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The Doctor's Corner

Dr. David Harley B.A.,M.A.,M.A.,Ph.D.

Dr. Harley completed a Master’s degree in Philosophy specializing in analytical philosophy and philosophy of mind as well as a Master’s degree in History specializing in early 20th century intellectual history.  He completed a Ph.D. degree in Education at the University of Toronto specializing in educational theory in general and the educational theory and practice of the noted British philosopher Bertrand Russell in specific.  His thesis research employed the assistance of Bertrand Russell’s daughter to track down ex-teachers and ex-students from his experimental school Beacon Hill.  He was awarded a Canada Council Doctoral Award as well as a Canada Council Post Doctoral Award.  He has over 30 years of direct experience as an educational consultant, principal, school administrator and researcher.

The purpose of his blog is to present various opinions, articles and book reviews related to the current state of education and the changing challenges presented to students, teachers and parents. 

The Ten Commandments of Education

The Ten Commandments of Education


You shall not consider your level of boredom to be an index of relevance


You shall not consider your feeling that something is true to be the same as knowing that it is true


You shall not consider that a reluctance to do something is the same as having an inability to do it


You shall not consider selfishness to be individualism


You shall not believe that you can only express your uniqueness by conforming to fashion


You shall look no further than yourself to explain your failures


You shall always look to others to explain your successes


You shall not consider being able to access information as being the same as knowing it


You shall not escape responsibility by doing nothing


You shall always be ignorant of that which you do not know

Book Review: Saving Normal: an insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. Allen Frances, M.D. New York: Harper Collins, 2013. 314 pages.

Among the many books published about learning disabilities and the associated debates, few authors could approach the issues better qualified than Dr. Frances who in addition to serving as Chair of the DSM-IV Task Force and serving as part of the leadership group for the DSM-III and DSM-IIIR, is professor emeritus and former chair of the Department of Psychiatry and Behavioral Science at Duke University School of Medicine.  His attacks on the assumptions guiding the directions of modern psychiatry are profound in their implications.  This is a book that cannot be recommended enough to those interested in the subject matter or who have a child or family member who has been subject to a psychiatric or psychological  evaluation. The DSM or Diagnostic and Statistical Mannual of Mental Distorders has become the standard reference for all mental health issues and as a definitive authority few dare question it. Having served a pivotal role in the DSM, the author is in a unique position to question it.

Dr. Frances states a main argument with regard to his concerns;

“Human difference was never meant to be reducible to an exhaustive list of diagnosis drawn carelessly from a psychiatric manual.  It takes all types to make a successful tribe and a full palette of emotions to make a fully lived life.  We shouldn’t medicalize difference and attempt to treat it away by taking the modern day equivalent of Huxley’s soma pills.  The cruelest paradox of psychiatric treatment is that those who need it most often don’t get it, while those who do get it often don’t need it.  So how do we save normal, preserve diversity, and achieve a more rational allocation of scarce resources?”

This diagnostic inflation has its roots in a form of emotional reductionism in which the emotional ups and downs of life are rendered as treatable abnormalities requiring medication or therapy or both.  His concerns are that with this inflation has come the danger of discrediting the central core of diagnostic progress initiated by the DSM.   So what is the DSM and how did it reach this state of influence and crisis?

The author gives an informative history of psychiatry leading up to a crisis in the 1970s where psychiatry was thoroughly discredited as a result of two studies.  The first of these focused on a study where videotapes of patients were given to different psychiatrists in America and England only to show very serious discrepancies in the diagnostic results.  In another study, graduate students staged that they were hearing voices in order to be admitted to psychiatric wards and despite behaving in a perfectly normal manner were held for prolonged periods of time.   The net result was to hold the reliability of psychiatric practice in question. 

The solution to this problem was seen in the creation of the DSM III (Diagnostic and Statistical Manual of Mental Disorders) which aimed to standardize diagnostic practice in the same manner as a dictionary would standardize spelling and definitions.  The aim of this was to create consistency.  Whereas the first DSM published in 1952 and the second printed in 1968 had been largely unread and ignored, the success of the much enlarged DSM III was extraordinary.  It shortly became a runaway best seller as well as a standard text of reference throughout many countries.  This was followed by the DSM III (Revised), the DSM IV and the current DSM V with each edition increasing exponentially in terms of size and content.  So how were the DSM editions created?

The DSMs were created by panels of experts who came together to decide what would be included or excluded as well as what the exact defining conditions were for each condition.  As such, conditions were given a name and then defined in terms of the specific descriptors required as the necessary and sufficient conditions to qualify.  The process was therefore inherently subjective and as the sufficient and necessary qualifications were either tightened or loosened the number of people who could be described as falling under that condition would be either increased or decreased.  As a result of other pressures such as the ability to qualify for special services or insurance coverage, the inherent dynamic was to relax the standards.  Additionally, the influence of pharmaceutical companies to promote their products as well as their unique ability to advertise directly to the public (unique among all countries in the Western Hemisphere) contributed to this tendency.  As a result, throughout the history of the various editions there is a notable decrease in the requirements for major conditions as well as an increase in the number of named or identified conditions.  This double thrust has resulted in a monumental level of diagnostic inflation that now appears to have taken on a life of its own.

