Cosmetic neurology? The New York Times “Week in Review” devotes front page space to the possibility and quotes Anjan Chatterjee, an associate professor at the University of Pennsylvania, as the authority. The particular example of enhancement that interests the Times is the use of stimulants to improve concentration or mental quickness, for such challenges as test-taking in school. But—why the new phrase? Aren’t we talking here about cosmetic psychopharmacology?
When I wrote Listening to Prozac, in 1993, I used that expression, asking whether people might be tempted to take “psychic steroids for mental gymnastics.” Then I referenced what the philosopher Thomas H. Murray called “free choice under pressure,” the risk that if medication were used by some people to improve performance, that behavior might compel others to do the same, in the fashion of steroid use in competitive sports. I also cited cases—Jean-Paul Sartre ‘s writing books while on amphetamine—in which competition was not at issue and the human race might benefit from cosmesis. Those topics are the very ones the Times discusses.
Tonight, I will post what I consider an important entry on this site, a consideration of the complaint that psychiatry misdiagnoses ordinary sadness as major depression. But where's the fun in conducting a blog if you can't now and then make a cranky claim on your own behalf? I believe that I coined the phrase “cosmetic psychopharmacology.” I am miffed that when, a decade later, Chatterjee contributed a scholarly article on the subject, he neglected to give me credit. He titled his monograph “Cosmetic neurology: The controversy over enhancing movement, mentation, and mood.” In his essay, Chatterjee referenced Listening to Prozac and employed the steroid analogy—but nowhere did he note the coinage that precedes his own.
I should add that although I have never seen any, it is possible that there are usages of cosmetic psychopharmacology that predate mine. I first employed the phrase in an essay I published in 1990. Wherever Chatterjee might trace the introduction of the word cosmetic (to describe medical interventions to alter normal, but not ideal, mental functioning), by the standards of scholarly attribution, he ought, I think, to have cited it. And then the Times, which has covered this issue before, might have done the same.
Of course, neurology is a broader concept than psychopharmacology. We can imagine genetic engineering, electric and magnetic simulation, and psychosurgery to perk up mind and brain. But cosmetic neurology is clearly cosmetic psychopharmacology's offspring. And for the moment—as in the “Week in Review” piece—the interventions under discussion involve medications that psychiatrists prescribe. (Similarly, the conclusion to Chatterjee's paper lists five examples of cosmetic neurology, and every one involves a psychoactive drug.) It’s a case of cosmetic psychopharmacology by any other name, and depending on your ethical judgments it smells as sweet or sour.
