1 billion, an amount that has been matched and exceeded several times over in research on the genome conducted since then. Many people assumed that having our DNA coding read meant the end of mental illness and addiction.

To our disappointment, the reverse has been true, for both addiction and mental illness. Remarkably little useful therapy has been developed due to the completion of the genome map. And this has been, by far, most evident with addiction and mental disorders.

Prior to HGP, periodic announcements were made of the discovery of a gene for this or that mental disorder—depression, bipolar, schizophrenia. And then? Disappointment.

The gene for alcoholism is a case in point. In 1990, Ken Blum and Ernest Noble identified the alcoholism gene as a variant of the D2 dopamine receptor gene in the prestigious Journal of the American Medical Association.

Neither of the researchers was a geneticist (Blum is a pharmacologist, Noble a psychiatrist). Actual genetic epidemiologists pursue two paths. One is tracing a family where a disorder occurs frequently, and seeing which gene differs in those in the family line who do, or do not, manifest the disorder. The second is to conduct a general population study to find people who display a disorder, and see how their genetic make-up differs from the general population.

Blum and Noble instead studied 35 males who died from alcoholism, and generalized from this small group’s genetic differences to a general population. But, unfamiliar with the population’s origins (it turned out that they were largely African American), their group’s genetic distinctiveness was due to traits found more commonly in this racial group.

This problem invalidated the Blum-Noble research from the start, as I noted at the time in The Atlantic. Then, too, researchers (none actual geneticists) proposed a dizzying array of potential genetic sources for alcoholism, each one independent from, and often contradictory to, the other! I wrote too about this cacophony, this time in the Journal of Studies on Alcohol.

The Blum-Noble “discovery” actually marked the end of the search for individual genes that cause mental disorders or addiction. Now 25 years old, the dopamine receptor gene allele that supposedly caused alcoholism—and then was claimed to cause addiction in general—has turned out to be useless. (Have you ever heard that someone was diagnosed as being alcoholic because they carried the A1 allele of the dopamine D2 receptor gene?)

In the area of mental disorders, research teams search for clumps of DNA that are in common associated with the total range of disorders, including autism, ADHD, depression, schizophrenia and bipolar disorder. According to Jordan Smoller, a coordinator of this research, “these genetic associations individually can account for only a small amount of risk for mental illness, making them insufficient for predictive or diagnostic usefulness by themselves.”

That specific genes can account for mental illness or addiction was actually, amazingly, disproved by the HGP. The first major surprise to arise from mapping the genome was the discovery of how little of DNA comprised actual genes—fewer than 25,000 were identified, a figure remarkably lower than the 70,000 or more genes researchers expected to find.  This number was rather  uncomfortably close to the number of genes found in even the lowest life forms—that is, what puts us on top of the evolutionary ladder is not individual genes.

Read more from The Influence:

Pushing Naltrexone as the Answer to Our Heroin Problems Is Unscientific and Unethical

Three Buddhist Truths About Curing Alcoholism, Demonstrated by My Enlightened Drinking Buddy

…and follow us on Facebook and Twitter.

As I describe in Recover!, the vast majority of DNA on our chromosomes is not organized as specific genes. Much of this DNA (referred to as “switches”) is now understood to catalyze processes that then proceed to different genetic outcomes. As Dr. Bradley Bernstein, an Encode (one subtask of HGP) researcher at Massachusetts General Hospital, commented, “The system, though, is stunningly complex, with many redundancies. Just the idea of so many switches was almost incomprehensible.”

The implications of this degree of complexity are still incomprehensible. Not only do such switches impact the course of genetic development (ontology), but the form and expression of genes are influenced by such random events as the mingling of DNA across the chromosomes, along with such seemingly casual influences as temperature and light during gestation.

All together, the picture of the genome that has emerged is one of a seething mass of activity, of change, often unpredictable, and of interactions between different components of the genome and the genome and its environment.

The ideal image many people had of the genome as a straightforward template that maps out human beings in a predictable way was, and is, a fantasy. And this is nowhere more evident than in the case of human personality traits and mental illness. There simply are no bright neon signs in all of that DNA blaring: “introverted/extroverted,” let alone “schizophrenic,” “autistic,” “bipolar,” “addict,” et al.

According to the CDC: “Scientists believe that many mental disorders result from the complex interplay of multiple genes with diverse environmental factors.”

True, but meaningless. And addiction—with all the individualism and changeability noted by Influence writers Maia Szalavitz and Meghan Ralston, two people with direct experience—epitomizes the now-definitive practical uselessness of genetic models in our field.


