Speak No Evil?

Fifty years ago, Marie Jahoda shared with me her insight that most mental disorders are learned patterns of disturbed interpersonal (and intrapersonal) feelings and behavior. If they are learned, she said, they can be unlearned (psychotherapy), and they might be prevented by arranging the social world of infants and children in ways that maximize their self-esteem and interpersonal skills in a strong community support system. The problem with implementing this straightforward preventive model is that it threatens the existing status quo that supports human exploitation, social class and gender inequality, and imbedded beliefs about racial superiority and inferiority. We live in a society driven by corporate-inspired political conservatism, consumerism, patriarchy, and corrupt exploitative power systems. To accept a social learning model of mental disorders and their prevention would challenge this whole exploitative economic structure. The system prefers a social—Darwinian model that stresses genetic brain defects.

Perla (1997, this issue) calls for more public visibility for prevention programs. We must learn social marketing principles, he says, and he gives as an example the pro bono efforts of the National Advertising Council. Unfortunately, this group has been responsible for the endless series of television advertisements that proclaim the fiction that, "All mental disorders are medical diseases." They also parrot the proclamation of the National Institute of Mental Health that during the "Decade of the Brain," the 1990s, researchers will find the brain diseases responsible for most mental disorders. Clearly not everyone has learned that the ruling ideas of a society are those that support the status quo. Many effective prevention programs are controversial. When California Governor Jerry Brown tried to run a series of public service television ads to discourage young people from drinking wine, the threats of the wine industry to withhold campaign contributions (or give them to an opponent) effectively killed the proposed campaign.

O'Brien and Cox (1997, this issue) are highly critical of me for urging "what effectively amounts to a political agenda masquerading as science" (p. 1142). Psychologists should be "neutral in scientific inquiry" (p. 1142). There must be a fire wall between science and politics, they say. Yet elsewhere in their comment, they approve expanding educational opportunities for children suffering violence and abuse and for underfunded schools in depressed neighborhoods–"a top priority" (p. 1142). Is this inconsistent?

A wide variety of scientific groups is heavily into political advocacy. Those who urge more funds for particle accelerators, for telescopes in space, for programs for HIV prevention, for mapping genes, for fluoridization, for environmental protection, and so on (the list is enormous) are not constrained by a fire wall. Why should preventionists be singled out? Is it because our data suggest changes in the social forces that perpetuate inequality and exploitation? Is it because some prevention programs offend the delicate sensitivities of the sexually repressed? Efforts at the prevention of AIDS (i.e., HIV infections) may demand a clear knowledge of a variety of common sexual practices outside of not only the experience but the imagination of members of the Moral Majority. Indeed, applicants for AIDS prevention research grants are often cautioned to generate grant titles and abstracts that are not sexually inflammatory.

If we discover in our scientific research on the prevention of mental disorders that a high level of stress in a particular group is associated with a high level of emotional disorder, are we allowed to tell politicians, or even the general public, of our findings? May we suggest to politicians ways to reduce stress, like providing jobs for the involuntarily unemployed? If we discover that full-term babies who are born wanted are at much lower risk for later mental morbidity than premature babies who are born unwanted, can we recommend social policies that encourage the former and discourage the latter? May social scientists oppose slavery? (The World Federation for Mental Health has a committee that opposes the enslavement and sexual exploitation of girls.) May we urge an end to the genital mutilation of millions of girls if our research shows this to be a risk factor for mental disorders? Or should we not question religious and culturally induced pain and stress? Is it too political?

Perhaps it will be a comfort to millions of children who live in poverty and despair to learn that 80% of American millionaires made their fortunes rather than inherited them. And that "America's continuing commitment to an ideal of rugged individualism and a meritocracy ... is a political matter quite beyond the scope of science" ( O'Brien & Cox, 1996 , p. 1142).

If we are interested in the prevention of mental—emotional disorders, we must change those social conditions that produce these disorders. In 1974, Kenneth B. Clark wrote, "Any form of rejection, cruelty, and injustice inflicted on any group of human beings by any other group of human beings dehumanizes the victims overtly and in more subtle ways dehumanizes the perpetrators"(p. 144). So we know what to change.

I confess to advocating public policy changes (on the basis of scientific research) to increase social equality and to reduce the stresses of racism, sexism, ageism, and homophobia that lead to emotional distress ( Albee, 1982 ). I am in good company ( Albee, Bond, & Monsey, 1992 ; Joffe & Albee 1981 ; Ryan, 1981 ). Many of the programs proposed in these books are opposed by defenders of the status quo and by proponents of "value-free" science.

Correspondence may be addressed to George W. Albee, 7157 Longboat Drive North, Longboat Key, FL, 34228.