Friday, December 30, 2011

A Response to Dr. Weil...

A review of Dr. Andrew Weil's: Spontaneous Happiness

I always enjoy Dr. Weil. I've heard him speak and have had some contact with the Integrative Program that seems to be his legacy. All of this is real, compassionate and makes sense. I also am a Registered Nurse and have been working in the Mental Health field for twenty years.

I found his chapter on the prevalence (and causes of) depression within our society interesting. I especially resonate with his descriptions of the lack of connection to good old fashioned "hard work" and being outside. Bravo! His discussion of alternatives is good. Especially his advocacy of the use of Fish Oil, Vitamin D and the B vitamins. Common sense!

There are a few things that bother me about Dr. Weil. I write these things as a fan of the man. A person who respects him and the work he does.

1. I'm not too enamored with the cult of personality surrounding the guy. Yes, I know that branding helps sell books. But does he really have to display his cherubic, monster bearded face on every book he writes? And must he really have a corporation attached to his name and his ideology?

2. Footnotes please! Yes, he states you can go on-line to get more information. And there is a short end note section. The bibliography is quite deficient for further reading. The book is written for a lay audience, but that doesn't mean that we can't have a bit more intellectual rigor attached to his claims.

3. Culturally, this book comes from the White, Enviro, Suburban, BMW driving class. The book is written from, and for, the upper ends of the socio-economic ladder. Poverty is the number one predictor and cause of mental illness. There is no discussion of that in this book, with the exception to maybe glorify the hard life we used to have when we all farmed.

4. He relies too much on anecdotal evidence. I found all the letters to him tireseome. And it seemed like these letters were written from the same sorts of people that I talked about in my critique above.

5. Where are the nurses? Dr. Weil doesn't mention one nurse as an expert through out his entire book. The fact is that nursing has been way ahead of even Dr. Weil in their advocacy of the reforms he mentions. In fact, nurses have been quicker to adopt such reforms than the AMA. The Wholistic Nurses Association has been around for 35 years. Nurses have re-invented the therapeutic touch movement---with no mention of that from Dr. Weil. Dr. Weil quotes pharmacists, MD's, LCSW's, psychologists, psychiatrists---but never does he mention a nurse who is an expert. He does cite one nurse who had retired to Sweden. This letter was written not as an expert, but as a client. In short, there is a hierarchical chauvinism present in Dr. Weil's writing that discounts the talents and skills of nurses. This is a systemic problem within the health care establishment. My rule of thumb is, if you really want to know what is going on with your patient, ask an experienced nurse who is taking care of the client. You'll get better and more useful information.

6. Dr. Weil's view of anti-depressants is contradictory. He cites a study that states that SSRI's are junk; later in the book he cites evidence that people should not go off of anti-depressants. He seems to think that anti-depressants should only be used for severe depression. My view is that anti-depressants are helpful, but should be used in tandem with all the things he talks about---and even more.

But my number one critique would be that he never mentions that poverty is the number one predictor and cause of mental illness.

In short, this book is a good first attempt at reforming our mental health system. Ending poverty would do more to reduce severe mental illness in our society. Also ending the stigma of mental illness to the point where it has less unappealing stereotypes to it. If Schizophrenia was seen the same way that Grave's Disease is, then we would have made progress.Ending poverty; ending stigma: accomplish those items and then we could go along with these more natural reforms that are intended for a more narrow, less severe dysthymic disorders.

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