The Discovery of Hyperkinesis: Notes on the Medicalization of Deviant Behavior

Author(s): Peter Conrad

Source: Social Problems, Vol. 23, No. 1 (Oct., 1975), pp. 12-21
Published by: University of California Press on behalf of the Society for the Study of Social
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 THE DISCOVERY OF HYPERKINESIS: NOTES ON THE
MEDICALIZATION OF DEVIANT BEHAVIOR*
PETER CONRAD
Drake University,Des Moines, Iowa

The increasingmedicalizationof deviant behavior and social control is seen in

the way hyperkinesis, a medical label for certaindeviantbehaviorsin children,has
become prevalentin recentyears. First,this paper presentsa brief historyof the
diagnosis and treatmentof hyperkinesis;social and clinical factorsinvolved with
this medicalizationare discussed. The social control mechanism (stimulant drug
treatment)was available twentyyears before the medical label was described.We
speculate on whetheravailable social control leads to new medical labels. The
process of medicalization,often seen as humanitarianreform,has another side.
The second sectionof the paper will consider: (1) the problemof expertcontrol;
(2) medical social control; (3) the individualizationof social problems; and (4)
the depoliticizationof deviantbehavior.Ramifications for the studyof the sociology
of devianceare presented.

INTRODUCTION termsof psychotechnology (Chorover,

The increasing medicalization of de- 1973). This approach includes a variety
viantbehavior and the medical insti- of medical and quasi-medical treat-
tution'srole as an agent of social ments or procedures:psychosurgery,
controlhas gainedconsiderable notice psychotropic medications, geneticengi-
antibuse, and methadone.
(Freidson,1970; Pitts,1971; Kitterie, neering,
This paper describeshow certain
1971; Zola, 1972). By medicalization
we meandefining behavioras a medi- forms of behaviorin children havebe-
cal problemor illnessand mandating come defined as a medicalproblemand
or licensingthe medicalprofession to how medicine has become a major
agent for their socialcontrol since the
providesometypeof treatment forit.
of hyperkinesis.
Examples includealcoholism,drug ad- discovery By discovery
dictionand treatingviolenceas a genet- we meanbothoriginof the diagnosis
ic or braindisorder.This redefinitionand treatment for this disorder;and
is not a new function of the medical discovery of children who exhibitthis
institution: andpublichealth behavior. The first sectionanalyzes
psychiatry of hyperkinesis and why
havealwaysbeenconcerned withsocial thediscovery
behaviorand have traditionally func- it suddenly became popular in the
tionedas agentsof socialcontrol(Fou- 1960's. The second section will dis-
cuss the medicalization of deviantbe-
cault,1965; Szasz,1970; Rosen,1972).
Increasinglysophisticatedmedicaltech- haviorand its ramifications.
nologyhas extendedthe potentialof THE MEDICAL DIAGNOSIS OF
thistypeof socialcontrol,especially in
HYPERKINESIS
* This paper is a revised version of a recent
Hyperkinesis is a relatively
paper presentedat the meetingsof the So- as a medicaldiagnostic
ciety for the Study of Social Problems in phenomenon
San Francisco,August 1975. It was partially category.Onlyin thepasttwodecades
supportedby a National Science Foundation has it been availableas a recognized
dissertationgrant(SOC 74-22043). I would
like to thank Drs. Martin Kozloff, James
diagnosticcategoryand only in the
E. Teele, John McKinlay and the anony-
last decadehas it receivedwidespread
mous refereesforcommentson earlierdrafts noticeand medicalpopularity. How-
of this paper. ever,the rootsof the diagnosisand

