The mythology of contemporary youth SAUL V. LEVINE,* MD,
FRCP[C]
Anyone who has worked with or taken an interest in youth over the past few years has probably been struck by the seemingly rapid modifications in their attitudes and behaviour, the waves of dogma and enthusiasm that seem to envelop them, and their responses to the unpredictable and hectic changes in the world. It is equally apparent that much of what many of us deem either basic change or an inherent character¬ istic of youth is, in fact, neither. It is on this point that I offer a personal perspective developed from professional
work and studies I have undertaken in the past few years. I was trained in psychiatry at Stan¬ ford University between 1964 and 1968, when the war in Vietnam was raging, young people were demonstrat¬ ing against the Establishment, and "hippies" and "flower children" were going to save the world through a new ethos of grass, inner peace and love for all. Back then I was an activist, an idealist and an optimist. I returned to Canada in the year of President Johnson's decision to quit and the assassination of Martin Luther King and Robert Kennedy. It was the year of Wood¬ stock; it was also the year of Altamont, the dark side of Woodstock. To borrow from Dickens, "it truly was the best of times; it truly was the worst of times." Since then, young people have gone beyond simplistic solutions in their pursuit of the millennium, and beyond simplistic answers to existential ques¬ tions, but adults have had trouble adapting to the younger generation's state of perpetual flux. One way to
?Associate professor, departments of psychiatry and psychology, University of Toronto; senior staff psychiatrist, The Hospital for Sick Children, Toronto
Reprint requests to: Dr. Saul V. Levine, The Hospital for Sick Children, 555 University Ave., Toronto, Ont. M5G 1X8
handle this dilemma is to create myths that ascribe to youth a variety of immutable characteristics, irrespective of their reality and validity. Webster defines a myth as "a tradi¬ tional story of unknown authorship, ostensibly with a historical basis, but
serving usually to explain some pheno¬ of nature, the origin of man, customs, institutions, religious rites, ete. of a people", or "any fictitious story". I will use the term in the latter sense now. and later in the former meaning. The myths I will dis¬ cuss are the kinds harboured, accepted and spread by many of us. They suffer from the weakness of any generalization; that is, the exceptions are rampmenon or the
ant.
Myths of youth's adulators The flower-child myth, in which the young are seen as all-happy, peaceful and loving, was (one hopes) put to rest at Altamont, in the Haight-Ashbury district of San Francisco, and in the Yorkville area of Toronto during the late 1960s. Did these flowers wilt be¬ cause of improper soil or were the plants defective? This metaphoric di¬ lemma is the crux of the arguments by pro- and antiyouth forces. The myth of youth as nonviolent is readily debunked when we realize that most of the physically destructive acts in the world today are perpetrated by young people. Even if we discount the cannon-fodder hypothesis, in which the young fight the wars of the old, this observation is still valid if we consider who commits the crimes of passion and other criminal acts and who is jingoistic. The myth of sexually liberated youth is becoming increasingly difficult to maintain in the face of the increasing incidence of venereal disease and premarital pregnancy and the high fre¬ quency of sexual problems; adolescent
boys
still
use sex
love to get sex, and girls get love. What we see is not
use
to
liberation but conformity to social expectations an intense cultural pres¬ sure to perform early and frequently or face self-generated or peer-group opprobrium and ostracism. The ecology myth, in which the leaders of society ravage the countryside, despoil our resources and pollute our environment while the young are left with the "spoils" is simplistic and invalid. The believers in this myth have obviously not seen the aftermath of a rock festival or heard a youth's soupedup car. The myth of nonconformist youth is ludicrous when one can foresee a world of denim. Jeans are the closest thing yet to a universal uniform. As recent studies have shown,1 contemporary youth not only conform to each other, but many also conform closely to their parents' values, politics, aims and aspirations. One only has to check consumer ex¬ penditure data to easily puncture the myth of antimaterialistic youth. The youth spend on and consume the useless on a grand scale. Not surprisingly, the advertising media pander to this age group in a manner reminiscent of the ubiquitous political propaganda di¬ rected at the young in
some
other coun¬
tries, like China or Cuba. The myth of the antiwork ethic is not illustrated by the youth with whom I associate. The young in the labour force, in high schools, community col¬ leges and universities seem to work as diligently toward goals as we did, and
their
aspirations are not dissimilar to The myth of youth as selfless,- altruistic and tolerant is inane. The young do not have a monopoly on these ours.
virtues, which have less to do with age than with other characteristics of per¬ sonality and background.
CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113 501
The myth of
youth
as
social
con¬
science warrants some attention. The young have always been idealists, sensi¬ tive to the faults, frailties and foibles of their elders and quick to point accusing fingers at those they blame. The definition of an adult as "a radical with a mortgage" is perhaps relevant, for it is easier to criticize when one is not yet burdened with needs of subsistence, responsibility for others, inflation, dis¬ ease in self and others, and the perpetual identity crisis of the postadolescent years.
how are we going to deal with our preoccupation with sexuality? Do they talk about it, do it and enjoy it more than we do? The young are under great social pressure to perform, but they are also more honest and less hypocritical about their sexuality.