To give a concrete example of this in terms of impact, a person might be considered as being accurately diagnosed as being ADHD according to the DSMV who would not have qualified according to the DSM IV.  As such, the attribution is conditional upon the defining characteristics.  But as any first year philosophy student will tell you, defining the characteristics of something does not determine existence.  For example, determining the characteristics of Santa Claus does not confer existence upon him.  Therefore, whatever existence ADHD may be said to have is not the same as say measles in which there is an identifiable and discrete biological causative agent that generates the symptoms.  In other words, there is an existent thing independent of the attributes.  In the event of all mental conditions, the underlying assumption is that there is some biological, neurological underpinning that though not identified is the causative agent.  Therefore, in keeping with the best traditions of behaviorist psychology, the DSM focuses on observed behaviors and does not concern itself with explanations involving the inner mechanisms of conscious or unconscious motivations or intent.  This however is suggestive of a naïve sense of Cartesian dualism in which mind and body or mind and brain are two distinct things that somehow interact or in which mental phenomena is in some manner merely derivative of the brain.  Sophisticated explanations of this issue are involved in what in philosophy are referred to as The Mind/Body problem.  The most satisfactory explanations involve the view that mind and brain are one and the same thing but looked upon from different aspects leading to a description of individuals as mind/bodies.  As such, mental states can be described in terms of chemical balances but are not ultimately reducible to them any more than the Mona Lisa can be reducible to five primary colours.

As such the consistency offered by virtue of the DSM though necessary has also given rise to an inherent reductionism or simplicity of interpretation.  Although Dr. Frances alludes to this, he does not in my opinion go far enough because looking closely at some conditions can arguably undermine the very foundations from which they are formed.  In short, inferences based upon behavior devoid of intention can give rise to simplistic interpretations.  Repeated behaviors around not paying attention can lead to the conclusion that the subject has difficulty paying attention but if asked might say that no effort to pay attention is forthcoming because the subject has no interest or perceived benefit from engaging in the activity.  The term ‘disability’ has as an underlying assumption that the subject wishes to do something but has the desire to.  A cunning proponent will argue that the subject has no desire to because they experience difficulty doing so.  However, this argument is clearly circular and is of the same form as defining good as what is not bad and what is bad as is not good.  We know from our own experience that our interests are largely dictated by whether we find value in something or not. Therefore some people will experience great excitement watching a hockey game and be able to remember all of the events in detail while another may follow a chess tournament with equal attention.

In talking to boys over the years about why they have exhibited so little effort in individual classes or school generally it is common to discover that it is not an inability to focus or put forward effort but a lack of willingness based upon a lack of interest in doing so.  This is often tied in with three important factors.  First, they perceive no immediate useful utility in what they are learning.  Second, there is no immediate tangible reward for this effort or disincentive either. Third, many believe that there is no sense in learning what can be readily accessed on a smart phone.  As such, access to information and its repetition is equated with the ability to know and process information.

However, the consistent theme in all learning disabilities as with all behavioral and mental disabilities is the focus on the observed behaviors as a cluster of information not unified or directed by an agent or self.  The result of this is language such a John has ADHD when in fact it might be more accurate to say that John is ADHD.  The language itself directs the narrative along the lines of an affliction impinging upon the individual from the outside as opposed to behaviors for which the individual has control or is accountable.  In this manner, personal responsibility for behaviors is removed and the individual is then represented as a victim of an agency external to their control.  Just as you would not blame a person for having measles the same implication results from the diagnosis that a person has ASDHD.

As such, the dysfunctions identified by clinical psychologists and psychiatrists are largely a result of reified clusters of behaviors that are then interpreted in terms of an affliction largely addressable by prescription drugs as opposed to any cognitive adjustment in terms of processing and accountability.  This is where the talk therapy that emanated from what used to be referred to as depth psychology has given way to prescriptions and pharmaceutical solutions.  Talk therapy once practiced by psychiatrists and psychoanalysts has increasingly given way to medication partly as a result of their success in suppressing the symptoms of mental illness but also in part as a result of cost effectiveness.  The talk therapies practiced by figures such as Freud, Adler, Jung and others could involve hundreds of hours of patient contact and as such even if they proved to be effective would be financially untenable for any general applicability.  These practical underpinnings have resulted in talk therapies being used by therapists and social workers under such banners as Mindfulness and Cognitive Behavioral Therapy.

However, to return to the issue of the medicalization of ‘normal’ behaviors I am reminded of a television commercial that was current a few years ago.  It started with a scene of a party in a room in a house or apartment with people standing around engaged in happy conversation contrasted by a single young woman seated by herself on a sofa looking quite uncomfortable.  A deep voice then materialized asking the questions “Do you feel awkward in social settings?’  “Do you find yourself lacking the confidence to interact with others?” “Do you feel alone and hopeless?” Then the answer comes that if you say yes to these questions you are probably suffering from Social Anxiety Disorder.  The good news being that once identified, the problem can be addressed and solved.  There is a medication, the name of which is given prominently on the screen, and with this your problems can be solved.   You are advised to see your physician and to ask for this medication.  The next scene in this commercial consists of a repeat of the initial scene but with the solitary female now standing and happily interacting with an eligible male who is equally animated.

This commercial serves as an excellent example of the overall template used to market pharmaceutical solutions.  First there is an identified problematic behavior quickly followed by the naming of the behavior or behaviors as if in some manner the process of naming it implies some power, control or understanding of it.  Then there is the presentation of a medication that will instantaneously solve the problems by eliminating the problematic behaviors with the assumption that once the behaviors are eliminated or controlled the causes are no longer relevant ---assuming of course that they ever were.  In the case of the woman in question, the internal mental conditions responsible for her behaviors or causing her to behave in this manner become irrelevant.  Once the symptoms are addressed the problem is viewed as solved.  The formula involves the exaggeration of a problem to the level of a crisis followed by the suggestion that the problem having been named is understood followed by a simple solution step resolving the issues and bring about a hopeful future.  In such a manner, a shy or timid person is rendered dysfunctional and in need of normalization through medication.  The complexities of thought, feeling and personality vanish.