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 Discovery of Hyperkinesis 13

treatment of this clinical entityare the emergence of the new diagnostic

foundearlier. category.
Hyperkinesis is also knownas Mini-
mal Brain Dysfunction, Hyperactive Clinical Factors
Syndrome,Hyperkinetic Disorder of
Childhood,and by severalotherdiag- Bradley(1937) observedthatam-
drugshad a spectacular ef-
nosticcategories. Althoughthe symp- phetamine
fectin alteringthebehaviorof school
tomsand the presumedetiologyvary,
who exhibitedbehaviordis-
in generalthebehaviors arequitesimi- children
orders or learningdisabilities. Fifteen
lar and greatly overlap.1 Typicalsymp- of the
thirtychildren he treatedactu-
tom patternsfor diagnosingthe dis-
more subdued in their
orderinclude:extreme excessof motor ally became
behavior. Bradley termedthe effect
activity(hyperactivity); veryshortat- of this medication
tentionspan (the child flitsfromac- paradoxical,since
he expectedthatamphetamines would
tivityto activity);restlessness; fidgeti- stimulatechildrenas stimulated
ness; often wildly oscillatingmood adults.Afterthe medication they
was dis-
swings(he's fine one day, a terror the
continued the children'sbehaviorre-
next); clumsiness;aggressive-like be-
level.
havior;impulsivity; in schoolhe can- turnedto premedication
A scattering of reportsin themedi-
notsit still,cannotcomplywithrules,
cal literatureon the of stimu-
has low frustration level; frequentlylant medicationsforutility
"childhood be-
theremay be sleepingproblemsand
haviordisorders" appeared in thenext
acquisitionof speechmaybe delayed two decades.The next con-
(Stewart, 1966; 1970; Wender,1971). tribution significant
was theworkof Straussand
Most of the symptoms for the dis-
his associates(Straussand Lehtinen,
orderare deviantbehaviors.2 It is six
who found certainbehavior
times as prevalentamong boys as 1947)
(including hyperkinesisbehaviors)in
amonggirls.We use the termhyper- children
kinesisto represent all the diagnostic postencephaletic suffering
of fromwhattheycalled minimalbrain
categories this disorder.
injury(damage). This was the first
THE DISCOVERY OF HYPERKINESIS timethesebehaviors wereattributed to
theneworganicdistinction of minimal
It is usefulto divide the analysis
braindamage.
intowhatmightbe considered clinical This disorderstill remainedun-
factorsdirectly relatedto thediagnosis
namedor else it was called a variety
and treatmentof hyperkinesis and of names
social factorsthatset the contextfor (usuallyjust "childhoodbe-
haviordisorder").It did not appear
1 The U.S.P.H.S. report (Clements, as a specificdiagnostic categoryuntil
1966) included 38 terms that were used Laufer,et al. (1957) describedit as
to describe or distinguish the conditions the
that it labeled Minimal Brain Dysfunction. "hyperkineticimpulsedisorder"in
Although the literatureattemptsto differ-
1957. Upon finding"the salientchar-
entiate M.B.D., hyperkinesis,hyperactive acteristics of thebehaviorpattern...
syndrome, and several other diagnostic are strikingly similarto those with
labels, it is our belief that in practicethey clear cut organiccausation"thesere-
are almost interchangeable. describeda disorderwithno
2 For a fullerdiscussionof the construc- searchers
tion of the diagnosis of hyperkinesis,see clear-cuthistory or evidencefor or-
Conrad (forthcoming),especiallyChapter6. ganicity(Laufer,et al., 1957).

