Taking America Off Drugs: Why Behavioral Therapy is More Effective for Treating ADHD, OCD, Depression, and Other Psychological Disorders Stephen Ray Flora State University of New York Press Taking America Off Drugs Taking America Off Drugs Why Behavioral Therapy is More Effective for Treating ADHD, OCD, Depression, and Other Psychological Problems Stephen Ray Flora State University of New York Press Published by State University of New York Press, Albany © 2007 State University of New York All rights reserved Printed in the United States of America No part of this book may be used or reproduced in any manner whatsoever without written permission. No part of this book may be stored in a retrieval system or transmitted in any form or by any means including electronic, electrostatic, magnetic tape, mechanical, photocopying, recording, or otherwise without the prior permission in writing of the publisher. For information, contact State University of New York Press, Albany, NY www.sunypress.edu Cover photo copyright Firebrandphotography/Dreamstime.com Production by Michael Haggett Marketing by Fran Keneston Library of Congress Cataloging-in-Publication Data Flora, Stephen Ray, 1963– Taking america off Drugs : why behavioral therapy is more effective for treating ADHD, OCD, depression, and other psychological problems / Stephen Ray Flora. p. cm. Includes bibliographical references. ISBN 978–0–7914–7189–0 (hardcover : alk. paper) ISBN 978–0–7914–7190–6 (pbk. : alk. paper) 1. Behavior therapy. 2. Neurobehavioral disorders—Chemotherapy. 3. Psychotropic drugs. I. Title. RC489.B4F56 2007 616.89(cid:2)142—dc22 200636595 10 9 8 7 6 5 4 3 2 1 Contents Chapter 1. Introduction: The Drug Deception 1 Chapter 2. The Behavioral Balance 17 Chapter 3. Eating Disorders: Anorexia, Bulimia, Binge Eating, and Obesity 29 Chapter 4. Specific Phobias 43 Chapter 5. OCD: Obsessive-Compulsive Behavioral Problems 63 Chapter 6. ADD and ADHD 71 Chapter 7. Depression 95 Chapter 8. Schizophrenia 111 Chapter 9. Health Concerns, Head to Toe 123 Chapter 10. Conclusion 143 References 159 Name Index 177 Subject Index 180 v Chapter 1 Introduction The Drug Deception THE DECEPTION America has been deceived—deceived by the drug companies, by psychi- atry, by our children’s teachers, by well-meaning physicians, and by mental health workers of all stripes. The deception has been so complete and successful that Americans believe the deception is fact. As a result of this deception, Americans are suffering. The deception is that whatever one’s problem—hyperactivity, short attention span, depression, shyness, sadness, obsessive-compulsive disor- der (OCD), phobias, anxiety, panic, overeating, sexual dysfunction, poor athletic performance, sleeping difficulties, drug abuse, irritable bowel syn- drome, and even schizophrenia, to name a few—there is a drug that can help the problem, if not cure it. But to keep the current customer base, the drug companies do not really want to permanently solve the problem. Rather, they want to keep selling Americans drugs. The drug deception is now widely entrenched, thus those with behavioral problems have been so completely fooled that they are now unknowingly reinforcing the deception. The deception has become self-perpetuating. In fact, many with behavioral problems and their advocates do not even consider their behavioral difficulties behavioral. No, they believe it is “fact” that their problems are “neurochemical” or “brain based.” And if a problem is assumed to be neurochemically, brain based (although behavioral prob- lems are not), then a logical—but often an incorrect—assumption is that the best way to help the problem is with chemicals, with drugs. 1 2 TAKING AMERICA OFF DRUGS It is the nature of deceptions that they are believed to be true by those deceived. This is the case with the mental health community. The mental health community—the “professionals” and patients—has so completely bought the drug companies’ and psychiatry’s sales pitch that behavioral problems are “brain disorders,” that now it too is perpetuat- ing the deception. I was invited to be on the speakers’ bureau of a local mental health organization “funded by a grant from the Ohio Department of Mental Health.” Included in its mailing to me was the flier “Some Facts about Mental Illness,” which included the statements: “Mental illnesses are disorders of the brain that disrupt a person’s think- ing, feeling, moods, and ability to