I think that Dr. Frances’s book is a valuable and thought-producing work.  It should be carefully read and digested in terms of its implications both in terms of mental health issues but also within the framework of human diversity of personality, temperament and abilities. 

Bertrand Russell as Educator: The Freedom of Discipline or The Therapeutic Applications of Philosophy

A Paper Presented to the American Bertrand Russell Society at the Annual Meeting Held at McMaster University in May of 2018 by Dr. David B. Harley B.A.Hons.,M.A.,M.A.,Phd. (Toronto)

Preliminary Remarks

In 1980 I completed my Ph.D. Thesis at the University of Toronto entitled “Beacon Hill and the Constructive Uses of Freedom”.  Over the next three years it was expanded and modified and then laid to rest in a drawer as I gave up the theory of education to become immersed in its practical application within the private sector.  Recently, the manuscript has been unearthed and I have started a final revision with a view to publication that now benefits from three decades of practical experience.  Russell’s ideas have guided me throughout my career.  As the theory and practice of education have developed over the intervening years, I have become increasingly convinced that Russell’s core ideas about education have taken on increased relevance especially in and around what I have chosen to call The Freedom of Discipline.

Contrary to every rule of writing an essay, I have therefore decided at my own peril to not restrict my subject matter to a manageable selective presentation but have instead opted to try to cover too much in too little time.  My offered defense lies in the fact in as much as this represents a kind of précis of a much larger work, I hope that you will make allowances accordingly.   The arguments presented and the facts to justify them are not as lengthy or as detailed as the originals from which they have emerged.  There is therefore a certain impoverishment necessitated by imposing upon content the limitations of time. 

This presentation is focused on three central arguments.  First, that Russell’s interest in education, though commonly perceived as being aroused primarily only after the birth of his children, can in fact be traced well into his earliest years and extends through most of his writings and as such should not be viewed as being merely tangential to his primary interests.  Second, that Russell’s educational theories as put into practice at the experimental Beacon Hill School in 1927 bore only superficial similarities to A.S. Neill’s Summerhill and were indeed distinguished by very profound differences in approach arising from what were incompatible views on how individual freedom could best be promoted within an educational context.  Third, that many of the changes in modern educational theories and practice since the 1960’s have  been largely inspired by views arising from Neill’s influence and have suffered accordingly as a result of a flawed concept of how freedom should be applied and understood in the upbringing and education of children.

Anyone who has read Russell’s autobiography knows that his early life was unhappy and characterized by death, loneliness and fear of mental instability.  His sister died in 1874 followed quickly by the death of his mother in the same year.   Russell’s father Amberley died two years later upon whose death Russell and his brother Frank were removed to stay with their paternal grandparents despite the dying wishes of Amberley who had made other arrangements in order to spare them the evils of a religious upbringing.  In 1876 the two boys went to live at Pembroke Lodge and Frank was quickly sent away to a boarding school leaving the young Bertie alone.  In 1878, Lord John Russell, his grandfather, died followed in 1880 by the death of Russell’s aunt’s child and then Russell’s aunt in the same year.   After Lord Russell’s death it was necessary to undertake a considerable downsizing of staff and servants as well as the  the shutting down of portions of the house.   

The lack of other children and a stern religious upbringing gave rise to an introverted childhood filled with insecurities and finding solace in nature , books and increasingly in mathematics.    According to Russell, his upbringing was repressive to the extreme and characterized by religious orthodoxy.  He endured the onset of puberty with intense confusion, guilt and ignorance. 

In 1889 at the age of 17 he met and fell in love with Alys Pearsall Smith, an American Quaker who Lady Russell, his grandmother, made it clear she felt was not an appropriate match.  After his 21st birthday, Russell inherited funds sufficient to enable him to make an independent choice, and so a meeting was arranged with the family doctor during which time he was made aware that his Aunt Agatha had suffered from insane delusions, that his father had been subject to epilepsy and that he had an uncle whose existence had been kept a secret who was committed to an insane asylum.  The fact that there was some insanity in Alys’s family provided additional barriers to the marriage for fear that mental infirmness would be passed to children.  Russell then decided to have a childless marriage.   However at the time the use of contraceptives was believed to contribute to insanity and mental disabilities and so Russell was then confronted with the prospect of a marriage without children and without sex.  Fortunately, he was able to find another physician who advised him that there were no negative effects from the use of contraceptives and that he himself employed them with no injurious effects.  Russell decided to go forward with the marriage only to have another obstacle brought to bear by Lady Russell who had arranged for him to leave England to accept a position with the British Embassy in Paris.  This did nothing to diminish his resolve, and he was married In December of 1894.

The rich exchange of letters between Russell and Alys during this period reveals a great deal of self-examination of his own upbringing,  how he would avoid these shortcomings if he had children and the growing belief that the mental infirmness in his own family was the direct result of upbringing and mis-education.

In one such letter he states: “…I remember saying to myself:  When I have to do with children I will remember my present feelings and avoid those mistakes that are being made with me.”

and again:

“I wish we were going to have children, if only to give them a sensible education in matters of sex---I should almost like to start a co-educational school for the purpose of applying my theories…”

The shortcomings in Russell’s early education are presented by him as being directly attributable to his grandmother’s inflexible, puritanical and moralistic attitudes towards all matters but especially sex as well as the inappropriate circumstances of solitude imposed upon him.  His grandmother, as he states, was interested in piety and nothing else.  The only highlights of his upbringing are attributed to being introduced to the joys of science by his uncle Rollo and to Euclid and mathematics by his brother Frank.