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14 SOCIAL PROBLEMS

In 1966 a taskforcesponsoredby andsubstantial federalfundshavebeen

theU.S. PublicHealthServiceand the investedin etiologicaland treatment
NationalAssociation forCrippledChil- research.Outsidethe medicalprofes-
drenand Adultsattempted to clarify sion,teachers have developeda work-
theambiguity and confusion in termi- ingclinicalknowledge of hyperkinesis'
nologyand symptomology in diagnos- symptoms and treatment(cf. Robin
ing children'sbehaviorand learning and Bosco, 1973); articles appear
disorders. Fromoverthreedozendiag- regularly in masscirculationmagazines
noses,theyagreedon theterm"mini- and newspapers so thatparentsoften
mal brain dysfunction" as an over- cometo clinicswithknowledge of this
riding diagnosis that would include diagnosis.Hyperkinesis is no longer
hyperkinesisand other disorders the relatively esotericdiagnosticcate-
(Clements,1966). Since this time goryit may have been twentyyears
M.B.D. has been the primary formal ago, it is now a well-known clinical
diagnosisor label. disorder.
In the middle1950's a new drug,
Ritalin,was synthesized, thathasmany Social Factors
qualities of amphetamineswithout The social factors the dis-
some of theirmore undesirableside affecting
covery of hyperkinesis can be divided
effects.In 1961 this drug was ap-
intotwo areas: (1) The Pharmaceuti-
provedby the F.D.A. for use with cal Revolution;
children.Since this time there has (2) Government Ac-
tion.
been muchresearchpublishedon the
useofRitalinin thetreatment (1) The PharmaceuticalRevolution.
of child- Since the1930'sthepharmaceutical in-
hood behaviordisorders. This medica-
dustry hasbeensynthesizing andmanu-
tionbecamethe "treatment of choice" a numberof psycho-
for treatingchildren with hyper- facturing large
activedrugs,contributing to a virtual
kinesis.
revolution in drugmakingand drug
Since the early sixties,more re-
searchappearedon the etiology, takingin America(Silverman and Lee,
diag- 1974).
nosis and treatment of hyperkinesis
Psychoactive drugsare agentsthat
(cf. DeLong, 1972; Grinspoonand effect thecentralnervoussystem. Ben-
Singer,1973; Cole,1975)-as muchas zedrine,Ritalin,and Dexedrineare all
three-quarters concernedwith drug
treatment of the disorder.There had synthesized psychoactivestimulants
whichwere indicatedfor narcolepsy,
been increasingpublicityof the dis- control(as "dietpills"), mild
orderin themassmediaas well. The appetite
Reader's Guide to PeriodicalLiterature depression, fatigue,and morerecently
children.
had no articleson hyperkinesis before hyperkinetic
Until the early sixtiestherewas
1967,one eachin 1968 and 1969 and littleor no and advertise-
a total of fortyfor 1970 through1974 promotion
mentof anyof thesemedications for
(a meanof eightper year). use with childhooddisorders.3 Then
Now hyperkinesis has becomethe
mostcommonchild psychiatric prob- 3
lem (Gross and Wilson, 1974: 142); American Medical
The Association's
in
change policy in acceptingmore pharma-
clinicshavebeenestab- ceutical
specialpediatric advertisingin the late fiftiesmay
lished to treathyperkinetic children, have been important.Probably the F.D.A.

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 Discovery of Hyperkinesis 15

