Friday, April 01, 2005

A Turbocharged America with a Psychiatric Problem?

American Mania: When More Is Not Enough

By: Donald Calne, D.Sc.



Peter Whybrow, M.D., professor of psychiatry and biobehavioral science at the University of California, Los Angeles, writes well, and his new book American Mania: When More Is Not Enough is easy to read. The dust jacket of the book states that Whybrow “grounds the extraordinary achievements and excessive consumption of the American nation in an understanding of the biology of human craving and the reward system of the brain—offering for the first time a comprehensive physical explanation for the addictive mania of consumerism.” We might expect from this a book focussed on the psychology of human drives, how they arise, how they are satisfied, and how our knowledge of the biochemistry and pharmacology of the brain might allow us to control a national epidemic of abnormal, materialistic motivation. Sadly, such insight, with its important practical implications, proves elusive. 

Whybrow’s thesis is that the United States is building on a philosophical foundation of unbridled self-interest and commercial freedom: 

Supercharged now by a revolution in technology, we have built a dynamic society of tantalizing appeal...We live in a culture in which our acquisitive cravings have been promoted beyond our needs, and the demand and strain, which that craving now inflicts on mind and body, are beginning to exceed the flexibility inherent in our biological heritage. Thus do we promote our own sickness. 

This sickness, according to Whybrow, is mania, which is afflicting the United States, just as it can afflict a person. He considers this problem specific to the United States. “The material wealth and the abundant choice available in contemporary U.S. society are unique in human experience.” Both the affluence and the consequent problems derive, in Whybrow’s opinion, from the aggressive, competitive, risk-taking temperament of the immigrants who built the country. The excessive pleasure-seeking behavior that results is driven by pathways in the brain, recently investigated in animals, that use the neurotransmitter dopamine—the same pathways that are engaged in addictive behavior with such substances as cocaine. 

This all sounds plausible, and nobody could argue with some of Whybrow’s examples of decadence arising from having too much: 

The scandals that came to light in the aftermath of the telecommunications bubble, surrounding the leadership of Enron, Global Crossing, and other corporate giants drew public attention and much indignation. But these stories were just the flotsam on a current that now runs broad and deep in America’s business culture. As an example, in 2003 Richard Grasso, the chairman of the New York Stock Exchange, resigned after it was revealed that he was to receive $188 million in accumulated benefits. 

Other corporate executives, some sports celebrities, and many entertainers also receive incomes that most of us would regard as excessive, sometimes obscene. Here Whybrow is on a firm footing in his attack on present-day American society. 


Let us look at his wider arguments. He frequently uses the terms “Fast New World,” “turbocharged,” and “unprecedented” in his description of how Americans acquire wealth through the use of new technologies. But should we not make use of advancing technology? Progress is real and inevitable with the passage of time—we have faster runners, faster transportation, and faster communication. What would happen to a society that chose to ignore developments that, among other things, have given us greater food production, increased ability to keep warm in cold climates, a revolutionary reduction in child mortality, and notable advances in the manufacturing of essential items such as clothing? Progress, whether we like it or not, is bound to occur in a free world. Discoveries are not all bad, and, in my opinion as a Canadian, Americans should be proud that the United States wins more Nobel Prizes than any other country. 

If we accept the irrefutable fact that advances in science and technology allow more access to information, longer life expectancy, and more people to exist on our planet, then many aspects of the modern world are, and must be, unprecedented. This has no moral implications. Of course, some discoveries will be put to what most of us regard as bad use, but this is not the fault of the discovery. The challenge of how to apply new information is not a new one. When our prehistoric ancestors discovered fire, it was useful for cooking, but it was not so welcome when hordes of hostile invaders torched their villages. In a more modern setting, bacteriology has given us immunization, but it also gave us weaponized anthrax. 


Whybrow’s book is critical of commerce and, in particular, commercial competition. But commerce is not an American invention, and competition is an inherent feature of commerce. Improvements in travel and higher levels of education in developing countries must lead to globalization, another feature of the 21st century that Whybrow dislikes and blames on the United States. He quotes, with apparent approval, the French antiglobalization activist José Bové. “Today, money works by itself,” says Bové, emphatically. “This has produced a new species of parasite: vampires thirsty for money. We reject the global model dictated by the American multinationals. The world is not for sale.” 