The myth of youth as violent may to contradict what I said earlier, but while I feel that the majority of violent acts are committed by youth, too often the acts are manifestations of their elders' needs, conflicts and seem
jingoism. The myth of youthful narcissism im¬ plies that maturity brings selflessness
already wrought havoc in our society: the myths that growth is equivalent to progress and that change is equivalent to improvement. We are living in an age of frenetic change. Our highly mo¬ bile culture and low birth rate have combined to produce millions of small, isolated nuclear families. In our frenzied devotion to unlimited mobility, unrestrained growth, technologic ad¬ vances, material acquisition and unbridled competition we have undermined the psychologic and social struts of our society. "Change for change's sake" has become the sine qua non of our existence. Hence, the predictable social structures of society have become ambiguous and blurred one of the situations least psychologically tolerable. Further, there has been a dissipation of agreed-upon social values. Traditions and rituals have become equated with reactionary entrenchment, and the leaders that have emerged do not inspire the call to "followership". The italicized words represent what Leighton3 includes as the components of "psychosocial disintegration" in a variety of cultures. Yet the mythology of our society has ensured that these elements, vital for the internal stability of its members, have all but been destroyed. But surely our youth is no more vulnerable to this phenomenon than their elders. And if alienation re¬ presents social isolation, self-estrangement, normlessness, powerlessness and meaninglessness,4 can we really say that contemporary youth succumbs more readily to this unpleasant experi¬ ence? If we believe the current litera¬ ture, alienation belongs wholly to the adolescent.5 To the contrary, I and others hold that these feelings and ex¬ periences are even more poignantly imposed upon those who have long since lost the illusions of their youth. Even the central task of adolescence, as de¬ fined by Erikson,6 that of achieving a considerable degree of "identity resolu¬ tion", is not confined to that age group. Who among you is not wrestling today with the crucial existential questions that both plague and enrich us through¬ out our lives: Who am I? Where have I been? Where am I going? and, most importantly, Why? Certainly not only the young. This is seemingly a neverending dilemma or task, and reaches crisis proportions for many at transitional stages throughout life. Another myth that imposes expectations on all of us is that to be young is to be beautiful, creative, exciting and worth while; to be older is to be ugly, boring, expendable and useless. This myth is a double-edged sword. On the one hand it makes the older generation feel unrespected, desolate and un¬
youth's detractors and aitruism. This is not true, as the The myths of contemporary youth's 1974 World Food Conference in Rome detractors do not differ much from demonstrated. We seem to be teaching their age-old counterparts, as the fol¬ our youth that self-interest, power and lowing quotations demonstrate: money are what count. There may well be realistic reasons for adult conservaOur adolescents now seem to love lux- tism, but the idealism of youth makes ury. They have bad manners and contempt our seem shallow aspirations by com¬ for authority. They show disrespect for adults and spend their time hanging parison. The myth of hedonistic youth conaround places gossiping with one an¬ other they are ready to contradict jures up an image of the young reveltheir parents, monopolize the conversation ling in exercises and excesses of selfin company, eat gluttonously, and tyran- indulgence while the rest of us look Socrates nize their teachers. on with jealousy, anger and anxiety. The current ethos of indulging one's I would there were no age between ten and three-and-twenty, or that youth would needs for pleasure is as much a preoccupation of middle age as a phenom¬ sleep out the rest; for there is nothing in enon of youth. with the between but getting wenches The myth of youth as lazy and child, wronging the ancientry, stealing, and fighting. Shakespeare: "The Winter's apathetic has little validity as a blanket Tale", Act III, Scene 3 condemnation, save to make us ques¬ tion failure to "turn on" our The myth of anarchistic youth is no young.society's have not accepted Leary's They more valid (or invalid) than describing invitation to "Tune in, turn on and any of us as susceptible to antisocial drop out", but they are questioning the acts upon the abrogation of laws and traditional attitudes to work, producti¬ rules of behaviour. Some of the most vity, and competition. growth and mutually sup¬ organized, gentle portive communal societies I have studied were predominantly populated Myths of adulthood by young people.2 Golding's "Lord of While we have concentrated on the Flies" and Burgess's "A Clockwork harboured by adults about the myths Orange", both focused on young peo¬ youth, let us not forget that the reverse selfof reflect our lack ple, really confidence rather than indict youth. holds true: young people are under a or myths variety of illusions Perhaps Orwell's "Animal Farm" is about adults. We who are over 30 are more to the point. The myth of youth as chemically often seen as hypocritical, materialistic mercenary. We are attacked for spaced-out is one that adults insist on and and for being racist, sexist polluting be perpetuating. This situation would ludicrous if it were not tragic; we see and militaristic. We are described as uptight, chronically depressed and sexu¬ an age group vilified because "their" ally repressed. We are accused of being to somehow are us, threatening drugs selfish while advocating aitruism, when we all know that "our" drugs while feigning open"power-tripping" sedand nicotine, alcohol, tranquillizers and immoral while ness, being covertly are more prevalent, more atives We are piously peddling morality. dan¬ more and widely used, probably blamed for planet, and gerous. We certainly should not be tak¬ are told messing up this unequivocally that the next ing solace in the fact that today's youth have largely abandoned amphetamines, generation will correct (finally) the dis¬ psychedelic chemicals and narcotics, parities and distemper of our time. and are now heavily involved with al¬ cohol. Further mythology If the myth of youth as sexually There is further mythology that has wanted, which leads obsessed and promiscuous is true, then Myths
.
of
.
.
.
502 CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113
to
sadness, loneli-
all-consuming, passionate For the Optimum with one possible an¬ Management of swer, which we inevitably see as self- Iron Deficiency destructive. When we liken their euphoria to "psychic orgasm" we cer¬ tainly don't refer to intense transcendental pleasure; instead, we imply transcience, hedonism and immorality. But Formula: Each SLOW-FE tablet contains 160 mg. it is not only the young who are in¬ of dried ferrous sulfate U.S.P. (equivalent to 50 mg. of volved in this quest: religion freaks, ferrous iron), in a specially formulated slow release encounter group freaks, mysticism and base. The iron1 content is released evenly over an aver¬ period of Yz hours, the optimum time for maximum biofeedback freaks, political and com- age effective absorption. The tablets are film-coated. all mune freaks pervade age groups. Indications: The management of iron deficiency We all know that these movements are states. SLOW-FE is formulated to be better tolerated aided tremendously by the media and than ordinary ferrous sulfate tablets and it is therefore suitable for prolonged administration. that their substance or popularity can especially The minimization of nausea and gastrointestinal radically change overnight. But to call irritation is advantageous in pregnancy, gastroin¬
and
describe their
of the sword is
preoccupation
depression. The other edge equally debilitating, for it also "lays a heavy trip" on youth. What do we mean when we say to young people "Act your age!" To paraphrase Sartre, the young are "con¬ demned to be free". Almost in spite of themselves the young are being forced into a mould determined by our mythol¬ ogy, which in a sense acts out our needs and our regrets about lost opportuni¬ ties, lost romance, lost excitement and lost freedom. We expect youth to live up to our stereotypes. As we all know, social expectations are powerful shapers of behaviour; before any of us contravenes these implicit edicts, he or she should be prepared to pay a heavy price. This myth, adhered to by many, ness
is destructive to all of us, young and old. Earlier I presented the formal defini¬ tion of a myth. What we are engaged in is the process of "mythicizing" creating myths or beliefs about people, which in this case are based more on emotion than fact. These myths are really exaggerated biases currently pre¬ valent in society, and their superficial dismissal does not invalidate them. The danger, as I see it, is that these biases might become institutionalized (which refers us back to our first definition of myth), thus further serving to polarize the age groups in society.