twomajorpharmaceutical firms (Smith, five to ten percentof the 62,000

Kline and French,manufacturer of grammarschool childrenin Omaha,
Dexedrine and CIBA, manufacturerNebraska were being treatedwith
of Ritalin)beganto advertise in medi- "behaviormodification drugs to im-
cal journalsand through directmailing provedeportment andincrease learning
and efforts of the "detailmen." Most potential"(quoted in Grinspoonand
of thisadvertising of the pharmaceu- Singer,1973). Althoughthe figures
ticaltreatment of hyperkinesis was di- were laterfoundto be a littleexag-
rectedto themedicalsphere;butsome gerated, it neverthelessspurred a
of thepromotion was targeted forthe Congressional investigation (U.S. Gov-
educational sector also (Hentoff, ernment PrintingOffice,1970) and a
1972). This promotion was probably conference sponsoredby the Officeof
in
significant disseminating informa- Child Development(1971) on the
tion concerningthe diagnosis and use of stimulant drugsin thetreatment
treatment of thisnewlydiscovered dis- of behaviorally disturbed schoolchil-
order.4Since 1955 theuse of psycho- dren.
activemedications(especiallypheno- The Congressional Subcommittee on
thiazines)forthetreatment of persons Privacychairedby Congressman Cor-
who are mentallyill, along withthe nelius E. Gallagherheld hearingson
concurrentdramaticdecline in in- the issue of prescribing drugsforhy-
patientpopulations, has made psycho- peractiveschoolchildren.In general,
pharmacology an integralpartof treat- the committee showedgreatconcern
mentformentaldisorders. It has also overthe facilityin whichthe medica-
undoubtedly increasedthe confidence tion was prescribed; morespecifically
in the medical professionfor the that some childrenat least were re-
pharmaceutical approachto mentaland ceiving drugs from general practi-
behavioralproblems. tionerswhose primarydiagnosiswas
(2) Government Action.Since the basedon teachers' and parents'reports
publication of theU.S.P.H.S. reporton that the child was doing poorlyin
M.B.D. therehave been at least two school.Therewas also a concernwith
significantgovernmental reportson theabsenceof follow-up studieson the
treating schoolchildrenwithstimulant long-term effectsof treatment.
medicationsfor behavior disorders. The H.E.W. committee was a rather
Both of thesecame as a responseto hastily convened groupofprofessionals
the nationalpublicitycreatedby the (a majoritywere M.D.'s) manyof
WashingtonPost report(1970) that whom alreadyhad commitments to
drug treatmentfor childrens'behavior
approval of the use of Ritalin for children problems.Theyrecommended thatonly
in 1961 was more significant.Until 1970, M.D.'s make the diagnosisand pre-
Ritalin was advertised for treatmentof scribe thatthe pharmaceu-
treatment,
"functionalbehaviorproblemsin children." tical
Since then, because of an F.D.A. order, it companiespromotethe treatment
has only been promoted for treatmentof of the disorderonlythrough medical
M.B.D. channels,thatparentsshould not be
4 The drug industryspends fully25 per- coercedto
acceptanyparticular treat-
cent of its budget on promotionand adver-
tising. See Coleman et al. (1966) for the
ment and thatlong-term follow-upre-
role of the detail men and how physicians search should be done. This report
rely upon themfor information. served as blue ribbonapproval for

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16 SOCIAL PROBLEMS

treatinghyperkinesis withpsychoactivecantin "promoting" hyperkinesis as a

medications. disorder withinthemedicalframework.
These agentsmightbe conceptualized
DIscussioN in Becker'stermsas "moralentrepre-
thosewho crusadeforcreation
We will focusdiscussionon three neurs,"
and enforcement of therules(Becker,
issues:How children'sdeviantbehav-
. In this case the moral entre-
ior becameconceptualized as a medi- 1963)
were the com-
cal problem;whythisoccurredwhen preneurs pharmaceutical
panies andtheAssociation forChildren
itdid; andwhataresomeof theimpli-
withLearningDisabilities.
cationsof themedicalization of deviant
The pharmaceutical companies spent
behavior.
considerable timeand moneypromot-
How does deviantbehaviorbecome forthisnew
stimulant medications
conceptualized as a medicalproblem? ing
disorder.Fromthemiddle1960's on,
We assumethatbeforethediscovery of
medicaljournalsand thefree"throw-
hyperkinesisthistypeof deviancewas
containedelaborate
seen as disruptive, disobedient,rebel- away" magazinesforRitalinand Dexedrine.
advertising
lious, anti-socialor deviantbehavior. These ads
explained the utilityof
Perhaps the label "emotionallydis- treating and urged the
hyperkinesis
turbed"was sometimes used,whenit to and treathyper-
was in voguein the earlysixties,and physician diagnose
kineticchildren. The ads runfromone
the childwas usuallymanagedin the
to six pages.For example,a two-page
contextof the familyor theschoolor
ad in 1971 stated:
in extremecases, the child guidance
clinic.How thendid thisconstellation MBD ... MEDICAL MYTH OR DI-
AGNOSABLEDISEASE ENTITY What
of deviantbehaviors becomea medical medical has not,at one time
practitioner
disorder ? or another, beencalleduponto examine
The treatment was available long an impulsive, excitablehyperkinetic child?
beforethedisordertreatedwas clearly A childwithdifficulty in concentrating.
Easilyfrustrated. A
conceptualized.It was twentyyears classroomrebel.Unusually aggressive.
In the absenceof any
afterBradley'sdiscovery of the "para- organicpathology, the conductof such
doxicaleffect" of stimulantson certain children was,untila fewshortyearsago,
deviantchildren thatLaufernamedthe usuallydismissed as . . . spunkiness, or
disorderand describedits character- evidenceof youthfulvitality.But it is
now evidentthatin manyof thesechil-
isticsymptoms. Onlyin thelate fifties drenthehyperkinetic syndrome existsas
wereboththediagnostic label and the a distinct medicalentity. This syndrome
pharmaceutical treatmentavailable.The is readilydiagnosedthrough patienthis-
pharmaceutical revolutionin mental tories,neurologic signs,and psychometric
healthand the increasedinterestin testing-hasbeenclassified by an expert
child psychiatryprovideda favorable 5 Freidson also notes the medical pro-
backgroundfor the dissemination of fessionalrole as moral entrepreneurin this
processalso:
knowledgeabout this new disorder.
The latterprobablymade the medical The
professiondoes treat the illnesses
professionmorelikelyto considerbe- laymen take to it, but it also seeks to
haviorproblemsin childrenas within discoverillness of which the laymenmay
theirclinicaljurisdiction. not even be aware. One of the greatest
Therewereagentsoutsidethemedi- and ambitionsof the physicianis to discover
describea "new" disease or syndrome
cal professionitselfthatweresignifi-
S.. (1970:252)