These statements seem rather paranoid. We can rent almost anything, from a house to a tuxedo, so what is wrong with renting money—Bové’s “money working by itself”? Financial compensation for financial investment is at the ancient root of capitalism, so what is Bové saying? It sounds Marxist to me. He is, of course, entitled to a Marxist viewpoint, but he professes to be an apolitical little Frenchman hurt by American big business and, in particular, by American globalization. I am a neurologist—not a politician or a sociologist—and from my possibly naive viewpoint I find it difficult to see what is so morally reprehensible about globalization. 

Globalization comes under forceful attack in Whybrow’s book, but is there not something chauvinistic about protesters who rally to the antiglobalization call? Globalization is the redistribution of corporations to maximize efficiency, which may mean relocation of industry to distant and often economically disadvantaged countries. The purpose of the redistribution of effort is to cut costs. This, in turn, means that jobs are lost from the “have” countries and gained by the “have not” countries. It also means that the products are cheaper than they would have been if they were made in developed countries, and this means that more people can buy them. It is not clear why the transfer of jobs to poorer countries is morally bad; indeed, the economic gain to developing countries may reasonably be regarded as good. Of course, the multinational corporations may increase their profit through globalization, but why is profit, per se, bad? This brings us to what is perhaps the essence of Whybrow’s book.


Whybrow attacks the pursuit of money and spends much time in showing us that acquiring money—which the American public, he says, mistakenly thinks equates with achieving happiness—does not, in fact, bring happiness. He argues that “One thing is clear: the pursuit of happiness through the accumulation of material wealth is proving to be a blind alley.” But it seems pretty obvious that riches have never been tied to happiness. Any casual observer sees newspaper reports of wealthy people engaged in alcoholic excess (or even more destructive addictions), sexual scandals, divorces, mental breakdowns, and even suicides. 

There is, of course, the question of why people who have made more money than they can ever spend continue on the treadmill. A simple answer can be found by drawing an analogy with other competitive activities such as sports. The leaders in professional golf tournaments do not retire after winning a few main tournaments; they continue attempting to show they can beat their competitors, because this is what sport —and commerce—is all about. Is sport bad because it is competitive? 

Whybrow uses discussions with patients and friends to support his arguments. He has one of these discussions over a luncheon with “Tom” at New York City’s legendary Algonquin Hotel. From considering the Fast New World too hectic to be enjoyed, the talk moves to examining the nature of happiness. 

“Happiness and pleasure, I’ve decided, are entirely different beasts,” Tom said, raising his glass in a mock salute, “So here’s to pleasure, of the two it’s by far the more attainable...What is happiness?” Tom had asked rhetorically...happiness, he had concluded, emerged from balance, from finding harmonious fit with one’s circumstances. Later, Tom says “Pleasure has something to do with external reward and the dopamine circuits but not so happiness. Happiness cannot be pursued. Happiness is something that wells up from inside.” 

Later, Whybrow agrees with Tom, emphasizing the happiness to be found in the companionship of friends and family. 

The question of how to define happiness is worth pursuing. The Oxford Concise Dictionary defines “happy” as “lucky, fortunate; contented with one’s lot.” It is clear that the concept of happiness is elusive, so I used Whybrow’s technique of seeking the opinion of others. At a recent meeting of neuroscience researchers, I was dining with two neurologists, two psychologists, and a school teacher. (Whybrow also uses this “committee” approach.) One psychologist said he obtained happiness from attaining something difficult, such as making a discovery in his field of research. A neurologist agreed in principle but gave an example of hitting a good golf shot. The teacher said that she found happiness in seeing a slow student spell a word correctly for the first time. The second psychologist said he did not think that pleasure and happiness can be separated. I would conclude that happiness means different things to different people, but included somewhere in the concept is the possibility that success in a difficult business venture may lead to happiness from mastering a challenging task, rather than from achieving financial gain. 

Whybrow draws on his background in biobehavioral science to explain that human addictions use dopaminergic pathways within the brain. He may well be correct in arguing that the drive to make money engages these same pathways, but where does this lead us? The dopaminergic pathways to which Whybrow refers are used in motivation for activities such as seeking food and drink; in fact, dopamine seems to be involved whenever a “reward” is expected in experimental animals. Although more difficult to study in human subjects, there is good evidence that dopamine is released when we take a medication with an expectation that it will help us—the “placebo” effect. 

Whybrow does not provide any real exploration of the biology of dopamine, such as its depletion in Parkinson’s disease or its overactivity in schizophrenia. He simply infers that, because dopamine plays a role in addictive behavior, it is likely to be involved in the drive to make money. Because dopamine is likely to be involved in most if not all drives, the suggestion that it is released when people make money is not particularly informative. 