Stanton Peele is a columnist for The Influence. His latest book, with Ilse Thompson, is Recover!: An Empowering Program to Help You Stop Thinking Like an Addict and Reclaim Your Life.  He has been at the cutting-edge of addiction theory and practice since writing, with Archie Brodsky, Love and Addiction in 1975. He has since written numerous other books and developed the online Life Process Program. His website is Peele.net. Dr. Peele has won career achievement awards from the Rutgers Center of Alcohol Studies and the Drug Policy Alliance. He is currently working on his memoir. You can follow him on Twitter: @speele5

  • issueman

    so are you saying that the idea that alcoholism running in family trees is false? Are people predisposed to alcoholism or not. The article seems to say that all that talk was just reaching for an answer. What is the solution in your opinion?

    • Stanton Peele

      Thanks for asking issueman!

      If alcoholism runs in families, groups and cultures, and isn’t a matter of genes, what could it be due to? I write books about this (The Meaning of Addiction, Addiction-Proof Your Child) in which I speak about cultural, family, and individual beliefs that a particular substance is both magically redeeming, and overwhelming. (Do you know that great biological reducer George Vaillant found in his famous study, “The Natural History of Alcoholism,” that Irish Bostonians were more than three times as likely to become alcohol dependent over their lifetimes as Italians, Greeks, and Jews — do you guess that’s due to their genetics?)

      Beliefs are hard things to get our heads around — Americans don’t really believe that beliefs create mental health-addiction outcomes (as I say in my post). Within cultures, I speak of social groups, particularly disadvantaged ones, about which I quote Maia Szalavitz (who is kind of a biological determinist herself): “Addiction rates are higher in poor people . . .because they are more likely
      to experience childhood trauma, chronic stress, high school dropout,
      mental illness and unemployment, all of which raise the odds of getting
      and staying hooked.” That’s pretty explicit, I think.

      Here’s a fascinating anomaly — daughters of male alcoholics are less likely than average to develop drinking problems. This is a mindfulness outcome (a la Ellen Langer) — being in the middle of a problem but having some disconnect from it gives people the same detachment Ilse Thompson and I use mindfulness meditation techniques for in our book, Recover!, to allow people to escape cognitive traps they may have inherited or acquired.

      Meanwhile, who believes more in the uncontrollable biology of addiction than Americans — we Americans who are experiencing record levels of painkiller, heroin, and tranquilizer deaths, as well as a fifty percent increase in alcohol use disorders over the last decade. (I wrote about this in my first post for The Influence, http://theinfluence.org/why-were-losing-the-war-on-addiction/.)

      You seem a little irked with me, issueman. Are you as upset that our cultural milieu is creating such record levels of negative, even fatal, substance and addiction-related outcomes?

      Hope this issuseful!

      • issueman

        Not irked at all, just in question mode. Keeping an open mind. Grateful for people that study a disease like alcoholism that has touched so many lives in a painful way. It is personal to me so maybe my tone was too intense to passed off as a general question. I did not mean for anyone to feel i was irked.
        But our society’s discussion on this topic seems to me to look more & more polar, as if we were discussing republican/democratic ideology, with tones of no middle ground & it feels like many articles in this blog have taken the side that genitic prediposition to alcoholism is ludicris & it is something the other side is making uo to brainwash people – just a big hoax that only unlearned folk woulf fall for. That particular tone does not seem to be very helpful to people who are trying to find a solution. That is just my viewpoint from out here in smalltown America.

    • stmccrea

      Speaking Spanish and liking to cook potato dishes for dinner also runs in families. If you grow up in a family where the dad beats up the mom, it’s more likely that the boys will be abusive and that the girls will be victims. If you grow up in a family where arguing and opposition are accepted, you would be less likely to be upset by others’ arguments and opposition. (On the other hand, you may also become hypersensitive to it.) If you grow up with an alcoholic parent, it seems pretty obvious that alcoholism might seem like a normal solution to managing stress to you. Of course, not everyone in the family will make that decision, but it will happen more often than in a family with no alcohol abuse, leading to “proof” of heritiability.

      Environmental differences are sufficient to explain most aspects of “heritability.” Even obviously physiological things like heart disease are not reducible to simple genetic explanations. It defies logic to think something as subjective as an addiction to a particular substance could be reduced to a simple genetic explanation when heart disease cannot.

      • issueman

        I didn’t have amyone in active alcoholism around me growing up. Did’t find out about the family history until
        I got sober 7yrs ago. I Just drank really different fron all my friends? Must’ve been potty trained sideways or maybe my mom had square nipples or something. I was a well loved, well adjusted child. ????
        I would love to learn a viable reason may alcoholism from someone so well lerned on the subject. Ignorance is not bliss when you have three smazing choldren like i do.

