The whatever culture

What about medication? In the book, you talk to a number of teens who became fed up with all of the medication they were on -- the ones most commonly mentioned were Prozac and Depakote -- and eventually rejected the pills. "B.J.," who had problems with drugs, self-mutilation and depression, criticized her doctor because "he was like, 'Well, we'll just give you this pill.'"

Drugs are, among other things, a cheap, easy, un-engaging way to deal with people's problems. The kids would say, "It's not that some kids don't need medication; they need a whole lot more than that." They need people to listen to them, ameliorate some of their problems. If your only response [as a doctor] is to "shit out the pills," as B.J. put it, that really is kind of a cultural tendency toward a quick fix.

In the book, you describe the way we deal with our troubled adolescents, with an attitude of "harsh individualism" and sink-or-swim "social Darwinism," as being particularly American condition.

That attitude is more extreme in America than anywhere else. It goes along with other things we see in us that differentiate us from other industrial societies. We are the country that doesn't provide much of a safety net to our people. We are the quickest to incarcerate people if they break the law. We have no universal health program. We don't give family allowances.

What are family allowances?

Family allowances are social-policy measures that many European countries have. Families are automatically provided with a certain amount of money that is supposed to go toward child-rearing expenses. It's a grant that is designed to provide a floor under every family. It's not welfare. It's more of a resource like universal health care.

Back to what I was saying: In America, we force people to rely on themselves and their wits to get by in their life, and we, as a country, explicitly reject the idea that we should be helping them. It's not accidental that we see these characteristics in their more intense form after a period of almost 25 years during which the hard right dominated our country's social and cultural institutions. This individualism is an essential part of how they look at the world.

What role did religion play in lives of the teens you talked to?

There are strands of religion in American (and elsewhere) that create this "either/or" situation for kids. You're either a good little kid on the right side of the Lord, or you're a sinner on the side of a devil. If you're on the side of God and you screw up even a little it means you're bad. As "B.J." said in the book, "If I'm already bad, I may as well be even badder."

We hear so much about the negative effects that the media has on teens. But the media and pop culture never come up in your book.

The reason the media isn't in there is because the kids didn't talk about it. When I asked them about their problems, the media didn't factor into their response, and so I didn't push it.

The kids in this book make high school sound like prison, and their teachers sound like wardens at best and evil sadomasochists at worst. "Zack," an aggressive, confrontational teen who "got in a couple of fights [with] his teachers once or twice," complained that the teachers at his high school "treat you with no respect" and that some unfairly prejudged him. But was Zack easy to have in the classroom? What is the responsibility of the teachers in dealing with difficult, disruptive, teenage addicts?

It shouldn't be their responsibility alone. Right now, they're the only adults outside the family who have the responsibility for keeping kids under control. They don't have any backup. They don't have any support system themselves. There need to be other adults in the community who can take some of the load off the school in the first place, like community-based programs that could provide help for kids having trouble in school. This would take some of the pressure off teachers.

I say the same things about the parents. These parents are put in a bad situation. There is so little help for them. Where do you turn when you have a kid who is a real handful? In many places in America, there isn't anywhere to go.

You talk about the things that schools, teachers, treatment centers should do, but don't: identifying troubled kids, establishing aftercare programs, setting up safe havens for kids to run away to. But these things would cost a lot of money.

Many of these things need not cost a lot. We could think of making use of volunteers. I talk about the possibility of enlisting retirees, for example, or college students. The students I met who were troubled adolescents said they would want to help that troubled community. There are so many people who would be willing to take on that role, who wouldn't need a salary if they feel like they're doing something important for people who need them.

It's very expensive to deal with kids the way we do now: Neglect is very expensive. The kid who doesn't have a decent, honorable counselor in high school may turn up again and again in emergency room, or he may crack up or kill people -- that situation will cost a lot of money when it reaches that phase. But you can head that off with relatively modest interventions like aftercare programs, safe havens, mentors. It's not rocket science. Most of these kids just need someone who pays attention, gives advice, gets them on the right track, helps them with their schoolwork.

How realistic do you think these ideas really are?

A lot of people [in the current administration] talk about mentoring and volunteering, they talk about all some of the same solutions that I do -- as long as it doesn't involve money. They could make some of those programs happen. If they actually did it, if they put their energy where their mouths are, we might see some improvement.

You come down very hard on parents, treatment centers, mental health professionals -- pretty much everyone in the adolescents' lives except the adolescents themselves.

I wound up being harder on parents and school personnel than I expected. That's partly because when I talked to some of them, I was appalled at the way they perceived parenting. We have to realize that there are a lot of parents out there who don't want to do the job of parenting. It's hard. It involves sacrificing your own pleasures, taking on a very responsible role, which is beyond the capacity of a lot of American parents.

Why do you think contemporary parents have such a difficult time parenting?

In the book I provide two answers: One, it's a problem of resources. Parents are pressed for time and money. In addition, there are very few sources of social support for parents. We're continually taking away money for childcare, school counselors, things that could help parents do a better job of parenting. We don't provide resources the same way many other countries do: universal childcare benefits, vacation time, family allowances.

One of the reasons these problems are getting worse is the hardening of the culture that lies behind this. Careless individualism has become our modus operandi. This behavior has roots in our individualist heritage, but it is sharpening in the 20th and 21st century. People are unwilling to take responsibility, unwilling to think about the consequences of their actions, whether it be barreling down the freeway in a Hummer and not caring about other drivers, other people, or the environment -- it's the same mentality.

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