Despite the fact that the early part of the 1900’s is associated with Russell’ work in theoretical mathematics and logic, between 1901 and 1903 he wrote pieces that include “The Study of Mathematics”, ”A Free Man’s Worship”, “On History” and in addition began a book on education of which the manuscript's first chapter has survived entitled “The Education of the Emotions”.  The importance of this manuscript cannot be overestimated for it proves that Russell had thought enough about the topic of education to feel compelled to write a book about it.  Moreover, the ideas presented in “The Education of the Emotions” demonstrates a remarkable continuity with those that he later developed and published.

Russell begins by stating that the division of the mind between intellect and emotions is largely fictitious and based upon convention.   Given that people understand best what interests them and since interests are derived from emotions, it follows that intellect and emotions are inextricably woven together.  The education of the emotions must take place during the first seven years of life and should foster the development of good emotions and remove evil ones where ‘good’ emotions come from a love of what is good as opposed to a renunciation of what is bad.  Good emotions are those that expand the boundaries of self to include others and eventually all of mankind.  Early education should aim to instill a “love of great ends” the pursuit of which he believes constitutes the good life.  Discipline, he maintains, is only second in importance to magnanimity and is of such importance that its cultivation must be started from the earliest of years.

Russell goes on to consider an opposing philosophy of education which espouses the natural goodness of man, a belief that the need for discipline is exaggerated, and that the child’s impulses are only good as long as they are left unthwarted, so that the goal of education is merely to allow free play.  Although Russell agrees that it is important to train good impulses, Russell argues that good impulses are rarely sufficient because the means to realize the end cannot immediately follow the urge and may require many intermediary steps.  Hence “Whoever has not learnt to endure tedium and pain is incapable of persistence, or of difficulties which resist prolonged and repeated assaults.”  He goes on to argue that it is sometimes as important to restrain good emotions as bad ones since exclusive concern with the welfare of those close to us may counter the dictates of just action.  Therefore, even someone with no bad impulses would still need discipline:

“It becomes, consequently, an unavoidable element in education to teach the habit of judging all desires, even the best, in the court of reason, and of allowing scope only to such as are acquitted in that tribunal.” 

As such, objectivity and reason as manifestations of mental discipline combined with knowledge to afford the basis of action such that concrete ways to secure good ends can be realized and in so doing bring happiness and fulfillment. 

This view of what is to be ideally achieved through education is what I shall refer to as the Freedom of Discipline which finds itself ideally expressed many years later in his autobiography when discussing the views that he shared with Joseph Conrad.

“His point of view, one might perhaps say, was the antithesis of Rousseau’s…. (man) becomes free, so I believe Conrad would have said, not by letting loose his impulse, not by being casual and uncontrolled, but by subduing wayward impulse to dominant purpose.”

Small wonder therefore that Russell named his first son John Conrad and his other son Conrad Russell.

Beacon Hill School was established in 1927 and could be seen as the fulfillment of his intention expressed in 1894 to Alys.  He maintained  that having looked at available alternatives, he could find no school that was fully satisfactory despite the fact that he was able to find school placements for his children both before and after Beacon Hill. But then indeed, starting up new experimental schools and advocating innovations in education seemed to be the thing to do as a wave of new private schools made their appearance such as Bembridge School (1919), Rendcomb School (1919), The Malting House School in Cambridge (1924),  A.S. Neill’s Summerhill (1924, Dartington Hall 1926) and the Bryanston School in 1928 among others.  H.G. Wells, though not starting up a new school, still took it upon himself to provide the new textbooks for the wave of educational reform and produced The Outline of History, The Work Wealth and Happiness of Mankind and the Biology of Life  thereby covering the fields of History, Economics and Science.

The Beacon Hill prospectus that was mailed to interested parents described the proposed program and its objectives.  These included:

  • combining physical and psychological care as suggested by modern knowledge of the growth of personality
  • dispelling or avoiding anxieties and nervousness to which developing children are liable
  • open air activities to give children every opportunity for “running wild” as in the old-fashion large family
  • aesthetic development through sense training
  • active as opposed to passive learning
  • great emphasis to be placed upon intellectual development
  • free speech and open discussion on any topic
  • teaching of the classics to be held to a minimum
  • main emphasis to be placed upon science and modern humanities
  • individual initiative and curiosity to provide the main thrust for learning as opposed to authority, external disciple and drill
  • knowledge to be presented not as mere knowledge but as an instrument of progress
  • not to produce listless intellectuals but young men and women filled with constructive hopefulness

The setting for this experiment was no less impressive than its aspirations. Telegraph House in Sussex was large and spacious with the then modern conveniences of electric light and central heating situated among 230 acres of forest and 600 feet above sea level.  It belonged to Russell’s brother Frank and was rented from him for this purpose.

The staff included a cook, a housekeeper, three maids, two chauffeurs and a gardener, a matron, an assistant matron, science, art and language instructors, a part-time music teacher, a visiting doctor and Russell’s own private secretary.  Both Russell and his second wife Dora also acted as teachers.  With a student population that varied between about 15 and 25, it was small wonder that the school consistently lost money.    The days were marked by a rigid schedule.  Each morning would begin with a lineup of naked children who one by one received a cold shower.  Students were expected to make their own beds before breakfast and after breakfast everyone would proceed upstairs to brush their teeth.  After that, each student would take out their pot and sit on it in a line.  The importance of regular bowel movements was considered important and as his daughter Katharine Tait recounted years later, it was a little shameful to have not produced something in one’s pot.  At 11:00 there was a break from classes at which time orange juice was served.  This was considered a radical departure at the time as considered opinion dictated that it was too acidic for children’s digestive systems.  At 1:00 there was lunch and there was full tea served at 4:30. His daughter recalled:

“We had no choice in food, which was dreary and institutional English, though eminently nourishing….Cookies were rare, cake unknown, sugar frowned upon unless it was deep dark brown.  There were no snacks between meals, and everything was plain and nutritious.”