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 Discovery of Hyperkinesis 17

panel convenedby the United States De- in oursociety.Physicians findtreatment

partmentof Health, Education and Wel-
fareas Minimal Brain Dysfunction,
MBD.
relativelysimpleand theresultssome-
timesspectacular.Hyperkinesis mini-
The pharmaceutical also
firms supplied mizes parents' guilt by emphasizing
sophisticatedpackets of "diagnostic "itsnottheirfault,itsan organicprob-
and treatment" information on hyper- lem" and allowsfornonpunitive man-
kinesis to physicians,paid for pro- agementor controlof deviance.Medi-
fessionalconferences on the subject, cationoftenmakesa childless disrup-
and supported researchin theidentifi- tive in the classroomand sometimes
cationand treatment of the disorder. aids a childin learning. Childrenoften
Clearlythesecorporations had a vested like their"magicpills" whichmake
interestin the labelingand treatmenttheirbehaviormoresociallyacceptable
of hyperkinesis; CIBA had $13 million and theyprobablybenefitfroma re-
profit from Ritalin alone in 1971, ducedstigmaalso. Thereare,however,
whichwas 15 percent of thetotalgross someother, perhapsmoresubtleramifi-
profits(Charles, 1971; Hentoff,1972). cationsof the medicalizationof deviant
The othermoralentrepreneur, less behavior.
powerful thanthepharmaceutical com-
THE MEDICALIZATION OF DEVIANT
panies,but nevertheless influential, is
the Associationfor Children with BEHAVIOR
LearningDisabilities.Althoughtheir Pittshas commented that"medical-
focusis notspecificallyon hyperkineticization is one of the most effective
children,theydo includeit in their meansof social controland thatit is
conceptionof Learning Disabilities destinedto becomethemainmodeof
along withaphasia,readingproblems formal social control" (1971:391).
like dyslexiaand perceptualmotor Kitterie
(1971) has termedit "the
problems.Foundedin theearly1950's comingof thetherapeutic state."
by parentsand professionals, it has Medicalizationof mental illness
functioned muchas the NationalAs- datesat leastfromtheseventeenth cen-
sociationfor MentalHealth does for
tury(Foucault, 1965; Szasz, 1970).
mentalillness:promoting conferences,Even slaveswho ran awaywereonce
sponsoring legislation,
providing social considered to be sufferingfromthedis-
support. One of the main functions ease drapedomania (Chorover,1973).
has been to disseminateinformationIn recent
yearsalcoholism,violence,
concerning thisrelatively new area in and
drugaddictionas well as hyper-
education, LearningDisabilities. While activebehaviorin children haveall be-
theorganization doeshavea moreedu- come definedas medical
cationalthanmedicalperspective, problems,
most bothin
etiologyor explanation of the
of theliterature indicatesthatforhy- behaviorand themeansof socialcon-
perkinesismembershave adoptedthe trolor treatment.
medicalmodel and the medical ap- There are manyreasonswhy this
proach to the problem.They have medicalization has occurred.Muchsci-
sensitizedteachersand schoolsto the entificresearch,
especiallyin pharma-
conception of hyperkinesis as a medical cologyand genetics,has becometech-
problem. nologicallymore sophisticated, and
The medicalmodel of hyperactivefoundmoresubtlecorrelates withhu-
behavior hasbecomeverywellaccepted man behavior.Sometimesthesefind-

