The Myth of Normal

Introduction

Why Normal Is a Myth
(And Why That Matters)

The fact that millions of people share the same vices does not make these vices virtues, the fact that they share so many errors does not make the errors to be truths, and the fact that millions of people share the same forms of mental pathology does not make these people sane.

— Erich Fromm, The Sane Society

In the most health-obsessed society ever, all is not well.

Health and wellness have become a modern fixation. Multibillion-dollar industries bank on people’s ongoing investment—mental and emotional, not to mention financial—in endless quests to eat better, look younger, live longer, or feel livelier, or simply to suffer fewer symptoms. We encounter would-be bombshells of “breaking health news” on magazine covers, TV news stories, omnipresent advertising, and the daily deluge of viral online content, all pushing this or that mode of self-betterment. We do our best to keep up: we take supplements, join yoga studios, serially switch diets, shell out for genetic testing, strategize to prevent cancer or dementia, and seek medical advice or alternative therapies for maladies of the body, psyche, and soul.

And yet our collective health is deteriorating.

What is happening? How are we to understand that in our modern world, at the pinnacle of medical ingenuity and sophistication, we are seeing more and more chronic physical disease as well as afflictions such as mental illness and addiction? Moreover, how is it that we’re not more alarmed, if we notice at all? And how are we to find our way to preventing and healing the many ailments that assail us, even putting aside acute catastrophes such as the COVID-19 pandemic?

As a physician for over three decades, in work ranging from delivering infants to running a palliative care ward, I was always struck by the links between the individual and the social and emotional contexts in which our lives unfold and health or illness ensue. This curiosity, or should I say fascination, led me in time to look deeply into the cutting-edge science that has elegantly delineated such links. My previous books have explored some of these connections as they manifest in particular ailments such as attention deficit hyperactivity disorder (ADHD), cancer and autoimmune disease of all types, and addiction. I have also written about child development, the most decisively formative period of our lives.

This book, The Myth of Normal, sets its sights on something far more encompassing. I have come to believe that behind the entire epidemic of chronic afflictions, mental and physical, that beset our current moment, something is amiss in our culture itself, generating both the rash of ailments we are suffering and, crucially, the ideological blind spots that keep us from seeing our predicament clearly, the better to do something about it. These blind spots—prevalent throughout the culture but endemic to a tragic extent in my own profession—keep us ignorant of the connections that bind our health to our social-emotional lives.

Another way of saying it: chronic illness—mental or physical—is to a large extent a function or feature of the way things are and not a glitch; a consequence of how we live, not a mysterious aberration.

The phrase “a toxic culture” in this book’s subtitle may suggest things like environmental pollutants, so prevalent since the dawn of the industrial age and so antagonistic to human health. From asbestos particles to carbon dioxide run amok, there is indeed no shortage of real, physical toxins in our midst. We could also understand “toxic” in its more contemporary, pop- psychological sense, as in the spread of negativity, distrust, hostility, and polarization that, no question, typify the present socio-political moment.

We can certainly fold these two meanings into our discussion, but I am using “toxic culture” to characterize something even broader and more deeply rooted: the entire context of social structures, belief systems, assumptions, and values that surround us and necessarily pervade every aspect of our lives.

That social life bears upon health is not a new discovery, but the recognition of it has never been more urgent. I see it as the most important and consequential health concern of our current moment, driven by the effects of burgeoning stress, inequality and climate catastrophe, to name a few salient factors. Our concept of well-being must move from the individual to the global in every sense of that word. That is particularly so in this era of globalized capitalism, which, in the words of the cultural historian Morris Berman, has become the “total commercial environment that circumscribes an entire mental world.” Given the mind-body unity to be highlighted in this book, I would add that it constitutes a total physiological environment as well.

It is my contention that by its very nature our social and economic culture generates chronic stressors that undermine well-being in the most serious of ways, as they have done with increasing force over the past several decades.

Here’s an analogy I find helpful. In a laboratory, a culture is a biochemical broth custom- made to promote the development of this or that organism. Assuming the microbes in question start out with a clean bill of health and genetic fitness, a suitable and well- maintained culture should allow for their happy, healthy growth and proliferation. If the same organisms begin showing pathologies at unprecedented rates, or fail to thrive, it’s either because the culture has become contaminated or because it was the wrong mixture in the first place. Whichever the case, we could rightly call this a toxic culture—unsuitable for the creatures it is meant to support. Or worse: dangerous to their existence. It is the same with human societies. As the broadcaster, activist, and author Thom Hartmann asserts, “Culture can be healthy or toxic, nurturing or murderous.”

From a wellness perspective, our current culture, viewed as a laboratory experiment, is an ever-more globalized demonstration of what can go awry. Amid spectacular economic, technological, and medical resources, it induces countless humans to suffer illness born of stress, ignorance, inequality, environmental degradation, climate change, poverty, and social isolation. It allows millions to die prematurely of diseases we know how to prevent or of deprivations we have more than enough resources to eliminate.

In the United States, the richest country in history and the epicentre of the globalized economic system, 60 percent of adults have a chronic disorder such as high blood pressure or diabetes, and over 40 percent have two or more such conditions. Nearly 70 percent of Americans are on at least one prescription drug; more than half take two. In my own country, Canada, up to half of all baby boomers are on track for hypertension within a few years if current trends continue. Among women there is a disproportionate elevation in diagnoses of potentially disabling autoimmune conditions like multiple sclerosis (MS). Among the young, non-smoking-related cancers seem to be on the rise. Rates of obesity, along with the multiple health risks it poses, are going up in many countries, including in Canada, Australia, and notably the United States, where over 30 percent of the adult population meet the criteria. Recently Mexico has surpassed its northern neighbor in that unenviable category, with the result that thirty-eight Mexicans are diagnosed with diabetes every hour. Thanks to globalization, Asia is catching up. “China has entered the era of obesity,” Ji Chengye, a child health researcher in Beijing, reported. “The speed of growth is shocking.”