“For some obscure reason, drinking with meals was supposed to be bad for us.  We had to wait until after the meal, when tin mugs of tepid water would appear on large tin trays….After a particularly dry meal, we would all sit in a row on the bottom of the stairs, as close as possible to the kitchen door, waiting for the water tray to come in.”

And again:

“Though we were not free to ruin our health with late hours and bad food, we were never required to “behave ourselves” at meals, which were often quite wild occasions.  A favorite amusement was putting a dab of butter on the end of a knife and flicking it at the ceiling, where it stuck and gradually melted away into a grease spot.”

Perhaps it was from witnessing such things that some visitors came away believing that Beacon Hill was the “do as you please school”.  Sir A.J. Ayer who visited it in 1931 described it as “anarchic” and one supposes that he was one of many who shared that view.  However, Russell’s apparently strange juxtapositions of freedom and order had the effect of disguising just how much structure there was at Beacon Hill School if only one looked past first impressions.  Responding to such an attack in 1930,

Russell wrote: (the critic) “appears to think that the principles upon which we run our school can be described as ‘Back to Nature Don’t Discipline the Child theories’.  It may possibly interest you to know that self-discipline, and more particularly intellectual discipline, is one of the main things taught in our school.”

In a letter to H.G. Wells dated May 24th, 1928 Russell wrote: “You will realize that hardly any educational reformers lay much stress upon intelligence.  A.S. Neill, for example, who is in many ways an admirable man, allows such complete liberty that his children fail to get the necessary training and are always going to the cinema, when they might otherwise be interested in things of more value.”

And then many years later in Portraits from Memory: "It seemed to me, and still seems, that in a technically complex civilization such as ours a man cannot play an important part unless in youth he has had a very considerable dose of sheer instruction.”

Whereas Neill and many others to the present time believe that children are like turnips that should be left in the soil and watered but otherwise left to grow naturally and that any outside interference with that will inevitably lead to malformation,  Russell’s views are seen to be very different.   His promotion of individual growth involves a freedom of emotions such as to produce a foundation for intellectual growth that will fuse with emotions in such a manner as to promote the self-discipline required for rational self-regulation and moral purpose.

It is clear that Russell’s views on education can be distinguished by several main themes:

  • That in childhood emotional health should be viewed as a priority for providing a platform for intellectual growth which in turn feeds from and directs emotional growth
  • Education should direct its energies towards cultivating a certain mental framework through which the individual can best realize their potential through the assimilation of knowledge.
  • The end result of realizing individual freedom through discipline is an ongoing dynamic process at an intellectual/emotional level enabling the individual to acquire, process and act upon knowledge while being orchestrated by self-control imposed through the strength of the will.

It is clear that within the restrictions of current educational possibilities much of Russell’s educational proposals could not pass present day standards of political correctness or religious or nationalistic orthodoxy.  It is interesting to note however that his concerns with  emotional/intellectual growth are now increasingly reflected in therapeutic movements such as Cognitive Behavioral Therapy and Mindfulness all of which attempt to stress-self-examination of actions relative to consequences as well as attempts to focus emotions outside of the self in order to gain some level of objectivity and to combat the growing trends towards narcissism.

Impulsivity among the young is certainly on the rise and now has an official diagnosis in the form of Executive Functioning Disorder (DSM 5).  But so is a rising tendency towards intolerance towards the views of others and a growing tendency to attack offending points of view either personally or through intimidation.  Dogmatism is certainly on the rise and the slumber of decided opinion has certainly taken on a new force.  Increasingly, people seem to argue from a position that they feel that they are right and the intensity of that feeling is an indicator of the truth of their position.  These tendencies are dangerous and do not certainly encourage optimism for the future.

The development of Russell’s mind throughout his life and his struggle with powerful emotions demonstrated a disciplined approach to knowledge as reflected in both his analytical philosophy as well as his promotion of a scientific outlook.  There is little doubt in my mind that for Russell a certain lurking fear of insanity remained throughout his life giving rise to a distrust of strong passions and actions not sanctioned or directed by reason and evidence.  In the present day strong emotions or passions towards fixed beliefs and positions seem increasingly embraced.  At no time has it been more important, one could argue, than in the present to refocus education towards the goal of teaching students how to think rather than what to think.   Recent movements in pre-university education have focused exclusively on Learning Outcomes rather than on the development of cognitive skill sets that given the facts would suggest outcomes rather than demand them.  Computers and the internet have provided limitless information accessed by those increasingly incapable of intellectually processing that information.  Just as the ownership of a book does not by itself suggest that a person has either read it or understood it, the immediate access to information in no way implies that it has been understood or can be rationally processed in a meaningful manner.  

In conclusion, I think that Russell’s focus on what education should attempt to achieve is of great importance today.  Indeed the very future of liberal democracies may well depend upon the promotion of the Freedom of Discipline at the individual level that is required to halt the drift towards the polarization, intolerance and growing self-absorption evident in modern society.

BOOK REVIEW: ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic. Alan Schwarz

ADHD Nation is one of the latest of many books devoted to the topic of ADHD.  It is unique in that it brings into the discussion the current views of Dr. Conners (an early pioneer in the area) while at the same time introducing the reader to some interesting and informative facts.   