.
The search I am forever amazed that the "root of all evil" sometimes dictates patterns of behaviour or provision of services that are distinct improvements over the situations that prevailed during times of unlimited funding. For example, partly because of rampant inflation, shortages of resources and excessive worldwide consumerism and popula¬ tion, we may be forced to slow down and recapture some of the values we so blithely surrendered. This in part accounts for a reduction in growth, a concern for the quality of life a return to the earth, so to speak and concentration on relationships and communities. Again, because of their relatively few responsibilities and the few demands upon them, the youth are paradoxically pioneering the re¬ turn to simpler lifestyles. Also account¬ ing for what I see as a positive trend is a gross dissatisfaction with contem¬ porary Western life and a concerted search by all of us for some meaning in our lives, for a better answer to the existential questions posed earlier. "The pursuit of the millennium" has given rise to so-called freak movements or cults of enthusiasm.7 We apply labels like speed freak, Jesus freak, drug head, ete. to the young to pejoratively
Slow-ffe
them fads or freak movements, and their devotees faddists or freaks, is to dismiss all the searchers as deluded and their answers as delusions. Not only is this a provocative, polarizing stance, it is also invalid. Similarly, it is untrue that the searchers are "sicker" than their peers. Any young adult or late adolescent group has a signifi¬ cant incidence of mental illness, emo¬ tional incapacity and antisocial beha¬ viour,8 as our studies of this age group, in a variety of settings, have borne out.9"11 But the searchers are no more disturbed and may be particularly resourceful, using normal coping mech¬ anisms in an attempt to adapt to a com¬
plicated, puzzling society;12 they can immigrants to a new so¬ ciety, trying to get their bearings in a be likened to
system that is often incomprehensible. I
am
under
no
illusions about
a
uto-
testinal disorders, e.g. peptic ulcer, convalescence and in old age, all of which may be associated with simple iron deficiency anemias. and Administration: Because it is Dosage slowly released an adequate dose is possible by giving SLOW-FE only once daily. As the ferrous sulfate content is evenly distributed through the special slow release base only a very small quantity is released in the stomach. There is therefore no need to advise that SLOW-FE tablets be taken with or after food as with other ferrous sulfate tablets. Prophylaxis; A single tablet daily is sufficient to maintain iron intake both during pregnancy and in patients with simple iron deficiency. Iron Deficiency; Depending on the severity, one or two tablets of SLOW-FE daily, usually in one dose. In mild anemias, e.g. hemoglobin above 75%, one tablet daily will usually suffice. Fox moderate or severe anemias two tablets daily should be given, until the hemoglobin levels return to normal. This physiological process may require up to approximately eight weeks. In most patients the dose can then be reduced to one tablet daily for maintenance, to build up iron reserves over a further 12 to 16 weeks. For Children: One tablet of SLOW-FE daily is a suitable dose for children able to swallow a small tablet. Side Effects: Gastrointestinal side effects such as nausea and gastrointestinal irritation usually occurring with other iron-containing tablets, are unlikely to arise with SLOW-FE. Treatment of Overdosage: Care has been taken to minimize the risk of accidental consumption of Slow-Fe by children by making the tablets a relatively unattractive off-white colour with an almost tasteless film coat rather than the customary sweet-tasting sugar coat. Moreover the push-through type of foil packaging makes the extraction of many tablets difficult and tedious for children. However, in the event of overdosage the usual treatment for iron poisoning should be instituted. Because the iron is only slowly released the risk of toxic levels of ionic iron being absorbed is less and there is a wider time margin in which to carry out stomach wash outs; also the use of an iron-chelating agent such as Desferal® (deferoxamine CIBA) is likely to be more effective. The treatment of iron poisoning is described in detail in the CIBA literature
pia on earth; Messianic individuals, absolutists and those with unequivocal magic answers make me extremely uncomfortable. But is it all immature irrationality or hocus pocus? I do not find it surprising or think it an accident that neo-Hindu religions are making themselves felt in the West, that mystical beliefs are being studied and pur¬ sued, even on university campuses the home of Western thought and rationality. There has long been this undercurrent of thinking in our so¬ ciety13 but never has it been so popular and open. Our youth are avidly reading Casteneda and Watts, for example, because they are being offered a dif¬ on Desferal®. ferent perspective on life and self. Contraindications: Iron therapy is contraindicated Yoga, meditation, altered states of con¬ in the presence of hemochromatosis, hemosiderosis sciousness and awareness, and tran- and hemolytic anemia. scendental belief systems are gaining Precautions: SLOW-FE like all oral iron prepara¬ existing peptic ulcer, regional phenomenal popularity. There are ma¬ tions, mayandaggravate ulcerative colitis. jor attempts not only to lend scientific enteritis in Supplied: SLOW-FE tablets are30packaged credibility to these belief systems but push-through packs containing tablets per sheet also, more importantly, to explore phy¬ and are available in units of 30,120 and 4,800 tablets. 1. Nutrition Canada National Survey. siologic correlates of these psychologic AReference:Nutrition Canada to The Department of report by states14 and to help us use them in our National Health and Welfare, Ottawa, Information therapeutic efforts. The possibility Canada, 1973. .
exists that there are other, sometimes better, ways of tuning in to ourselves, each other and our environment. Our
CIBA
DORVAL, QUEBEC H9S1B1
C-5024
CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113 503
work in psychiatry has certainly taught us that our perceptions of reality are arbitrary, that others perceive their space in highly personal and at times radically different terms. The crosscultural similarities between psychiatry and religion, psychotherapy and belief systems have been demonstrated clearly."'17 I have known many individuals in dire personal and social straits, for whom psychotherapy failed, who have achieved a sense of self, a feeling of self-esteem, self-realization and a reduction of symptoms through a belief in a new way of life.
