An interdisciplinary collaboration between the Faculties of Arts and Medicine & Health at the University of Leeds
The Centre for Medical Humanities at the University of Leeds opened officially on 20 February 2012. The opening was chaired by Stuart Murray, Professor of Contemporary Literatures and Film and Director of the Centre. The Vice-Chancellor, Michael Arthur, introduced the event and special guest speaker Lennard Davis, from the University of Illinois at Chicago, gave a paper on “Depression and Disability.”
Arthur praised the centre as a model initiative for the university, drawing from different existing pools of research and expertise, and intercalating disciplines previously operating in isolation. He also noted that the centre provided an opportunity for the university to work with other Leeds-based bodies, in both health and the arts.
Murray gave a brief account of the rationale behind the centre and the developing discipline (or inter-disciplinary space) of medical humanities. He acknowledged that medical humanities currently occupies a peculiar place in the consciousness of the academy: simultaneously felt to be very relevant and very nebulous. For medical humanities to come to an understanding of what it actually is, or might be, rightly constitutes a central component of the discipline’s mission. In thanking the University of Leeds for its support and faith in establishing the centre, Murray also detailed some of the work in which the centre had already been engaged, and touched on upcoming events, including the following day’s workshop with staff from the University of Hong Kong.
Davis then presented his paper, the central argument being an interrogation of the science and assumptions supporting the medical disease model of depression, a model that has gained considerable currency over the past half century. Providing a brief cultural and medical history of both the term and the condition, he argued against the existence of a discrete disease entity called depression. Further, he suggested that the current diagnostic categories of major depressive disorder and major depressive episode were swallowing up a significant part of the human phenomenological experience, medicalizing a portion of the common emotional range. Noting the imminent arrival of the next expansive version of the DSM, he asserted that a nonsensically high pro- portion of the population was fated to be defined as disabled by depression.
Davis quoted two recent meta-studies and drew at length from research by Irving Kirsch to make the argument that both depression’s nosological status as a brain illness and the curative properties of selective serotonin reuptake inhibitors (SSRIs) were, at best, unproven and, at worst, bunkum. In particu- lar, Davis’s suggestion that SSRIs were little more than antihistamines in long white coats provoked considerable discussion in the subsequent Q&A session, at the following reception, and—no doubt—in correspondence and discussion between attendees for some time after the launch.
If Davis presented the problem of depression as a construct of what he referred to as Big Pharma, he clearly positioned the condition’s solution as social. Although it might, as he remarked, “take a village to make someone depressed”—delineating a shared concept of how any given individual ought to feel, creating the conditions that might cause an individual’s feelings to fall outside that definition, and then providing the public recognition of this mis-match—collectives and communities also potentially hold the key to preventing depression (whether defined according to the “broken brain” medical model or not) from becoming a disability epidemic. He argued that public accept- ance of what might be termed depressive phenomenology, coupled with activist groups such as Mind Freedom International, could restrict the social and med- ical weight of depression, in effect maintaining the illness at the level of a mood impairment, with society accommodating rather than disabling those affected.
Davis appeared to be drawing on two different paradigms: explicitly, he referenced the social model, whereby the individual has an impairment and society constructs the disability; implicitly, there were parallels with the LGBT rights movement. Rightly, he noted that it is in the gift of society to ensure that individuals enjoy equality of opportunity, experience, respect, legal protection, autonomy, and access regardless of any impairment, sexual orientation, or tendency of mood.
But there is an obvious difference between the social model and the sexuality model: in the former, there exists an impairment; in the latter, the impairment is purely socially constructed. It seems that to understand how to calibrate the social response to depression, research into the existence (or not) of a discrete disease entity is not of secondary importance, as Davis seemed to suggest, but rather, is absolutely essential. Again, in the social model, the social response has to be twofold: an acceptance of the impairment and an accommodation of the concomitant need to prevent the impairment from being disabling. Conversely, questions of sexuality (or race for that matter) require a different social response: an acceptance that there is no impairment present, or rather that the impairment is located in a homophobic (or racist or, in the case of depression, moodist, or affectiphobic) society. It might be the case that people diagnosed with depression want both medical proof and public acknowledgement that they have an impairment. Or they might want recognition that there is nothing wrong or ill in their response to the world. Certainly, the responses of individuals with depression and the social strategies for accommodating these will be fundamentally altered by an unequivocal refutation or confirmation of the medical model.
Davis illustrated his argument with a selection of highly memorable cultural medical artefacts, from the amusingly apple-pie visions of American family (and especially female) life from the Eisenhower era espoused by the print ads for Elavil and Miltown, to the delightfully ghoulish “Symposium in Blues,” a soundtrack of symptoms produced by pharmaceutical company Merck, complete with Elavil adverts and lyrics such as “My heart is heavy as lead / Because the blues has done spread / Rocks in my bed.”
After the paper and a Q&A session, a reception was held in the School of English. Before the talks, attendees also had the opportunity to examine a selection of medical paraphernalia from the University of Leeds’s new Museum of the History of Science, Technology and Medicine. In addition to members of various University of Leeds faculties and other academic institutions, the launch was attended by non-academic interested parties, including the local NHS and Opera North.
(A version of this article appears in the current issue of The Journal of Literary and Cultural Disability Studies.)