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18 SOCIAL PROBLEMS

ings (as in thecase of XYY chromo- issue include(1) the problemof ex-
somesandviolence)becomeetiological pertcontrol;(2) medicalsocial con-
explanations for deviance.Pharmaco- trol;(3) theindividualization of social
logicaltechnology thatmakesnewdis- problems;and (4) the "depoliticiza-
coveriesaffecting behavior(e.g., anti- tion"of deviantbehavior.
buse, methadone and stimulants)are 1. The problem of expert control.
usedas treatment fordeviance.In part The medicalprofession is a profession
this applicationis encouragedby the of experts;theyhave a monopolyon
prestigeof themedicalprofession and anything thatcan be conceptualized as
its attachment to science.As Freidson illness.Becauseof thewaythemedical
notes,themedicalprofession has first profession is organizedand the man-
claimto jurisdiction overanything that date it has fromsociety,decisionsre-
dealswiththefunctioning of thebody lated to medicaldiagnosesand treat-
and especiallyanythingthat can be mentare virtually controlled bymedi-
labeled illness (1970:251). Advances cal professionals.
ingenetics, pharmacology and "psycho- Someconditions thatenterthemedi-
surgery"also mayadvancemedicine's cal domainare not ipso factomedical
jurisdiction overdeviantbehavior. problems,especiallydeviantbehavior,
Second, the application pharma- whetheralcoholism,hyperactivity
of or
cologicaltechnology is related to the drug addiction. a
By defining problem
humanitarian trendin the conception as medicalit is removedfromthepub-
and controlof deviantbehavior.Al- lic realmwheretherecan be discussion
coholismis no longer sin or even byordinary peopleand puton a plane
moralweakness,it is now a disease. whereonlymedicalpeoplecan discuss
Alcoholicsare no longerarrestedin it.As Reynolds states,
manyplacesfor"publicdrunkenness," The increasingacceptance,especially
theyare nowsomehow"treated," even amongthe more educatedsegmentsof
if it is onlyto be driedout. Hyper- our populace,of technicalsolutions-
activechildrenare now consideredto solutionsadministered by disinterested
and
politically morally neutral experts-
have an illnessratherthanto be dis- resultsin the withdrawal of moreand
ruptive,disobedient, overactive prob- moreareasofhumanexperience fromthe
lemchildren. Theyare notas likelyto realm of public discussion.For when
be the "bad boy" of the classroom; drunkenness, juvenile delinquency, sub
par performance and extreme political
theyare childrenwitha medicaldis- beliefsare seen as symptoms of an un-
order.Clearlythereare somerealhu- derlyingillnessor biologicaldefectthe
manitarianbenefitsto be gained by meritsanddrawbacks of suchbehavior or
such a medical conceptualization of beliefsneednotbe evaluated(1973:220-
deviantbehavior. Thereis lesscondem- 221).
nationof the deviants(theyhave an The publicmayhavetheirownconcep-
illness,it is not theirfault) and per- tionsof deviantbehaviorbut thatof
haps less socialstigma.In somecases, theexpertsis usuallydominant.
even the medical treatment itselfis 2. Medical social control. Defining
morehumanitarian socialcontrolthan deviantbehavioras a medicalproblem
thecriminaljusticesystem. allows certainthingsto be done that
There is, however,anotherside to couldnototherwise be considered; for
themedicalization of deviantbehavior. example,thebodymaybe cutopenor
The fouraspectsof this side of the psychoactive medications maybe given.

