The Subject of Lacan: A Lacanian Reader for Psychologists

16 Why Do People Take Prozac? Anxiety, Symptom, and the Inhibition of Responsibility

279 1 6 Why Do People Take Prozac? Anxiety, Symptom, and the Inhibition of Responsibility Patricia Gherovici When we consider how in our present unpsychological epoch neuroses appear in a hypochondriacal guise, masked as organic diseases, we need not to be surprised to find the neuroses of olden times masquerading in a demonological shape. —Freud T his paper explores the wide appeal Prozac holds for middleclass Anglo-Saxon patients and contrasts the appeal of Prozac with a marked preference of Xanax among the Puerto Rican low-income population in the North Philadelphia Hispanic ghetto. The author wishes to thank Michael Plastow for his helpful comments. This piece is dedicated to the memory of Henri Paul, who died behind the wheel. 32582 Chap 16 4/18/00, 9:34 AM 279 280 Patricia Gherovici The stories of two patients, Emily and Margarita, raise serious questions about the promotion of mood regulation by a chemical intervention. Both treatments resemble the iatrogenic induction of addiction to illegal drugs in their structure. The extensive use of chemicals as an answer to social and psychological difficulties has been critically assessed from a number of perspectives. The following examines quite precisely the intersection between the social and psychological that is “covered over” by popular medical treatments to “psychiatric” problems. But rather than treating medication merely as a form of social control or as biological reductionism, this chapter will invoke the Lacanian idea of subjectivity as the pivot from which we can understand the more pernicious effects of contemporary psychiatric solutions such as Prozac. I use the Lacanian concept of subjectivity to contrast psychopharmacological treatment with the effort to promote meaningful change through a particular use of speech, according to a process that is a hallmark of psychoanalysis. Subjectivity transcends common assumptions about the significance of cultural and class differences for clinical practice. For Lacan, the word subject is significant in psychoanalysis because it implies not just an individual but a person who is subjected , that is, divided by his or her unconscious, coming into being through castration, and entering into a social universe ruled by desire and difference. My use of subjectivity also suggests that the race, class, and culture of patients must relate to their singularity and specificity as individual human beings. “Listening to Prozac,” Once More Emily, a writer in her mid–thirties, came to see me because she was depressed. She had been in therapy before, but this time, she said, she was taking the medication prescribed by her family doctor , Prozac. Emily declared that the effect of Prozac on her depression had not been remarkable. Although she accepted her doctor’s prescription, she had not freed herself of the signs and symptoms of depression that made her begin this medication. She still considered herself depressed while stating that she “no longer cares,” “she is not concerned any more.” However, in spite of her recurring depression, she felt that she was more productive now, could concentrate on her work while being less severely critical of herself. Her frequent writer’s blocks had disappeared, and she paid less attention to what others thought of her. 32582 Chap 16 4/18/00, 9:34 AM 280 Why Do People Take Prozac? 281 What was she taking the well-known antidepressant for? Was she perhaps trying to obtain what the famous Prozac advocate Peter Kramer (1993) claims is one of the major responses to the medication ? Did Emily take Prozac for its purported qualities as a life enhancer, to “feel better than well?” Not precisely. The fact that Emily was “not feeling well but . . . no longer feeling it,” as she put it, seemed to be an attempt not at solving her current conflicts but a way to stop caring about conflict in her life. She said that she only came to see an analyst because a good friend of hers insisted upon it. In Talking Back to Prozac, Peter and Ginger Ross Breggin (1994) describe the reasons that Prozac became the most widely prescribed psychiatric drug. They believe that nearly everyone now knows a person who is taking Prozac, and they foresee a growing escalation in the consumption of Prozac. The Breggins contend that Prozac entered a new phase with the publication of Kramer’s (1993) bestseller , Listening to Prozac, becoming the drug that people who consider themselves normal take to enhance their lives. Although pharmaceutical companies have...