While stating that ADHD is real and exists and must be taken very seriously Schwarz puts aside the question as to whether or not it exists, states categorically that it does and then moves on to the issues of overdiagnosis and the rampant abuse of stimulant medications - or as he puts it “The Making of an American Epidemic”.   At first blush, this appears to be a safer argument to embark upon.  However, implicit in the information and arguments that he presents appear the very reasons why many question the legitimacy of the entire enterprise; any account of the rise and discovery of ADHD cannot be made without giving full credit to the pharmaceutical companies' role in the simultaneous promotion of an affliction together with its proposed cures. The underwriting, promotion and relaxing of the symptoms necessary to qualify for diagnosis are inexorably interwoven with the promotion of medications and the driving force behind the enterprise is unabashedly that of profit.  What Swartz clearly identifies is that with the billions of dollars now involved in the identification, therapies and medications of ADHD, few who are involved can free themselves from some degree of complicity in what has become a profitable industry.  As such, one is led to conclude that money and self- interest are compelling engines driving the phenomenon independently of genuine concern for the afflicted.

Interestingly enough, even the term ‘ADHD’ required some packaging. Early attempts to describe the general condition included  ‘Hyperkinetic Impulse Disorder’ and ‘Minimal Brain Damage’ among others.  Attention Deficit emerged as a satisfactory and acceptable description in terms of its messaging by striking a balance between what might be incomprehensible verbiage or an embarrassing personal flaw.  ‘Attention’ was after all a term that everyone knew and having difficulty paying attention was something that everyone experienced to some degree.   In a similar manner, the medications themselves needed names that would not ring alarms.  And so Ritalin was named by a research chemist after his girlfriend named Rita who benefited from the medication both by encouraging her weight loss and invigorating her tennis game. Other medications provided similar soothing or non-threatening names.  Having packaged the product both in terms of the problem and the cure, the next step was to identify the market.  However, unlike the common cold, the diagnostic process itself needed to be tailored and also marketed.

Schwarz maintains that according to the American Psychiatric Association’s determination, the condition of ADHD affects about 5% of children and most of this number are male.  However, Schwartz states that the current U.S. nationwide rate is 20% with some states topping 30% and some counties approaching 50%.  Early pioneers in ADHD research and development believed that no more than 3-5 % of the population would be affected.  Dr. Conners, who became famous and personally quite rich through his introduction of the Conner’s diagnostic test, very widely used for the diagnosis of ADHD, was distraught when interviewed for the book. Having originally been sure that no more than 3-5 % of children would be afflicted, the current inflated numbers could only be accounted for by virtue of misdiagnosis.  Thus Schwarz concludes that given this huge gap ADHD has become the most misdiagnosed condition in American medicine.  Therefore, the thesis promoted by this book is that the numbers can be rolled back by making the conditions for diagnosis stricter.  However, it would seem that Schwartz’s solution amounts to no more than bell curving undergraduate exam marks to ensure that 5% of the class fails.    In short, the admission that the definition and setting of the necessary and sufficient conditions of being diagnosed with ADHD are directly responsible for determining the number of people who can be legitimately identified as such infers that the diagnosis is determined by the definition.  The fact that Conners believed that the condition could only afflict a limited range of no more than 5% of the population is a belief and could not qualify as a scientific observation since there would be no way of knowing this before the fact.  How could one know therefore that no more than 5% of the population was afflicted? Perhaps the statement is more of the form that no more than 5% of the population ‘should’ be afflicted.  The argument that the sufficient and necessary conditions should be made more restrictive in order to reduce the percentage that would qualify for a diagnosis to a preconceived range infers an arbitrary character to the entire enterprise.

What therefore becomes apparent is that whatever current test is used to determine ADHD, all reduce ultimately to subjectivity as it is only a thing insofar as it is defined as being such.  As the sufficient and necessary condition is made more or less restrictive, more or less instances of the thing come or go out of existence. No growth, virus, bacteria or physical dysfunction can be identified with it. Despite attempts to argue that some physiological characteristics can be identified with ADHD through brain scans and computer colour enhancements, no credibility has been provided for this by the American Medical Association.  Instead, a cluster of diverse behaviours is made unique not by their existence but by their subjectively determined degree and effect on normal functioning.  Indeed, all of these behaviours can be ignored if there is no effect upon normal functioning and so there is an ad hoc character to the causal relationship insofar that the assumption exists that these behaviours could all exist to the same degree and either affect or not affect normal behavior.  In short, the behaviours associated with determining the existence of ADHD are necessary characteristics only after it is determined that there is a dysfunction within a specific environment.  In a real sense, the dysfunction comes first and the explanation follows later.

Looking at the actual diagnostic tools is a help to bring the discussion down from the abstract to the concrete.  For example one of the first commercially marketed rating scales developed by Dr. Conners described 28 behaviours:

  1. Restless in the “squirmy” sense
  2. Makes inappropriate noises when he/she shouldn’t
  3. Demands must be met immediately
  4. Acts “smart” (impudent or sassy)
  5. Temper outbursts and unpredictable behaviour       
  6. Overly sensitive to criticism
  7. Distractibility or attention span a problem
  8. Disturbs other children
  9. Daydreams
  10. Pouts and sulks
  11. Mood changes quickly and drastically
  12. Quarrelsome
  13. Submissive attitude towards authority
  14. Restless, always up and on the go
  15. Excitable, impulsive
  16. Excessive demands for teacher’s attention
  17. Appears to be unaccepted by group
  18. Appears to be easily led by other children
  19. No sense of fair play
  20. Appears to lack leadership
  21. Fails to finish things that he/she starts
  22. Childish and immature
  23. Denies mistakes or blames others
  24. Does not get along with other children
  25. Uncooperative with classmates
  26. Easily frustrated in efforts
  27. Uncooperative with teacher
  28. Difficulty in learning

Each of these behaviours is then rated 0 through 3 with 0 signifying never, 1 just a little, 2 pretty much and 3 very much.  The score would then be tabulated with a minimum score being selected to qualify as borderline ADHD and so on.