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 Discovery of Hyperkinesis 19

This treatment can be a formof social Ryan's(1971) notionof "blamingthe

control. victim;"seeingthecausesof theprob-
In regardto drugtreatment Lennard lem in individualsratherthanin the
pointsout: "Psychoactive drugs,espe- societywheretheylive.We thenseek
ciallythoselegallyprescribed, tendto to changethe"victim"ratherthanthe
restrain individualsfrombehaviorand society.The medical perspectiveof
experience thatare notcomplementarydiagnosingan illnessin an individual
to the requirements of the dominant lendsitselfto theindividualization of
valuesystem"(1971:57). Theseforms social problems.Ratherthan seeing
of medicalsocial controlpresumea certaindeviantbehaviorsas sympto-
priordefinition of devianceas a medi- maticof problems in thesocialsystem,
cal problem.Psychosurgery on an in- the medical perspectivefocuses on
dividual prone to violent outbursts theindividualdiagnosingand treating
requiresa diagnosisthat there was theillness,generally ignoring thesocial
somethingwrongwith his brain or situation.
nervoussystem.Similarly, prescribing Hyperkinesis servesas a good ex-
drugs to restless, overactive and dis- ample. Both the schooland theparents
ruptive schoolchildren requiresa diag- areconcerned withthechild'sbehavior;
nosisof hyperkinesis. These formsof thechildis verydifficult at homeand
socialcontrol,whatChorover(1973) disruptive in school.No punishments
hascalled"psychotechnology," arevery or rewardsseemconsistently to work
powerful andoftenveryefficient means in modifying the behavior;and both
of controllingdeviance.These rela- parentsand school are at theirwits'
tivelynew and increasingly popular end.A medicalevaluation is suggested.
formsof social controlcould not be The diagnosesof hyperkinetic behavior
utilizedwithoutthe medicalization of leads to prescribing stimulant medica-
deviantbehavior.As is suggested from tions.The child's behaviorseems to
the discoveryof hyperkinesis, if a becomemoresociallyacceptable, reduc-
mechanismof medicalsocial control ingproblems in schooland at home.
seemsuseful,thenthedeviantbehavior But thereis an alternate perspective.
it modifies will developa medicallabel By focusingon thesymptoms and de-
or diagnosis.No overtmalevolence on finingthemas hyperkinesis we ignore
the partof the medicalprofessionis the possibility thatbehavioris not an
implied: rather it is part of a complex illness but an adaptationto a social
process,of whichthe medicalprofes- situation. It divertsour attention from
sion is onlya part.The largerprocess thefamily or schooland fromseriously
mightbe calledtheindividualization of entertaining the idea thatthe "prob-
socialproblems. lem" could be in the structure of the
3. The individualization of social social system. And by givingmedica-
problems.The medicalization of de- tionswe are essentially supporting the
viantbehavioris partof a largerphe- existingsystems and do notallow this
nomenonthatis prevalentin our so- behaviortobe a factorof changein the
ciety,the individualization of social system.
problems.We tendto look forcauses 4. The depoliticizationofdeviantbe-
and solutionsto complexsocial prob- havior.Depoliticization of deviantbe-
lems in the individualratherthanin havioris a resultof boththe process
the socialsystem. This view resembles of medicalization and individualization

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20 SOCIAL PROBLEMS

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This strategy servedto neutralizethe 585.
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sent,rendering it the ravingsof mad 1971 "The case of Ritalin." New Re-
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