6. ERIKSON E: Identity: Youth and Crisis, New York, Norton, 1968 7. CoHN N: Pursuit of the Millennium, rev ed, Oxford U Pr, 1970 8. PASAMANICK B, ROBERTS D, LEMKAU P, et al: A survey of mental disease in an urban population, in Epidemiology of Mental Disorders, Am Acad Adv Sci, 1959 9. LEVINE
10.
11. 12. 13. 14.
Conclusion It has been said that the mythology of a people is in some ways a measure of the worth of that particular culture.IR Myths are said to be the great sense-making structure of human societies; they determine the ways in which people see the world and their place in it. The shattering of biases is difficult, the destruction of myths next to impossible. We can, however, attempt to overcome polarizing stereotypes by realizing that life is painful, as well as joyous, at times for all of us. To point fingers and say "J'accuse" just doesn't work. Instead of ridiculing the search of our youth for "a better tomorrow" we should be joining them. This does not mean repudiating our values and traditions, but it does necessitate an agonizing reappraisal of the stereotypes and dogmas we hold so dear. Growing up today is in many ways more absurd than even a couple of decades ago,1" as is living in general. This absurdity should predispose to humour, tolerance and sensitivity, rather than hostility and recrimination. What is needed, as Bronfenbrenner suggested recently,2" are innovative forms and forums where young and old can interact, now that schools, family and other social institutions have radically segregated the generations and further aggravated our sense of alienation. Richler recently said that we are fortunate in Canada because we have not yet developed a Canadian mythology. We now have a unique opportunity but I am not at all sure we are up to it. References 1. OFFER D, MARCUS D, OFFER 3: A longitu-
dinal study of normal adolescents. Am I Orthopsychiatry 126: 917, 1970 2. LEVINE SV: The urban commune: fact or fad - promise or pipedream. Am I Orthopsychiatry 43: 149, 1973 3. LEIGHTON D: The Empirical Status of the Integration-Disintegration Hypothesis in Psychiatric Disorder and the Urban Environment, edited by KAPLAN B, New York, Behavioral Pubns, 1971 4. SEaMAN M: On the meaning of alienation. Am Soc Rev 24: 783, 1959 5. KasusTON K: The Uncommitted: Alienated Youth in America, New York, Harcourt Brace World, 1965
15. 16. 17. 18. 19. 20.
SV,
LLOYD
D,
LONGOON
W:
The
speed user: social and psychological factors in amphetamine abuse. Can Psychiatr Assoc 1 17: 229, 1972 LEVINE SV, SALTER NE: Youth & contemporary religious movements: a social & psychological study. Paper to be presented at Canadian Psychiatric Association annual meeting, Banff, Alta, Sept 24-26, 1975 LEVINE SV: Draft dodgers: coping with stress; adapting to exile. Am I Orthopsychiatry 42: 431, 1972 HAMBURG D, ADAMS 1: A perspective of coping behaviour: seeking and utilizing information in major transitions. Arch Gen Psychiatry 17: 277, 1967 NovEs JH: Strange Cults and Utopias of 19th Century America, New York, Dover, 1966 TAYLOR T (ed): Altered States of Awareness, San Francisco, Freeman,1971 (Sci Am special issue) FRANK 1: Persuasion and Healing: A Comparative Study of Psychotherapy, Baltimore, MD, Johns Hopkins, 1973 TORREY EF: The Mind Game: Psychiatry & Witchcraft, New York, Emerson, 1972 PRINCE R, LEIGHTON A: The therapeutic process in cross-cultural perspective. Am / Psychiatry 124: 9, 1968 RAKOFF V: Perennial Man and the Slowed Machine. Delivered as part of a series of Massey College lectures, University of Toronto, Oct 1974 GOODMAN P: Growing Up Absurd, New York, Random, 1960 BRONFENBRENNER P: The Origins of Alienation. Sci Am 231: 53, 1974
Postgraduate courBes INAUGURAL SYMPOSIUM of new division of community health, faculty of medicine, University of Toronto. All sessions: Medical sciences auditorium, University of Toronto. Oct. 22 to 24, 1975. Topics will include cancer, occupational diseases, urban environment, health care delivery, population problems, lifestyle, health care for Canadian Indians and schemic heart disease. Information: Dr. T.W. Anderson, Chairman of program committee, FitzGerald Building, University of Toronto, Toronto, Ont. MSS IAl CIVIL AVIATION MEDICAL ASSOCIATION AN. NUAL MEETING. Montreal. Oct. 19 to 23, 1975. information: Albert Carriere, BOl Green Bay Rd., Lake Bluff, IL 60044, USA ONTARIO THORACIC SOCIETY ANNUAL SCIENTIFIC MEETING. Royal York Hotel, Toronto. Oct. 31 and Nov. 1, 1975. information: Ontario Thoradc Society, 157 Wiliowdale Ave., Willowdale, Ont. M2N 4Y7 BETA-BLOCKER SYMPOSIUM. Toronto. Oct. 31, 1975. information: Postgraduate medical education, Faculty of medicine, University of Toronto, Toronto, Ont. M5S 1A8 OTOLARYNGOLOGY FOR FAMILY PHYSICIANS. Toronto. Nov. 8 and 9, 1975. Information: Postgraduate medical education, Faculty of medicine, University of Toronto, Toronto, Ont. M5S lAB MENTAL RETARDATION. Toronto. Nov. 20 and 21, 1975. information: Postgraduate medical education, Faculty of medicine, University of Toronto, Toronto, Ont. M5S lAB DEFENCE MEDICAL ASSOCIATION OF CANADA ANNUAL MEETING. Canadian Forces Base Petawawa (Ont.). Nov. 20 to 22, 1975. Information: It. Col. C.P. Smith, 2111 Niagara Dr., Ottawa, Ont. K1H 6G9 SYMPOSIUM - LES ULC.RES GASTRODUOD.NAUX. Universial Laval. Lea 21-22 novembre 1975. Renseignements: Dr Robert Gourdeau, Facult6 de m6decine, Universit6 Laval, Ou6bec, 0u6. KiK 7P4 GREY CUP MEDICAL SYMPOSIUM. Calgary. Nov. 22, 1975. Information: Dr. G. Halgh, 3630 Morley Trail NW, Calgary, Aita. T2L 1KB MANAGEMENT OF BURNS. Sheraton-Caswell Hotel, Sudbury, Ont. Nov. 26, 1975. Information: Mrs. Deborah Button, Secretary, Evaluation of continuing medical education, Ontario Medical Foundation, 242 St. George St., Toronto, Ont. MSR 2P4