What is the function of dopamine and other neurotransmitters in social satiety? Can we modify the setting at which we feel satisfied when seeking social goals? If so, how? I would like to have seen much more discussion of the biology of happiness and pleasure. Whybrow’s subtitle is When More Is Not Enough. Is there any such thing as “enough” when it comes to seeking social goals? If the answer to this question is “no,” then nothing is ever enough. If the answer is “yes,” then there must be some way of knowing when we are satiated—just as there is for biological drives such as eating and drinking. What is the function of dopamine and other neurotransmitters in social satiety? Can we modify the setting at which we feel satisfied when seeking social goals? If so, how? To me, these are fascinating and important questions that I had expected would be discussed in American Mania


For Whybrow, American materialism is ugly. But let us spend a moment looking at the history of some nonmaterialistic ideologies. The earliest ideology, and no doubt the most influential, is religion. Compared with the alleged aggressive commercial ideology of the United States, the track record of militant religion has been decidedly more destructive. The crusades led to the slaughter of several generations of young men in the name of Christianity or Islam, not to mention the massacre of bystanders such as the Jews. In more recent history, the conflicts between Israel and Palestine, the terrorism in Northern Ireland, and the death of 3,000 New Yorkers on 9/11 show that religion still fuels hatred and murder. Moving from religious to political ideologies, the most appalling mass crimes have been the direct result of political systems of thought: fascism and communism. We know all too well the scale of death and destruction wrought by these ideologies. There is also the age-old ideology of national ascendency that led to the use of military force to carve out empires. 

Whybrow implies that globalization of commerce is a form of American imperialism, but America is hardly alone in this. The Europeans have multinational companies, such as Airbus, Daimler-Chrysler, BMW, Renault, British Petroleum, Shell, HSBC, Unilever, Phillips, Nestlé, Novartis, and Glaxo. The entire Japanese automobile and electronic industries are globalized. 

Commercial ideology has not produced human misery on the scale achieved by any of the dominant ideologies that preceded it. Indeed, far from being a fault in the thinking of the Founding Fathers of the United States, I consider that the plans laid out in the creation of their new nation represent an extraordinarily enlightened response to the challenge of creating a society that would, through democracy and free commerce, avoid the pitfalls of earlier societies. 

Another problem that I encountered in Whybrow’s book was the notion that the frenetically busy, commercially oriented American represents the country as a whole. To characterize the competitive commercial sickness of America, Whybrow takes as an example a mother he observed in a first-class lounge in the Los Angeles airport, torn between calling her daughter and chasing the multitasking demands of her job. She certainly illustrates the problems of high-earning corporate American women, but these are hardly average citizens. To illustrate American consumer excess, he observes how the “64-inch television became the norm.” Well, I frequently visit the United States and have yet to see a 64-inch television. It seems Whybrow is really talking about an elite class of affluent executives and professionals in his own Los Angeles—a class who, throughout the country, must represent less than 2 percent of the population. Although some of these economically privileged people choose to work exceedingly hard, even to an extent that may lead to anxiety, stress, and panic attacks, it seems unreasonable to draw a general conclusion from their lives that American society, as a whole, is sick. 


Whybrow frequently argues in his book that the powerful drive and competitiveness of the United States derives from the immigrant origins of its population and that the excessive industriousness of its citizens is starting to undermine the nation’s psychological health. In a nutshell, people work too hard, which leads to a manic social disequilibrium. I have difficulty with the argument. The Japanese and the Koreans work longer hours than Americans, and neither Japan nor Korea has significant immigrant populations. At the other end of the spectrum, Australia and Canada have populations largely based on immigrants, but as yet these countries have not been accused of displaying an excessive zeal for work. 

Whybrow frequently argues in his book that the powerful drive and competitiveness of the United States derives from the immigrant origins of its population and that the excessive industriousness of its citizens is starting to undermine the nation’s psychological health. 

Whybrow’s view of current U.S. culture, built by immigrants, conjures up the image of a society dominated by ruthless business men and women intent on prevailing in their quest for financial gain through their competitive aggression applied with single-minded selfishness. Such people have existed in the past, and no doubt they still do, but recent studies indicate that they are not the winners in modern commerce. In The Evolution of Cooperation, Robert Axelrod writes: “The key to doing well lies not in overcoming others, but in eliciting their cooperation.” Richard Dawkins argues the same case in the video Nice Guys Finish First.