        • stmccrea

          I think there are different reasons for every person. That’s why I don’t view it as a “disease” per se. That doesn’t mean that SOME people don’t become alcoholic at least partly or even totally because of some alterations in brain chemistry. But it’s not generalizable. Childhood trauma, neglect and abuse increases the likelihood of substance abuse issues many, many times over. So it can’t JUST be brain chemistry.

          Can’t comment on your potty training or mama’s nipple shape, but it is also true that sometimes stable families still fail to meet our needs. That was certainly the case for me – both parents loved me and wanted the best but my mom in particular didn’t really “get” who I was and what I needed and I ended up very shy and insecure. Did I have genetic tendencies toward that direction? Probably so. But those tendencies interacted with the environment I was presented with and made it worse than it needed to be.

          Maybe some people just start drinking and have no precipitating events and become hooked biologically. I can’t really say. But my experience and career working with abused/neglected children and adults with that kind of history tells me that trauma history massively impacts the likelihood of substance abuse, and the stats back me up on that big time.

          —- Steve

  • As for the bio-psycho-social “reductionist” there are several independent factors playing together.

    For genetic predisposition in familiy members of alcoholics its better positive effect and / or less negative ones. FE needing less drinks to feal comfortable, slower alcohol-metabolism or faster aldehyd metabolism. A pre-dispositon for alcoholism is also a pre-disposition for health drinking.

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  • Mark Eccles

    “In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain
    insane behaviour, which we attribute to causes (diseases).” Szasz

    Vice and Virtue

    1 Lust Chastity

    2 Gluttony Temperance

    3 Greed Charity

    4 Sloth Diligence

    5 Wrath Patience

    6 Envy Kindness

    7 Pride Humility

    Before psychiatry there was sin and virtue, vice and virtue. We can’t have one without the other.

    “In our fervor to medicalize morals, we have transformed every sin but one into sickness.Anger(5), gluttony(2), lust(1), pride(7), sloth(4) are all the symptoms of mental diseases.Only lacking compassion (kindness 6) is still a sin.” wrote Thomas Szasz.

    Szasz missed the sins of Envy(6) and Greed(3)

  • stmccrea

    An excellent article! I don’t know why it isn’t obvious to all that such things as “oppositional defiant disorder” and “conduct disorder” and “disorder of written expression” are mere social constructs, and that the likelihood of a social construct that simply describes behavior we don’t like being consistently associated with specific genes is absurdly and vanishingly small. I think it mostly has to do with denial – we’d like to pretend that our society is perfect and that anyone who is unhappy or upset or unable to fit into those social institutions is “disordered” and needs “treatment” so they can decide to be happy with the status quo. To attribute “mental disorders” to trauma, stress, oppression, and inappropriate expectations means that the adults in power have to take responsibility for addressing these problems, and it’s a lot more convenient to blame those who aren’t willing or able to kowtow to the current regime.

  • youngcanoli

    Decriminalization/legalization is necessary, it needs to be backed up with public health announcements explaining exactly why it is needed. Its not in any way condoning the abuse of addictors, it is done bc the alternative, the drug war, has made things infinitely worse on almost every level, to include making all drugs abundantly available to any & all that wants them. We need to pull LE out of the drug biz – that will free up a lot of resources currently chasing their collective tails. When the laws create more harm and cause more damage than they prevent, its time to change the laws. The $1 TRILLION so-called war on drugs is a massive big government failure – on nearly every single level. Its way past time to put the cartels & black market drug dealers out of business. Mass incarceration has failed. We need the science of addiction causation to guide prevention, treatment, recovery & public policies. Otherwise, things will inexorably just continue to worsen & no progress will be made. Addiction causation research has continued to show that some people (suffering with addiction) have a “hypo-active endogenous opioid system.” This is the (real) brain disease, making addiction a symptom, not a disease itself. One disease, one pathology. Policy must be made reflecting addiction(s) as a health issue. The war on drugs is an apotheosis of the largest & longest war failure in history. It actually exposes our children to more harm & risk and does not protect them whatsoever. In all actuality, the war on drugs is nothing more than an international projection of a domestic psychosis, it is not the “great child protection act,” its actually the complete opposite. We need common sense harm reduction approaches desperately. MAT (medication assisted treatment) and HAT (heroin assisted treatment) must be available options. Of course, MJ should not be a sched drug at all.

    “Prohibition goes beyond the bounds of reason in that it attempts to control a man’s appetite by legislation and makes a crime out of things that are not crimes. A prohibition law strikes a blow at the very principles upon which our government was founded.”

  • youngcanoli

    1. Prader Willi
    2. Epigenetics

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