504 CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113
L.esf1.6/30 Ly.st®1/60 CONTRAINDICATIONS. Thrombophlebitis, thromboembolic disorders, cerebral apoplexy, or a past history of these conditions; markedly impaired liver function; known or suspected carcinoma of the breast or genital tract; known or suspected estrogen dependent neoplasia; undiagnosed abnormal genital bleeding; during the period a mother is breast feeding an infant; any ocular lesion such as partial or complete loss of vision, defect in visual fields or diplopia arising from ophthalmic vascular disease; when epiphysial closure is not complete; when pregnancy is suspected; classical migraine; history of cholestatic jaundice; coronary thrombosis. WARNINGS. Should any thrombotic disorder occur or be suspected, the drug should be discontinued immediately. The pretreatment and periodic physical examinations should include special reference to breast and pelvic organs. Pre-existing uterine fibromyomata may increase in size. Conditions influenced by fluid retention, such as epilepsy, migraine, asthma, cardiac or renal dysfunction, require careful observation. PRECAUTIONS. A number of precautionary statements are associated with oral contraceptive usage. These include: endocrine, possibly liver function tests and thyroid function tests may be affected by treatment with oral contraceptives. Altered bleeding patterns may be induced. Diabetic patients or those with a familial history of diabetes should be carefully observed while receiving oral contraceptives. Oral contraceptives may mask the onset of the climacteric. Susceptible women may experience an increase in blood pressure. Patients with a history of jaundice should be given oral contraceptives with great care. ADVERSE REACTIONS. Oral contraceptives have been associated with a number of adverse reactions, including thrombophlebitis, pulmonary embolism, cerebral thrombosis, nausea, altered bleeding patterns, edema, breast soreness, changes in weight, headache, acne, depression, premenstrual tension and hirsutism. SUPPLIED. LOGEST 1.5/30, 21 blue tablets for 21-day on, 7-day off administration. LOGEST 1/50, 21 green tablets for 21-day on, 7-day off administration. PRODUCT MONOGRAPHS giving further information are available on request.
LEDERLE PRODUCTS DEPARTMENT Cyanamid of Canada Limited P.O. Box 1039 Montreal, Quebec H3C 2X4
FRCP[C]
Anyone who has worked with or taken an interest in youth over the past few years has probably been struck by the seemingly rapid modifications in their attitudes and behaviour, the waves of dogma and enthusiasm that seem to envelop them, and their responses to the unpredictable and hectic changes in the world. It is equally apparent that much of what many of us deem either basic change or an inherent character¬ istic of youth is, in fact, neither. It is on this point that I offer a personal perspective developed from professional
work and studies I have undertaken in the past few years. I was trained in psychiatry at Stan¬ ford University between 1964 and 1968, when the war in Vietnam was raging, young people were demonstrat¬ ing against the Establishment, and "hippies" and "flower children" were going to save the world through a new ethos of grass, inner peace and love for all. Back then I was an activist, an idealist and an optimist. I returned to Canada in the year of President Johnson's decision to quit and the assassination of Martin Luther King and Robert Kennedy. It was the year of Wood¬ stock; it was also the year of Altamont, the dark side of Woodstock. To borrow from Dickens, "it truly was the best of times; it truly was the worst of times." Since then, young people have gone beyond simplistic solutions in their pursuit of the millennium, and beyond simplistic answers to existential ques¬ tions, but adults have had trouble adapting to the younger generation's state of perpetual flux. One way to
?Associate professor, departments of psychiatry and psychology, University of Toronto; senior staff psychiatrist, The Hospital for Sick Children, Toronto
Reprint requests to: Dr. Saul V. Levine, The Hospital for Sick Children, 555 University Ave., Toronto, Ont. M5G 1X8
handle this dilemma is to create myths that ascribe to youth a variety of immutable characteristics, irrespective of their reality and validity. Webster defines a myth as "a tradi¬ tional story of unknown authorship, ostensibly with a historical basis, but
serving usually to explain some pheno¬ of nature, the origin of man, customs, institutions, religious rites, ete. of a people", or "any fictitious story". I will use the term in the latter sense now. and later in the former meaning. The myths I will dis¬ cuss are the kinds harboured, accepted and spread by many of us. They suffer from the weakness of any generalization; that is, the exceptions are rampmenon or the
ant.