Whybrow, a psychiatrist, sees excessive materialism in the United States driving people along a treadmill that erodes their enjoyment of leisure and may precipitate anxiety, panic attacks, and manic behavior. He also sees an analogy between people who develop diseases and societies that fail to function smoothly. Similar analogies have been popular over the past 50 years, but they must be viewed with caution. Fundamental differences exist between psychiatry and cultural anthropology. 

Whybrow, a psychiatrist, sees excessive materialism in the United States driving people along a treadmill that erodes their enjoyment of leisure and may precipitate anxiety, panic attacks, and manic behavior. He also sees an analogy between people who develop diseases and societies that fail to function smoothly. 

I find most of Whybrow’s arguments more political than biological, and, although he denies it, he does seem to be somewhat nostalgic for “the good old days.” But the good old days were often not so good at the time. In living memory, the Great Depression, racial segregation, three terrible wars, and a long nuclear arms race cast shadows that put our present difficulties in perspective. Although social problems are undeniably significant in the United States (and elsewhere), it may well be that when our children are old, they will look back on our present world as the good old days. 



From American Mania: When More Is Not Enough by Peter C. Whybrow. © 2005 by Peter C. Whybrow. Reprinted with permission from WW Norton & Company. 

Americans have an astonishing appetite for life. As the nation of bold ideas, big cars, fast food, sky-thrusting cities, and unparalleled military power, America is a monument to the ambition and industry of its people. In the brief span of a few generations the citizens of the United States have created a culture of unprecedented affluence. The Pharaohs were wealthy, as were many citizens of Rome, but neither empire achieved the broad distribution of riches and the seductive prosperity that exist in America today. In fact, the material wealth and the abundant choice available in contemporary U.S. society  are unique in human experience. Never before in the history of our species have so many enjoyed so much. 

This extraordinary accomplishment has brought America to the leading edge of an unusual human experiment. Building on a philosophical foundation of unbridled self-interest and commercial freedom, and supercharged now by a revolution in information technology, we have built a dynamic society of tantalizing appeal. But the resulting mix of technology, affluence, and competitive social challenge that we have created for ourselves is radically different from the natural world in which our species rose to dominance some two hundred thousand years ago. That radical difference in social habitat has fostered a craving and an acquisitive behavior in America that are now testing the limits of our ancestral biology—in mind and in body—and eroding the foundations of our community. In short, in our compulsive drive for more, we are making ourselves sick. How through knowledge of brain sciences we may better understand our acquisitive craving and its impact on the health and happiness of individual citizens, why such an addictive environment should have emerged first in America, and why in seeking a balanced civil society we must revisit the economic principles that now shape the material focus of our yearning are the subjects of this book. 

To want more is a basic human instinct, one that has been essential to our survival. It was our hunger for better things, and the intelligence to imagine them, that gave us mastery over the dangerous and depriving environment in which we evolved, and it was that same hunger that first propelled us forward in the search for a promised land. Having achieved something akin to El Dorado in contemporary American society, however, we now find ourselves in the confusing position of falling victim to our own acquisitive ambition.

This confusion became painfully obvious during the economic boom of the late 1990s, when our appetite for riches and material comfort triggered a competitive frenzy of greed and shortsighted speculation. In the words of George Carlin, the comedian and satirist, America became a land of puzzling contradictions, a nation of “bigger houses but smaller families; more conveniences but less time; wider freeways but narrower view points; taller buildings but shorter tempers; more knowledge but less judgement.” In our relentless search for material wealth, Carlin suggests, Americans have embraced a culture where steep profits and shallow relationships have multiplied our possessions but reduced our social values.

About Cerebrum

Bill Glovin, editor
Carolyn Asbury, Ph.D., consultant

Scientific Advisory Board
Joseph T. Coyle, M.D., Harvard Medical School
Kay Redfield Jamison, Ph.D., The Johns Hopkins University School of Medicine
Pierre J. Magistretti, M.D., Ph.D., University of Lausanne Medical School and Hospital
Helen Mayberg, M.D., Icahn School of Medicine at Mount Sinai 
Bruce S. McEwen, Ph.D., The Rockefeller University
Donald Price, M.D., The Johns Hopkins University School of Medicine
Charles Zorumski, M.D., Washington University School of Medicine

Do you have a comment or question about something you've read in CerebrumContact Cerebrum Now.