As of 1980 and the publication of the DSM or Diagnostic and Statistical Manual, Attention Deficit Disorder details as to how doctor’s should diagnosis the syndrome were provided as follows:

Inattention.  At least three of the following:

  1. often fails to finish things he or she starts
  2. often doesn’t seem to listen
  3. easily distracted
  4. has difficulty concentrating on schoolwork or other tasks requiring sustained attention
  5. has difficulty sticking to a play activity

B. Impulsivity.  At least three of the following:

  1. often acts before thinking
  2.  shifts excessively from one activity to another
  3. has difficulty organizing work(this is not due to cognitive impairment)
  4. needs a lot of supervision
  5. frequently calls out in class
  6. has difficulty awaiting a turn in games or group situations

C.  Hyperactivity.  At least two of the following:

  1.  runs about or climbs on things excessively
  2. has difficulty sitting still or fidgets excessively
  3. has difficulty staying seated
  4. moves about excessively during sleep
  5. is always “on the go” or acts as if “driven by a motor”

Each edition of the DSM has relaxed the sufficient and necessary conditions so as to increase exponentially the number of people who could qualify to be diagnosed.  As the DSM is not the only basis for diagnosis and professional interpretations as to what does and does not qualify someone to be diagnosed with ADHD further complicates the issue.  However, the fact that relaxing a definition or changing it can either increase or decrease a condition can lead to speculation as to whether or not the definition chases the condition or the condition chases the definition.

Ultimately, however, it would also seem that who and what qualifies may be less important than the issue of the millions who apparently benefit from the variety of medications now prescribed.  This brings up the issue of performance enhancing drugs in general. Schwarz mentions that during WWII Winston Churchill approved the production of 72 million Benzedrine tablets for distribution to troops to improve performance.  Widespread use and abuse of Benzedrine followed the war with people commonly taking it in the morning with coffee and with the Rolling Stones referring to it in song as “Mother’s Little Helper”.  Available without a prescription and over the counter, there were no curbs to consumption.  As an energizer and as a weight loss pill, it gained popularity to the point where it was recognized as a threat to public health and placed on a restricted substance list.  Another stimulant medication called Dexadrine was marketed as a substitute for the by then maligned Benzedrine.  However, by early 1970, some 4 billion Dexedrine tablets were being dispensed in the U.S. each year and some 7% of all Vietnam forces became abusers or addicts.

It becomes apparent therefore that a steady market for stimulant medications existed prior to the advent of ADHD or other learning challenges. Whereas there is no doubt that such medications enhance performance, the fact that they address symptoms in this process does not logically infer the existence of an ailment that they are supposed to address.  It remains to discuss ADHD medications, not as one would discuss an antibiotic that fights an infection and would have no beneficial effects unless you were sick as opposed to stimulant medications that enhance performance generally. 

To take the argument one step further, if stimulant medications increase most people's ability to focus and stay on task why not allow anyone to use them? This is a question that has been taken up at universities and colleges across the USA and Canada where thousands of students are accessing these performance-enhancing drugs to assist them in studying and writing exams.  In these contexts, the medications are valued because of their ability to enhance abilities in students whose abilities were strong enough to get them into top universities and competitive programmes.  In short, there is no argument that medications to address ADHD issues are effective in many cases.  It is equally true that these medications have similar effects in enhancing performance even where there is no dysfunction.  It could be therefore argued that in the athletic realm we should issue medications to athletes whose performance is substandard but not allow them to better athletes as a means of levelling the playing field.

It has always been recognized that school is not an environment suited to everyone and traditionally a number of students left school and entered the trades or the workforce.  It is also the case that school was viewed as a privilege rather than an affliction and was therefore valued.  As school has become an imposed obligation upon youth by the state, the academic component has strayed further away from learning along traditional lines to a form of socialization and enculturation designed to ensure that its products share common values, ideas and attitudes.  Despite universal claims from educators that government funded schools do a better job than ever, there is no empirical evidence to prove the claim that modern schools have advanced beyond the successes of the one-room schoolhouse. They are certainly more complex, expensive and inclusive.  Much of this misdirection is as a result of being all things to all people.  Failure at school is not a failure at life and those who are not suited by nature, temperament or timing to be successful in that particular environment may have many strengths in other directions that are better being capitalized upon than suppressed.

Part of the problems with much of current education is that students feel that they are being forced to attend and that what they are being taught has no value or interest to them.  It is interesting that in the third world education is regarded by most students as a privilege and a way to advance themselves whereas in the West many young people regard education as an affliction developed by adults to destroy their adolescence.  Just as all people are not destined to be athletes, it is equally true that not all people are destined to be scholars.  It would seem then that in keeping with principles of consistency that athletics should be considered for medications as well in order that poor performers might perform better.   However, it might be also argued in both academic and athletic environments that if any portion is receiving artificial assistance to enhance performance then perhaps everyone should enjoy the same benefit.

In conclusion, ADHD Nation is a book worth reading in terms of the new information and updates taking place as part of the crisis of overdiagnosis. It is however also of value insofar as it provokes discussion around the central issues concerning the birth and evolution of the ADHD phenomenon.

Fairness in University Applications Under Debate

An article was recently posted by Global News entitled “One university’s secret list to judge applicants by their high schools - not just their marks” 

The article discusses the use by the University of Waterloo of computerized studies in which the final high school marks by which students were admitted to the university are compared to the final university averages achieved by those students.  The results are organized by specific high schools from which the students originated. These have sometimes been referred to as drop rate studies.  The idea is that if you have a large enough sample from a school that this will give some information of value.  These studies have been rumoured to be carried on for years and they first came to my attention 30 years ago and arose from concerns arising from the different standards and values of marks given by individual schools and teachers.  