Myths of youth's adulators The flower-child myth, in which the young are seen as all-happy, peaceful and loving, was (one hopes) put to rest at Altamont, in the Haight-Ashbury district of San Francisco, and in the Yorkville area of Toronto during the late 1960s. Did these flowers wilt be¬ cause of improper soil or were the plants defective? This metaphoric di¬ lemma is the crux of the arguments by pro- and antiyouth forces. The myth of youth as nonviolent is readily debunked when we realize that most of the physically destructive acts in the world today are perpetrated by young people. Even if we discount the cannon-fodder hypothesis, in which the young fight the wars of the old, this observation is still valid if we consider who commits the crimes of passion and other criminal acts and who is jingoistic. The myth of sexually liberated youth is becoming increasingly difficult to maintain in the face of the increasing incidence of venereal disease and premarital pregnancy and the high fre¬ quency of sexual problems; adolescent
boys
still
use sex
love to get sex, and girls get love. What we see is not
use
to
liberation but conformity to social expectations an intense cultural pres¬ sure to perform early and frequently or face self-generated or peer-group opprobrium and ostracism. The ecology myth, in which the leaders of society ravage the countryside, despoil our resources and pollute our environment while the young are left with the "spoils" is simplistic and invalid. The believers in this myth have obviously not seen the aftermath of a rock festival or heard a youth's soupedup car. The myth of nonconformist youth is ludicrous when one can foresee a world of denim. Jeans are the closest thing yet to a universal uniform. As recent studies have shown,1 contemporary youth not only conform to each other, but many also conform closely to their parents' values, politics, aims and aspirations. One only has to check consumer ex¬ penditure data to easily puncture the myth of antimaterialistic youth. The youth spend on and consume the useless on a grand scale. Not surprisingly, the advertising media pander to this age group in a manner reminiscent of the ubiquitous political propaganda di¬ rected at the young in
some
other coun¬
tries, like China or Cuba. The myth of the antiwork ethic is not illustrated by the youth with whom I associate. The young in the labour force, in high schools, community col¬ leges and universities seem to work as diligently toward goals as we did, and
their
aspirations are not dissimilar to The myth of youth as selfless,- altruistic and tolerant is inane. The young do not have a monopoly on these ours.
virtues, which have less to do with age than with other characteristics of per¬ sonality and background.
CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113 501
The myth of
youth
as
social
con¬
science warrants some attention. The young have always been idealists, sensi¬ tive to the faults, frailties and foibles of their elders and quick to point accusing fingers at those they blame. The definition of an adult as "a radical with a mortgage" is perhaps relevant, for it is easier to criticize when one is not yet burdened with needs of subsistence, responsibility for others, inflation, dis¬ ease in self and others, and the perpetual identity crisis of the postadolescent years.
how are we going to deal with our preoccupation with sexuality? Do they talk about it, do it and enjoy it more than we do? The young are under great social pressure to perform, but they are also more honest and less hypocritical about their sexuality.
The myth of youth as violent may to contradict what I said earlier, but while I feel that the majority of violent acts are committed by youth, too often the acts are manifestations of their elders' needs, conflicts and seem
jingoism. The myth of youthful narcissism im¬ plies that maturity brings selflessness
already wrought havoc in our society: the myths that growth is equivalent to progress and that change is equivalent to improvement. We are living in an age of frenetic change. Our highly mo¬ bile culture and low birth rate have combined to produce millions of small, isolated nuclear families. In our frenzied devotion to unlimited mobility, unrestrained growth, technologic ad¬ vances, material acquisition and unbridled competition we have undermined the psychologic and social struts of our society. "Change for change's sake" has become the sine qua non of our existence. Hence, the predictable social structures of society have become ambiguous and blurred one of the situations least psychologically tolerable. Further, there has been a dissipation of agreed-upon social values. Traditions and rituals have become equated with reactionary entrenchment, and the leaders that have emerged do not inspire the call to "followership". The italicized words represent what Leighton3 includes as the components of "psychosocial disintegration" in a variety of cultures. Yet the mythology of our society has ensured that these elements, vital for the internal stability of its members, have all but been destroyed. But surely our youth is no more vulnerable to this phenomenon than their elders. And if alienation re¬ presents social isolation, self-estrangement, normlessness, powerlessness and meaninglessness,4 can we really say that contemporary youth succumbs more readily to this unpleasant experi¬ ence? If we believe the current litera¬ ture, alienation belongs wholly to the adolescent.5 To the contrary, I and others hold that these feelings and ex¬ periences are even more poignantly imposed upon those who have long since lost the illusions of their youth. Even the central task of adolescence, as de¬ fined by Erikson,6 that of achieving a considerable degree of "identity resolu¬ tion", is not confined to that age group. Who among you is not wrestling today with the crucial existential questions that both plague and enrich us through¬ out our lives: Who am I? Where have I been? Where am I going? and, most importantly, Why? Certainly not only the young. This is seemingly a neverending dilemma or task, and reaches crisis proportions for many at transitional stages throughout life. Another myth that imposes expectations on all of us is that to be young is to be beautiful, creative, exciting and worth while; to be older is to be ugly, boring, expendable and useless. This myth is a double-edged sword. On the one hand it makes the older generation feel unrespected, desolate and un¬
