America – so the song says – is the land of the free and home of the brave. It does not always feel that way. Last week the Food and Drug Administration said it would regulate e-cigarettes like normal tobacco. This is in spite of the fact there is no proof it leads people on to the real ones. Quite the reverse – the whole point is to help people kick the habit. Chicago, Boston and Los Angeles have gone further and banned e-cigarettes in public places. There is no evidence their vapour causes harm to users or bystanders. The sight of it alone is apparently offensive enough.
The US has always struggled between its impulse for freedom and a Calvinistic urge to meddle. The pendulum in early 21st-century America is swinging back to intrusion. Whether it is workplace safety, traffic, public health or social behaviour, there is a creeping impulse to micro-regulate.
Far from the freedom of the open road, today’s US offers a spider’s web of local and federal rules. Fancy bicycling without a helmet or unleashing your dog? Or perhaps opening a can of beer on the beach? There is an ordinance forbidding it. New York is trying to ban 16-ounce soda. Singapore’s Lee Kuan Yew would not feel out of place in Rahm Emanuel’s Chicago. Sugar is the new tobacco, we are told. How soon before we get to caffeine?
The fashion for paternalism is driven by a growing culture of conformity. Some of it is driven by demand. More than three generations after the Great Depression and the second world war, and almost two generations after Vietnam, there are few Americans alive who remember how hard life once was. Words such as thrift and rugged have dropped from everyday speech. People’s understanding of what is risky has expanded sharply while their resilience to setbacks has fallen. University administrators talk about “tea cup” students, who are so fragile they shatter easily. College freshers are so used to getting pass grades in high school for mediocre work many cannot handle the shock of accurate marking. Almost half of US college students fail to complete four-year degrees in six years.
Some of it is also driven by supply. In a labour market, where people are increasingly competing with machines for jobs, there is waning tolerance for antisocial behaviour. Employers routinely scrutinise an applicant’s online history, as well as conducting the more traditional drug tests and criminal checks. Daniel Patrick Moynihan, the great US senator, once complained that America was “defining deviancy down”. That trend has gone full throttle into reverse.
Hordes of American children apparently now suffer from some kind of mental condition. Ten per cent are diagnosed with attention deficit disorder – triple the level of 20 years ago. Many such diagnoses are surely authentic. And perhaps ADD used to be underreported. But it is hard to believe it has suddenly taken off. There was a time when chronic fidgeting in class got you detention. Now it is medicated with Ritalin. In 1992, one in 500 American children were diagnosed as autistic. Now it is one in 68. Prescriptions have rocketed.
The same applies to adults. Last year the American Psychiatric Association produced its latest Diagnostic Manual of Statistical and Mental Disorders – DSM5, as it is known. It is the psychiatrist’s bible. Among the recent conditions is Social Anxiety Disorder – otherwise known as shyness. Twelve per cent of Americans get SAD at some point, for which the helpful folk at GlaxoSmithKline prescribe Paxil. Other disorders include “hypersex”, “hoarding” and “bereavement”. Some psychiatrists believe there is an epidemic of anxiety in the US. That may be so – life can be stressful in the internet age. Far more likely, however, is an outbreak of diagnostic inflation.
Some of it can be blamed on the drugs companies, who bombard doctors with freebies. They also advertise directly to teachers and parents. But a great deal can be blamed on the widely held belief that every wayward emotion is the result of some chemical imbalance – and can thus be reversed by medication.
Many Americans – and not just those who support the Tea Party – chafe against suffocating regulations and the trend to “polypharmacy”. “Liberty or death” is a patriotic rallying cry. “Don’t tread on me” is another. Among the millennial generation there is rising support for libertarianism. And among Americans of all age groups there is growing support for gay marriage, legalised cannabis and even atheism. Freedom is a paradox. There are parts of America where it is difficult to smoke anything except for marijuana.
But the march of liberty is not a one-way street. Beneath the battles against racism and for sexual freedom, there is a deeper pull to conformity. What may once have been seen as eccentric is now liable to penalty, or prescription. Allen J Frances, a leading critic of DSM5, who headed the task force that produced an earlier manual, puts it well: “We are homogenising our crops and homogenising our people. Big Pharma [is] pursuing a parallel attempt to create its own brand of human monoculture.”
Compared with many democracies, America no longer feels unusually free. Psychiatrists keep turning up new forms of “dysregulated” behaviour. Legislators keep drafting regulations to address them. People’s tolerance of disorder is falling, as is their resilience to shock. Feeling unusually human today? There is a pill for that. There might even be a law against it.
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