Medications & Psychiatry

 email page    print page

All Topic Reviews
Psychiatry Under the InfluenceAlternatives Beyond PsychiatryAmerican MadnessAmerican PsychosisAn Unquiet MindAntipsychiatryBad PharmaBefore ProzacBetter Than ProzacBiological PsychiatryBipolar, Not So MuchBlack Man in a White CoatBlaming the BrainBrain Science and Psychological DisordersBrainwashedClinical Psychopharmacology Made Ridiculously SimpleComfortably NumbCompassion and Healing in Medicine and SocietyComplete Mental HealthConcise Guide to PsychopharmacologyCrackedCritical PsychiatryCultural FormulationDeconstructing PsychosisDemystifying PsychiatryDiagnosing the Diagnostic and Statistical Manual of Mental DisordersDiagnosis: SchizophreniaDiagnostic Issues in Depression and Generalized Anxiety DisorderDimensional Models of Personality DisordersDisordered Personalities and CrimeDoctoring the MindDoctors of DeceptionDrop the Disorder!DruggedDrugs for LifeEmpirical Ethics in PsychiatryEssential PsychopharmacologyEssential Psychopharmacology of Depression and Bipolar DisorderEssentials of Psychiatric DiagnosisEsssential Philosophy of PsychiatryEthics in PsychiatryEvidence-Based Treatment of Personality DysfunctionExercise-Based Interventions for Mental IllnessFinding the Right Psychiatrist:Forces of HabitHandbook of Clinical Psychopharmacology for TherapistsHappy Pills in AmericaHealing the Soul in the Age of the BrainHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHerbs for the MindHigh PriceHippocrates CriedHistory of Psychiatry and Medical PsychologyHookedHuman TrialsInfectious MadnessInspired SleepIntoxicating MindsIs It Me or My Meds?Let Them Eat ProzacLife-Threatening Effects of Antipsychotic DrugsLitLiving with Bipolar DisorderMad in AmericaMad ScienceMalignant SadnessMedicating ChildrenMedicating Modern AmericaMental Health in Asia and the PacificMind FixersMoments of EngagementMommy I'm Still in HereNatural Healing for DepressionNo One Cares About Crazy PeopleNot CrazyOrdinarily WellOur Daily MedsOverdosed AmericaPathologist of the MindPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPharmaceutical FreedomPharmacracyPharmageddonPharmageddonPhilosophical Issues in PharmaceuticsPoets on ProzacPower HerbsPowerful MedicinesPrescriptions for the MindProfits Before People?Prozac and the New AntidepressantsProzac As a Way of LifeProzac BacklashProzac DiaryProzac on the CouchPsychiatric DiagnosisPsychiatric HegemonyPsychiatrists and Traditional HealersPsychiatry and EmpirePsychiatry and the Business of MadnessPsychiatry as Cognitive NeurosciencePsychiatry at a GlancePsychiatry in PrisonsPsychiatry ReconsideredPsychopathyPsychopharmacology Problem SolvingPsychotropic Drug Prescriber's Survival GuidePsychotropic Drugs And Popular CulturePsychotropic Drugs: Fast FactsRaising Generation RxRe-Visioning PsychiatryRecovery from SchizophreniaReligious and Spiritual Issues in Psychiatric DiagnosisRitalin NationRunning on RitalinRutter's Child and Adolescent PsychiatrySaving NormalSchizophreniaShock TherapyShock TherapyShould I Medicate My Child?ShrinksSide EffectsSometimes Amazing Things HappenStraight Talk about Psychiatric Medications for KidsSuccessful PsychopharmacologySuffer the ChildrenTaking America Off DrugsTalking Back to ProzacTextbook of Cultural PsychiatryThe $800 Million PillThe Age of AnxietyThe Anti-Depressant Fact BookThe Antidepressant EraThe Antidepressant SolutionThe Antidepressant Survival ProgramThe Big FixThe Book of WoeThe Complete Guide to Herbal MedicinesThe Conceptual Evolution of DSM-5The CorrectionsThe Creation of PsychopharmacologyThe Cult of PharmacologyThe Dream DrugstoreThe Emperor's New DrugsThe Essential Guide to Prescription Drugs 2005The Essential Guide to Prescription Drugs 2006The Making of DSM-III®The Medical Model in Mental HealthThe Medicated ChildThe Medication QuestionThe Merck DruggernautThe Mind/Mood Pill BookThe Natural Pharmacist : Natural Health Bible from the Most Trusted Alternative Health Site in the World The Pill BookThe Pill Book Guide to Natural MedicinesThe PlaceboThe Rise and Fall of the Biopsychosocial ModelThe Sedated SocietyThe Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Truth About the Drug CompaniesThe Use and Misuse of Psychiatric DrugsThe World of CaffeineThomas S. SzaszToxic PsychiatryTrouble in MindTry to RememberTry to RememberTwilight of American SanityUnderstanding Physician-Pharmaceutical Industry InteractionsUnhingedVoluntary MadnessWarning: Psychiatry Can Be Hazardous to Your Mental HealthWhat Is Mental Illness?What Psychiatry Left Out of the DSM-5What Works for Whom?Will@epicqwest.comWomen, Madness and MedicineYour Drug May Be Your Problem

Related Topics
Suffer the ChildrenReview - Suffer the Children
The Case against Labeling and Medicating and an Effective Alternative
by Marilyn Wedge
W. W. Norton, 2011
Review by Shannon M. Bernard-Adams and Marcus P. Adams
Feb 14th 2012 (Volume 16, Issue 7)

Marilyn Wedge has provided an excellent resource for clinicians and parents. Her book, Suffer the Children, is a tour de force argument against the current trend in American education and psychiatry which assumes that children with behavioral difficulties will likely require medication. Throughout her argument against this trend, she provides positive support for the alternative treatment that she is recommending--strategic child-focused family therapy. This support comes by way of numerous case studies drawn from her years of clinical practice; perhaps the greatest virtue of the book is the large number of case studies that she provides for the reader.

