The Hundred Acre Wood could use a therapist

Or, alternatively, society could stand to think a little bit more about whether, in our efforts to understand mental illness and get help for people who need it, we're leaning a bit too far towards medicalizing difference. That's the point a group of pediatric neurologists were trying to get across back in 2000, when they published a commentary in the Journal of the Canadian Medical Association concerning the possible DSM diagnoses of Winnie-the-Pooh and his animal friends.

We begin with Pooh. This unfortunate bear embodies the concept of comorbidity.

Most striking is his Attention Deficit Hyperactivity Disorder (ADHD), inattentive subtype. As clinicians, we had some debate about whether Pooh might also demonstrate significant impulsivity, as witnessed, for example, by his poorly thought out attempt to get honey by disguising himself as a rain cloud. We concluded, however, that this reflected more on his comorbid cognitive impairment, further aggravated by an obsessive fixation on honey. The latter, of course, has also contributed to his significant obesity. Pooh's perseveration on food and his repetitive counting behaviours raise the diagnostic possibility of Obsessive Compulsive Disorder (OCD). Given his coexisting ADHD and OCD, we question whether Pooh may over time present with Tourette's syndrome. Pooh is also clearly described as having Very Little Brain. We could not confidently diagnose microcephaly, however, as we do not know whether standards exist for the head circumference of the brown bear. The cause of Pooh's poor brain growth may be found in the stories themselves. Early on we see Pooh being dragged downstairs bump, bump, bump, on the back of his head. Could his later cognitive struggles be the result of a type of Shaken Bear Syndrome?

While the letters replying to this article seem to be behind a paywall, you can read the authors responses to several of the letters, including one where they explain that the goal was poke fun at the modern tendency to see pathology everywhere.

Contrast this with an article I wrote about in 2010 that attempted to diagnose the mental problems of Darth Vader, Lord of the Sith, a project that had the stated goal of removing some of the stigma from mental illness. Looking solely at the authors' goals, I think the Pooh Bear paper succeeds where the Vader paper fails. After all, Vader pretty clearly has some problems, including a tendency towards genocide. It might be fun to give him an armchair diagnosis, but I don't see how that helps real people with mental illness seem less scary or their illnesses less taboo. Pooh Bear, on the other hand, for all his supposed problems, lives a pretty happy existence. As does Tigger and, arguably, most of the residents of the Hundred Acre Wood, with the exception of, probably, Rabbit (who really could use someone to talk to, I think) and Eeyore (but he likes it that way). Part of what distinguishes difference from mental illness is the question of whether traits and behaviors are getting in the way of your ability to live a healthy, happy life. It seems to me that Pooh has a pretty good lifestyle, Shaken Bear Syndrome notwithstanding.

Also, there are GIFs

Notable Replies

  1. I've always said that Eeyore should switch to Lithium. The Prozac obviously isn't working.

  2. This is kind of a problem with the fact that a short kids story got ballooned out into a media spanning franchise. So the secondary character in the book that showed that it was ok to be sad sometimes is now perpetually depressed.

  3. It's an important distinction that smart professionals realize that the public often fails to: a lot of mental illness diagnoses only happen when it's causing you distress.

    Like, you might get a cold this winter. Maybe you get a runny nose and a sore throat. You deal with it. It doesn't ruin your life. Or maybe you have mild allergies. It's something that makes spring a little unpleasant, but whatever, you get some Allegra and deal with it. You don't go to a doctor and get a diagnoses and medicalize your sniffles or your irritation at being the unwilling participant in a floral bukkake event. You only look for help when it's bad enough to make living your normal life a frickin' struggle.

    That's the difference between have a bit of the sads every once in a while, and being truly, medically, depressed. Or the difference between being a little geeky and having full-blown Asperger's. Or the difference between being bored at school and having ADHD. One doesn't really cause you pain and suffering in life. The other does. Just because the mild version exists doesn't mean the hard version is a lie, and just because the hard version exists doesn't mean every sniffle is the Black Death.

    Which isn't to say that people are always smart about that distinction. Shit gets crazy overdiagnosed, because mental illness is scarier for the West, because we have this unstated assumption that everyone has the same mind -- that your thinking is exactly like my thinking. That we have different bodies is obvious to anyone with eyes, but that we have different minds -- different ways to understand the world -- is bloody hard for a culture that respects individuality and choice so fucking intensely. So if someone thinks different, it's scarier than if someone has a cough, it makes us question our own assumptions of equality (and homogeneity).

    I mean, if that geeky kid isn't SICK somehow, what does it say about me that he's so good at computers and I'm not, right? If my child isn't ILL, what does it say about her that she can't get good grades like I did?

    Over-medicalization of mental difference is a symptom of our fear of other peoples' minds. Which, again, isn't to say that this difference, when big enough, doesn't cause some actual problems, just that we're probably over-sensitive to the difference that is permissible, because WTF DO YOU MEAN YOU THINK DIFFERENT THAN ME WHAT THE HELL IS THAT?!?!

  4. Paddington Bear is really an allegory about illegal immigration policies. Peter Pan illustrates the dangers of arrested development in boys. Did Mr Banks pay all the appropriate payroll taxes when hiring Mary Poppins?

    Where does the madness end?

  5. Say what you will, but Mary Poppins was at least as much about class politics as Downton Abbey. For example:

    • Working-class women lined up around the block for a chance at a demanding full-time job that only had one day off every two weeks.
    • Everyone treated Mrs. Banks' Women's Suffrage movement like a joke except for the downtrodden working-class chimney-sweeps, who sang and marched in solidarity.
    • A crazed aristocrat shot a cannon at said working-class chimney-sweeps and faced no consequences whatsoever.
    • A rich banker literally stole a child's life savings to prevent it from going to support a destitute woman who supported herself by selling pigeon food.

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