relate to others....Just as diabetes is a disorder of the pancreas, mental illnesses are brain disorders....As a dia- betic takes insulin, most people with serious mental illness need medica- tion to help control symptoms.” These “facts,” and the logic behind them, are wrong. The truth is, behavioral problems are behavioral. It is, the behavior that is dysfunctional and causing distress. A “chemical imbalance” in a person’s brain does not cause most of these problems; rather, it is a behavioral imbalance. Or, as one child being screened for attention deficit disorder (ADD) told his doctor: “It’s not a chemical imbalance, Dr. Diller—it’s a living imbalance” (Diller, 1998, italics in original). Troublesome behavior causes troublesome feelings and may result in atypical chemical and neurological profiles more often than any sup- posed chemical imbalance causes troublesome behavior and feelings. That is, when behavior is out of balance, the body, including the brain, gets out of balance, and when behavior becomes more balanced, the body, including brain chemistry, returns to normal. Furthermore, behav- ioral treatments are almost always more effective, and more widely bene- ficial, than drug treatments. Behavioral treatments have advantages that drug treatments do not, and drug treatments have disadvantages that behavioral treatments do not. Study after study will prove that behavioral treatment is more effec- tive than drug treatment for behavioral problems. In a minority of cases for a minorityof behavioral difficulties, drug treatment may be necessary, but only in combination with behavioral treatment. However, profits, political lobbying, and marketing directed at America’s quick-fix, fast-paced, immediate gratification-oriented culture have proven to be more powerful than careful, unbiased, outcome-based scientific research. The drug companies understand that children, par- ents, and others prefer, and are more likely to be influenced by, super- The Drug Deception 3 heroes, comic books, and warm stories than they are by a scientific report. Superheroes, comic books, and warm stories are exactly what the drug companies are using to promote their drugs. In September 2001, just in time for the school year, the drug companies began to market their amphetamines (or closely related drugs) for children targeted directly at parents in leading magazines, including Parents, Parenting, and Reader’s Digest, to name a few. The “soaps” (TV soap operas) might now more accurately be called the “drugs,” because the advertisements have shifted from household cleaning products to drug solicitations. But there may still be time to keep everyone on earth from being drugged. Some concerned professionals and parents are not swallowing the drug companies’ would-be cure-all (e.g., Antonuccio, 1995; Diller, 1998). In almost all cases, safe, effective behavioral treatments exist for “mental disorders,” psychological maladjustments, and behavioral diffi- culties. If effective nondrug alternatives exist, then why are they not more widely used and promoted? There are several reasons for the cur- rent state of affairs. DRUGS, THE FALSE PROMISES When we are sick, we go to the doctor and we expect him or her to give us something to make us feel better. We expect to be cured. If we went home with nothing, we would feel cheated. Now that America believes that behavioral problems are diseases—brain disorders and chemical imbalances—when Americans go to a mental health professional they expect to be given something that will cure them. Doctors are more than willing to oblige. Many give amphetamines prescriptions for chil- dren based merely on one 15-minute consultation with parents (Diller, 1998). Patients and parents may feel cheated if instead of being given pills to “cure” the problem they were given homework exercises and firm advice on systematic, consistent, large-scale changes in their daily lives that may be necessary in order to live with and manage the behav- ioral difficulty. Given the desire for an easy, immediate quick fix, many reject the behavioral approach and seek out someone who will give them drugs. But the drug “quick fix” is a delusion, because for many psychological difficulties, behavioral treatments will produce beneficial results faster than drug treatment will. For many real diseases—strep throat, flu, bacterial infections—vac- cines can prevent or drugs can permanently treat, if not cure, the illnesses.