In this review, we will highlight some of the book's features that recommend it to clinicians and concerned parents. In chapter 1, Wedge describes the current situation in child psychiatry and discusses some of the trends in family systems therapy since the 1970s. She questions the trend in child psychiatry to label emotional or social disorders as "brain diseases." She argues that medicating in many situations might appear to be a "quick fix," but often medicating a child causes unforeseen side-effects or other negative consequences.

Furthermore, Wedge argues that many so-called "disorders" with which children are diagnosed are most likely related children's family environments: "[…] instead of giving them a label or a diagnosis, I view children's symptoms--unhappiness, jumpiness, moodiness, suicidal thoughts--not as signs of a 'psychiatric disorder' but as evidence of something wrong in the family, something that I can remedy with the right interventions" (p. 2). The right intervention for Wedge is not merely to substitute talk therapy for medication; it involves working with a child's entire family and incorporating a child's teachers, friends, and others. It is a more holistic approach.

In chapter 2, Wedge illustrates how her recommended alternative framework, strategic child-focused family therapy, approaches issues in a dramatically different way. To do so, she works through a few case studies from her own practice. Among these cases is the example of a seven year old child named Paolo. Paolo was having difficulty paying attention in class and was also disruptive (p. 32). Paolo's teacher had recommended that he be evaluated for ADHD. After meeting with Paolo, Wedge determined that he did not display any signs of ADHD; however, since he had moved to the US at age 4 from the Philippines, she thought that he might be having difficulty comprehending English. After Paolo had been in an after-school program for reading comprehension and after he had been seeing his school's reading specialist, he still had difficulty in class. His teacher then suggested that he be reevaluated, this time for autism.

When Wedge observed no signs of autism, she began to be pressured to give some sort of diagnosis to Paolo: "The school counselor was pressing me for a diagnosis of ADHD, ODD (oppositional defiant disorder), or even autism" (p. 34). Wedge remained unconvinced that Paolo had any of these disorders, and so she sent him to a pediatrician. In the end it turned out that his eyesight needed to be corrected, and a pair of glasses took care of the issue. The worry with this situation was the assumption on the part of the teacher and the school counselor that there must be something wrong with Paolo that could be corrected with medication. Wedge argues that strategic child-focused family therapy provides an alternative starting point: "Working within the frame of strategic child-focused family therapy, I approached Paolo's problems without the preconception that he had a mental illness" (p. 36). Given the stigma that can surround the diagnosis of a disorder, as well as the myriad side-effects that can result from believing that one has a disorder, it seems that avoiding having such a preconception is well worth it.

At some points it is difficult to determine Wedge's general viewpoint on prescribing medication to children for behavioral difficulties. Sometimes it seems like Wedge is not completely against the use of medication for the treatment of children. Chapter 7 focuses on two cases where children were administered medication and improved somewhat. One of the cases she discusses is the case of Matt; Matt was having difficulty performing in school. His parents were resistant to having medication prescribed for their son, so Wedge began to treat his family. The parents responded somewhat well to therapy, but Matt did not improve. Finally, his parents decided to have Matt treated by a psychiatrist for ADHD with medication and discontinued family therapy; soon his performance improved in school.  Unfortunately, Matt had other difficulties that arose after he began taking medication, such as weight loss and difficulty sleeping. So Wedge contends that medication in Matt's case was a mere "band-aid" which helped only his performance in school but which did not treat other problems that resulted from dysfunctions at the family level, since his family stopped participating in therapy (p. 175).

Chapter 9 is a wide-ranging chapter, dealing with issues ranging from current debates in psychiatry over classification in the forthcoming publication of the Diagnostic and Statistical Manual (DSM) by the American Psychiatric Association to issues in the history of psychiatry such as the so-called "moral treatment" of 19th century French physician Philippe Pinel. Wedge is keen to criticize the current way in which the disorders in the DSM are classified, according to what she calls "classification by [the] consensus" of DSM panelists (p. 205). She contrasts this method of classification with one that would classify according to biological causes. However, it's not clear that this is entirely fair to the DSM panelists. After all, it is not mere consensus of a group of panelists that determines whether a disorder will be included or not; instead, for a given disorder there is a cluster of symptoms which are determined, and then the diagnostic criteria for that disorder are tested to determine their validity and predictive power. While Wedge is certainly correct to draw her reader's attention to the fact that the vast majority of so-called "mental" disorders are not classified according to some biological cause(s), she has not done justice to the process of classification that the DSM panelists actually undergo (and are currently undergoing as the DSM 5 is being finalized).

Wedge's book has much more of worth for practicing clinicians and for parents than we have discussed. Her argument encourages an overall caution in medicating children for behavioral difficulties. The force of her argument suggests that psychiatrists and family care physicians should be much more hesitant to prescribe medication than many currently are.


© 2012 by Shannon M. Bernard-Adams and Marcus P. Adams



Shannon M. Bernard-Adams, M.A. is a community mental health therapist in Pittsburgh, PA. Marcus P. Adams is a Ph.D. candidate in the department of History & Philosophy of Science at the University of Pittsburgh.


Welcome to Metapsychology.

Note that Metapsychology will be moving to a new server in January 2020. We will not put up new reviews during the transition. We thank you for your support and look forward to coming back with a revised format.

We feature over 8300 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than twenty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from for purchases through this site, which helps us send review copies to reviewers. Please support us by making your purchases through our Amazon links. We thank you for your support!

Join our Google Group!

Interested in becoming a book reviewer for Metapsychology? To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716