youth's detractors and aitruism. This is not true, as the The myths of contemporary youth's 1974 World Food Conference in Rome detractors do not differ much from demonstrated. We seem to be teaching their age-old counterparts, as the fol¬ our youth that self-interest, power and lowing quotations demonstrate: money are what count. There may well be realistic reasons for adult conservaOur adolescents now seem to love lux- tism, but the idealism of youth makes ury. They have bad manners and contempt our seem shallow aspirations by com¬ for authority. They show disrespect for adults and spend their time hanging parison. The myth of hedonistic youth conaround places gossiping with one an¬ other they are ready to contradict jures up an image of the young reveltheir parents, monopolize the conversation ling in exercises and excesses of selfin company, eat gluttonously, and tyran- indulgence while the rest of us look Socrates nize their teachers. on with jealousy, anger and anxiety. The current ethos of indulging one's I would there were no age between ten and three-and-twenty, or that youth would needs for pleasure is as much a preoccupation of middle age as a phenom¬ sleep out the rest; for there is nothing in enon of youth. with the between but getting wenches The myth of youth as lazy and child, wronging the ancientry, stealing, and fighting. Shakespeare: "The Winter's apathetic has little validity as a blanket Tale", Act III, Scene 3 condemnation, save to make us ques¬ tion failure to "turn on" our The myth of anarchistic youth is no young.society's have not accepted Leary's They more valid (or invalid) than describing invitation to "Tune in, turn on and any of us as susceptible to antisocial drop out", but they are questioning the acts upon the abrogation of laws and traditional attitudes to work, producti¬ rules of behaviour. Some of the most vity, and competition. growth and mutually sup¬ organized, gentle portive communal societies I have studied were predominantly populated Myths of adulthood by young people.2 Golding's "Lord of While we have concentrated on the Flies" and Burgess's "A Clockwork harboured by adults about the myths Orange", both focused on young peo¬ youth, let us not forget that the reverse selfof reflect our lack ple, really confidence rather than indict youth. holds true: young people are under a or myths variety of illusions Perhaps Orwell's "Animal Farm" is about adults. We who are over 30 are more to the point. The myth of youth as chemically often seen as hypocritical, materialistic mercenary. We are attacked for spaced-out is one that adults insist on and and for being racist, sexist polluting be perpetuating. This situation would ludicrous if it were not tragic; we see and militaristic. We are described as uptight, chronically depressed and sexu¬ an age group vilified because "their" ally repressed. We are accused of being to somehow are us, threatening drugs selfish while advocating aitruism, when we all know that "our" drugs while feigning open"power-tripping" sedand nicotine, alcohol, tranquillizers and immoral while ness, being covertly are more prevalent, more atives We are piously peddling morality. dan¬ more and widely used, probably blamed for planet, and gerous. We certainly should not be tak¬ are told messing up this unequivocally that the next ing solace in the fact that today's youth have largely abandoned amphetamines, generation will correct (finally) the dis¬ psychedelic chemicals and narcotics, parities and distemper of our time. and are now heavily involved with al¬ cohol. Further mythology If the myth of youth as sexually There is further mythology that has wanted, which leads obsessed and promiscuous is true, then Myths
.
of
.
.
.
502 CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113
to
sadness, loneli-
all-consuming, passionate For the Optimum with one possible an¬ Management of swer, which we inevitably see as self- Iron Deficiency destructive. When we liken their euphoria to "psychic orgasm" we cer¬ tainly don't refer to intense transcendental pleasure; instead, we imply transcience, hedonism and immorality. But Formula: Each SLOW-FE tablet contains 160 mg. it is not only the young who are in¬ of dried ferrous sulfate U.S.P. (equivalent to 50 mg. of volved in this quest: religion freaks, ferrous iron), in a specially formulated slow release encounter group freaks, mysticism and base. The iron1 content is released evenly over an aver¬ period of Yz hours, the optimum time for maximum biofeedback freaks, political and com- age effective absorption. The tablets are film-coated. all mune freaks pervade age groups. Indications: The management of iron deficiency We all know that these movements are states. SLOW-FE is formulated to be better tolerated aided tremendously by the media and than ordinary ferrous sulfate tablets and it is therefore suitable for prolonged administration. that their substance or popularity can especially The minimization of nausea and gastrointestinal radically change overnight. But to call irritation is advantageous in pregnancy, gastroin¬
and
describe their
of the sword is
preoccupation
depression. The other edge equally debilitating, for it also "lays a heavy trip" on youth. What do we mean when we say to young people "Act your age!" To paraphrase Sartre, the young are "con¬ demned to be free". Almost in spite of themselves the young are being forced into a mould determined by our mythol¬ ogy, which in a sense acts out our needs and our regrets about lost opportuni¬ ties, lost romance, lost excitement and lost freedom. We expect youth to live up to our stereotypes. As we all know, social expectations are powerful shapers of behaviour; before any of us contravenes these implicit edicts, he or she should be prepared to pay a heavy price. This myth, adhered to by many, ness
is destructive to all of us, young and old. Earlier I presented the formal defini¬ tion of a myth. What we are engaged in is the process of "mythicizing" creating myths or beliefs about people, which in this case are based more on emotion than fact. These myths are really exaggerated biases currently pre¬ valent in society, and their superficial dismissal does not invalidate them. The danger, as I see it, is that these biases might become institutionalized (which refers us back to our first definition of myth), thus further serving to polarize the age groups in society.
.
