Better Than Well: American Medicine Meets the American Dream
by Carl Elliott
“Why are Americans such nervously enthusiastic consumers of Paxil?” asks author Carl Elliott, author of Better Than Well. So begins a Elliott’s questioning of the new American take on health as addressed in this thought-provoking and highly original book-cum-philosophical exploration that addresses America’s love-hate relationship with what Elliott calls ‘enhancement technologies.’
Before “personality,” a word coined in the late eighteenth century, people had “character.” Character was different, Elliot notes, because it “had moral dimensions”: The word personality was more outward, or “bound up with the idea of self-presentation,” he writes. Historian Walter Susman observes, at the turn of the century, self-help books instructed individuals how to develop personality; or as Elliott says, “how to make yourself more interesting and attractive to other people.” Americans started to take on the idea that “we all put on a mask for the world.” The goal was to be “socially successful” – to be a certain way that would facilitate your fitting in. As Elliott notes, “If it isn’t, we have to fake it.” Perhaps “you could transform yourself.” In short, if you didn’t like who you were, you could change it, noting, “there has always been a minor cult of self-improvement in American life.”
This issue of personality became increasingly important in the workplace. Previously, it was worth ethic that mattered. With the advent of the twentieth century, Elliott writes, “advancement depended more and more on interpersonal skills.” Personality had a front seat in American life. No wonder then, that so many turned to drugs and other “enhancement technologies.” It is all part of the social role we must play in order to be successful. As Americans, Elliott posits, “we are highly conscious that these individual characteristics are being observed and judged by others whose good opinion we crave … this is, in part, a matter of, according to Elliott, “American cultural style.”
But how we change ourselves, through technology, surgery, or medication is important because in many cases it “may affect something central to [our] identities.” In a way that is “morally significant.” Still, while solving some problems, some people had trouble with anti-depressants, particularly the SSRIs like Prozac. As Elliot notes, “they no longer experience grief, anxiety of sadness quite so deeply,” and are “unable to call up the appropriate emotional reactions.” To quote one person, Elliot writes, “nothing mattered.”
Writer Ian Penman who took Prozac observed himself, “neutered, frozen, prone, Prozac me.” This “emotional blunting,” as Elliott calls it, is not uncommon or even unexpected. The assumption, Elliott surmises, is that we are dazzling extraverts, “frozen with self-consciousness.” Antidepressants and other drugs simply help us shed our shy, inhibited skin. A fine theory, but what if you are not an extravert at all? What if what is beneath is more of the same? Not all of us have the same “authentic” self. We live in a time when, Elliott points out, “If excessive self-conscious were not bad enough, now we are excessively self conscious about being self-conscious.”
Our desire to alter ourselves is most evident in the cosmetics industry, which began in earnest in the 1920s. “Face painting,” Elliott says “was seen as a kind of deception.” One ethical worry, Elliott notes, about enhancement technologies is the way they can play into racist ideals of beauty: a nose job “hiding your Jewishness.” And Prozac, he says, “hiding your true character.” And another: hair straightener, trying to look white, and so on. There is a pervasive homogenization at work. We want to fit in, and while we cherish our individuality and ethnicity, we crave social acceptance.
Elliott sites a Clairol ad depicting a young blonde woman being “swung around in the air by a handsome man.” The voice over says, “Chances are she’d have gotten the young man anyhow, but you’ll never convince her of that” (from Lady Clairol ad). The goal is to create just enough self-doubt that the consumer will purchase your product or service. Products were pitched not just as a means of self-improvement, but as “vehicles of liberation and self-transformation.” Elliott notes, you are conned into thinking, “I am doing this for me,” by savvy advertisers who have made liberation and self-expression an effective sales pitch.
It was in the fifties that American’s seemed overwhelmed by what Elliott calls, “the anxiety and depression of everyday life.” The drug Miltown was developed for this suburban ennui and the demand, he writes, “exceeded that of any other drug ever marketed in the United States,” notes Elliott. Why, many wondered did such a prosperous nation need a drug to “tolerate ordinariness?”
We are, Elliott says, “Faced with a nagging sense of dissatisfaction about the way we are living our lives.” Suburbs, Elliott observes, become “convenient but soul deadening” and we look to gadgets of all kinds for a quick fix. We turn to psychoactive drugs and other tools (leaf-blowers, mowing machines, big-screen TVs), “We look to Valium, to Prozac,” he contends, instruments “for the relief of boredom.” Soon, he notes, all “we feel is a gap … a vague sense of longing for what has been lost.”
“For intellectuals,” Elliott writes, “ironic detachment has become too familiar a stance.” The problem lies with our under appreciation for what we do have. If it can happen so simply, almost effortlessly, then it can’t be that meaningful is often the prevailing attitude.
The “mystery of American self-consciousness,” remarks Elliott, “is how eighty-four million citizens of a country famous the world over for its brash, open self-confidence could identify themselves as shy.” The “paradox,” Elliott notes, is that, Americans appear on confessional talk-shows, on the Internet, making their shyness and private problems public issues – a circus of self-revelation. Perhaps our sudden ease with our new and manipulated bodies, the right bra-size and hair-color, and Prozac, Paxil, Viagra, and myriad drugs swimming through our veins has been a success after all. To paraphrase Kurt Vonnegut, Elliot notes, if you pretend long enough, you may become what you are pretending to be.