At one time in Ontario, all students graduating from high schools in grade 13 were required to write standardized provincial examinations. The exams were set by people in the Ministry of Education and were sent to schools for students to write under strict supervision.  The completed exams were then sent to the Ministry to be marked by people who had no knowledge of who had written them.  The purpose was to ensure that there was no favouritism involved in the marking and that the same test was written by everyone.  This standardization was to ensure fairness and impartiality.  It was a system almost universally believed to be the standard of how to ensure the integrity of the system.  After the Hall Dennis report came into effect in the late 1960’s and Ontario abandoned the provincial exams, what the critics had expected happened and gradually the ability of teachers to set their own exams and mark their own papers began to give rise to variations in what those marks meant in terms of any gold standard.  The issue of fairness became particularly pressing given the value of marks or even portions of marks in terms of university admission and scholarships. It became obvious that some students were denied or granted admission to a program or scholarships merely because they attended the wrong school or were taught by the wrong teacher.  The inherent unfairness of this was apparent to university admissions departments and movements began to emerge proposing standardized entrance examinations for all Ontario universities.  My understanding is that such a proposal was put forth to then Premier David Peterson.  However, having standardized entrance tests administered at the same time that students were still attending high school would have created a potentially embarrassing situation by proving that significant variations existed and provide fuel for critics of the educational system and the government. These drop rate studies were often dismissed on the grounds that so many factors weighed into possible explanations as to why marks dropped including being away from home and coping with increased levels of individual freedom.  Testing while students were still attending high school would have removed these mitigating factors and arguably laid bare the problem in a way that could not be contested.   

The current article revolves around the story of Global News requesting in 2016 information from the University of Waterloo regarding the drop rate statistics or adjustment factor for students entering their engineering programme.   When the university refused to comply with the request, Global appealed to Ontario’s information and privacy commissioner resulting in a ruling to release the information in June of 2018.  According to the information released, the average drop in a student’s average in the engineering programme was 16 % coming from an average Ontario High School. However, some high schools had an average drop of over 27%.  The statistics released were for 2016 through 2018 admission cycles and the article publishes a long list of public, separate and private schools as well as their respective drop rates.   I would urge anyone interested in this to access the original article online. 

However, the article also indicates the problems associated not only with the varying standards of different schools and teachers but also different provinces and countries.  Students from New Brunswick, for example, had their marks drop on average by over 26 per cent as opposed to graduates of Quebec’s CEGEP stream who averaged a drop of only 5.2 per cent.  In terms of international students, the worst offenders came from Egypt, Saudi Arabia and Bangladesh.  Countries with the least drop in their marks were Indonesia, Singapore and Malaysia.

Historically, Ontario had two high school graduations. The first diploma was issued for grade 12 after which students either entered the workforce, attended community colleges or continued on to grade 13.  Grade 13 graduates received another diploma that allowed them to continue on to university.  The purpose of Grade 13 was specifically to prepare students for university and so course content and delivery was aligned to that purpose.  When grade 13 was eliminated we ended up with a system where graduation could be completed in 4 years, 4 ½ years or 5 years.  The total number of credits required was 30 instead of 33 and grade 13 credits were replaced with OACs or Ontario Academic Credits. As part of the reforms introduced, university professors were consulted in the preparation of these credits to attempt a seamless transition to university first-year subjects.  OACs were later eliminated as the system gravitated more towards an emphasis upon graduating from high school and less on high school as a preliminary for higher education.  As one ministry representative said to an audience of principals at an information seminar that I attended, “high schools are no longer and never should have been clearing houses for universities”.

The latest reforms in education have concentrated on the notion of student success while at the same time downplaying the competitive aspect of education as well as the notion of the educational process as part of a meritocracy.  It would appear that in practice the emphasis upon success has also implied the removal of failure and success seems to be defined in terms of either achieving a credit or obtaining a high school graduation diploma. Much of these initiatives have run counter to university culture which is highly competitive for admission but also within programmes for either completion of degrees or the ability to proceed onward to graduate school.

It is important here to stress the importance of meritocracy within the educational process.  In earlier times and in many other countries, access to higher education was severely restricted upon socio-economic grounds and access to preferred professions was and is comparatively easy provided the family had the means.  I read recently of the story of Banting (the inventor of insulin) who after entering the University of Toronto and failing his business programme decided to change to medicine in his next attempt with apparently very positive results.  This would obviously be impossible presently.  The concept of a meritocracy was founded upon the idea that opportunities should be accessed on the basis of merit rather than money and influence.  This would have the advantage of providing opportunities on the basis of pure merit and ability and would also be in keeping with a democratic concept of equal access.  In a sense then, the idea of a meritocracy was very much like a free market system in which individuals competed for desirable opportunities and jobs using merit as currency.  This is implicit in the current university application procedures where admissions standards fluctuate from year to year based upon the number and quality of applicants. The same principle is inherently present within high schools in that how students graduate determines post-secondary options going forward.  The elimination of a focus on academic competition is an essential aspect of the success movement since comparisons of relative levels of achievement as largely focused upon being relative to the individual as opposed to the achievement of others or to a uniform consistent standard.  So successful has this policy been that I have frequently encountered students over the past few years who were taken aback at the fact that they actually had to compete to get into university.  Many have had the impression that if they wanted to go and their parent was prepared to pay that they could go to any university or programme.

It is fairly clear that the alternatives to a meritocracy based upon competition are few and far between and range from conducting lotteries for admission to simply allowing applicants to bid financially for programmes.

At any rate, it is a worthwhile discussion to explore these issues and to consider carefully ‘fairness’ in the existing application process.