The Myth of Normal 198

editions, he refused. “I said, ‘Listen, in twenty-five years they are going to look back and won’t believe that we thought about people that way.’ It’s not a valid way to think about the complexities of human beings.” He practices what he preaches in the clinic he helps run. “We haven’t used diagnoses for fifteen, twenty years,” he said, “and it really has not interfered with our ability to do good clinical work. In fact, we’re able to do better clinical work without using those labels.” Based on my observations in family practice and my understanding of human development, I have followed the same lines. When I work with any mental health condition, say depression or anxiety or ADHD or addiction, I’m not so interested in the formal diagnosis as such. My “diagnostic” focus goes to the specific challenges the person is facing in their life and the traumas animating those challenges. As for “prescriptions,” I am primarily interested in what will promote the healing of the psychic wounds the ongoing traumatic patterns represent. Now, here’s a perhaps surprising assertion: I’m not anti-pharmacology. No one who’s felt or witnessed the beneficial effects of psychiatric drugs can deny that neurobiology must, indeed, play a role in the dynamics and potential easing of mental distress, just as it does in all our experiences. Sometimes the healing of which I just spoke can be helped along—not made to happen, certainly, but assisted—by the intelligent use of these medications. That is not just my professional opinion but my personal experience as well. In my mid-forties, I decided to go on the serotonin-enhancing drug Prozac. (Among the brain’s principal neurotransmitters, or chemical messengers, serotonin is believed to be active in such functions as mood regulation and the dampening of aggression.) The skepticism I harbored about this growing trend to medicate millions was eclipsed by my hunger for respite from the daily severities of my state of mind, as summed up grimly in a diary entry from that time: “I have no energy for life. I have spent every weekend for the past two months—every free weekend—in an enervated, passive, demoralized state, depressed and depressing to be with.” I was soon a different person. Within days, my wife noted with relief the softening of my facial features. I now greeted mornings with vim instead of