The search I am forever amazed that the "root of all evil" sometimes dictates patterns of behaviour or provision of services that are distinct improvements over the situations that prevailed during times of unlimited funding. For example, partly because of rampant inflation, shortages of resources and excessive worldwide consumerism and popula¬ tion, we may be forced to slow down and recapture some of the values we so blithely surrendered. This in part accounts for a reduction in growth, a concern for the quality of life a return to the earth, so to speak and concentration on relationships and communities. Again, because of their relatively few responsibilities and the few demands upon them, the youth are paradoxically pioneering the re¬ turn to simpler lifestyles. Also account¬ ing for what I see as a positive trend is a gross dissatisfaction with contem¬ porary Western life and a concerted search by all of us for some meaning in our lives, for a better answer to the existential questions posed earlier. "The pursuit of the millennium" has given rise to so-called freak movements or cults of enthusiasm.7 We apply labels like speed freak, Jesus freak, drug head, ete. to the young to pejoratively
Slow-ffe
them fads or freak movements, and their devotees faddists or freaks, is to dismiss all the searchers as deluded and their answers as delusions. Not only is this a provocative, polarizing stance, it is also invalid. Similarly, it is untrue that the searchers are "sicker" than their peers. Any young adult or late adolescent group has a signifi¬ cant incidence of mental illness, emo¬ tional incapacity and antisocial beha¬ viour,8 as our studies of this age group, in a variety of settings, have borne out.9"11 But the searchers are no more disturbed and may be particularly resourceful, using normal coping mech¬ anisms in an attempt to adapt to a com¬
plicated, puzzling society;12 they can immigrants to a new so¬ ciety, trying to get their bearings in a be likened to
system that is often incomprehensible. I
am
under
no
illusions about
a
uto-
testinal disorders, e.g. peptic ulcer, convalescence and in old age, all of which may be associated with simple iron deficiency anemias. and Administration: Because it is Dosage slowly released an adequate dose is possible by giving SLOW-FE only once daily. As the ferrous sulfate content is evenly distributed through the special slow release base only a very small quantity is released in the stomach. There is therefore no need to advise that SLOW-FE tablets be taken with or after food as with other ferrous sulfate tablets. Prophylaxis; A single tablet daily is sufficient to maintain iron intake both during pregnancy and in patients with simple iron deficiency. Iron Deficiency; Depending on the severity, one or two tablets of SLOW-FE daily, usually in one dose. In mild anemias, e.g. hemoglobin above 75%, one tablet daily will usually suffice. Fox moderate or severe anemias two tablets daily should be given, until the hemoglobin levels return to normal. This physiological process may require up to approximately eight weeks. In most patients the dose can then be reduced to one tablet daily for maintenance, to build up iron reserves over a further 12 to 16 weeks. For Children: One tablet of SLOW-FE daily is a suitable dose for children able to swallow a small tablet. Side Effects: Gastrointestinal side effects such as nausea and gastrointestinal irritation usually occurring with other iron-containing tablets, are unlikely to arise with SLOW-FE. Treatment of Overdosage: Care has been taken to minimize the risk of accidental consumption of Slow-Fe by children by making the tablets a relatively unattractive off-white colour with an almost tasteless film coat rather than the customary sweet-tasting sugar coat. Moreover the push-through type of foil packaging makes the extraction of many tablets difficult and tedious for children. However, in the event of overdosage the usual treatment for iron poisoning should be instituted. Because the iron is only slowly released the risk of toxic levels of ionic iron being absorbed is less and there is a wider time margin in which to carry out stomach wash outs; also the use of an iron-chelating agent such as Desferal® (deferoxamine CIBA) is likely to be more effective. The treatment of iron poisoning is described in detail in the CIBA literature
pia on earth; Messianic individuals, absolutists and those with unequivocal magic answers make me extremely uncomfortable. But is it all immature irrationality or hocus pocus? I do not find it surprising or think it an accident that neo-Hindu religions are making themselves felt in the West, that mystical beliefs are being studied and pur¬ sued, even on university campuses the home of Western thought and rationality. There has long been this undercurrent of thinking in our so¬ ciety13 but never has it been so popular and open. Our youth are avidly reading Casteneda and Watts, for example, because they are being offered a dif¬ on Desferal®. ferent perspective on life and self. Contraindications: Iron therapy is contraindicated Yoga, meditation, altered states of con¬ in the presence of hemochromatosis, hemosiderosis sciousness and awareness, and tran- and hemolytic anemia. scendental belief systems are gaining Precautions: SLOW-FE like all oral iron prepara¬ existing peptic ulcer, regional phenomenal popularity. There are ma¬ tions, mayandaggravate ulcerative colitis. jor attempts not only to lend scientific enteritis in Supplied: SLOW-FE tablets are30packaged credibility to these belief systems but push-through packs containing tablets per sheet also, more importantly, to explore phy¬ and are available in units of 30,120 and 4,800 tablets. 1. Nutrition Canada National Survey. siologic correlates of these psychologic AReference:Nutrition Canada to The Department of report by states14 and to help us use them in our National Health and Welfare, Ottawa, Information therapeutic efforts. The possibility Canada, 1973. .
exists that there are other, sometimes better, ways of tuning in to ourselves, each other and our environment. Our
CIBA
DORVAL, QUEBEC H9S1B1
C-5024
CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113 503
work in psychiatry has certainly taught us that our perceptions of reality are arbitrary, that others perceive their space in highly personal and at times radically different terms. The crosscultural similarities between psychiatry and religion, psychotherapy and belief systems have been demonstrated clearly."'17 I have known many individuals in dire personal and social straits, for whom psychotherapy failed, who have achieved a sense of self, a feeling of self-esteem, self-realization and a reduction of symptoms through a belief in a new way of life.
6. ERIKSON E: Identity: Youth and Crisis, New York, Norton, 1968 7. CoHN N: Pursuit of the Millennium, rev ed, Oxford U Pr, 1970 8. PASAMANICK B, ROBERTS D, LEMKAU P, et al: A survey of mental disease in an urban population, in Epidemiology of Mental Disorders, Am Acad Adv Sci, 1959 9. LEVINE
10.
11. 12. 13. 14.
Conclusion It has been said that the mythology of a people is in some ways a measure of the worth of that particular culture.IR Myths are said to be the great sense-making structure of human societies; they determine the ways in which people see the world and their place in it. The shattering of biases is difficult, the destruction of myths next to impossible. We can, however, attempt to overcome polarizing stereotypes by realizing that life is painful, as well as joyous, at times for all of us. To point fingers and say "J'accuse" just doesn't work. Instead of ridiculing the search of our youth for "a better tomorrow" we should be joining them. This does not mean repudiating our values and traditions, but it does necessitate an agonizing reappraisal of the stereotypes and dogmas we hold so dear. Growing up today is in many ways more absurd than even a couple of decades ago,1" as is living in general. This absurdity should predispose to humour, tolerance and sensitivity, rather than hostility and recrimination. What is needed, as Bronfenbrenner suggested recently,2" are innovative forms and forums where young and old can interact, now that schools, family and other social institutions have radically segregated the generations and further aggravated our sense of alienation. Richler recently said that we are fortunate in Canada because we have not yet developed a Canadian mythology. We now have a unique opportunity but I am not at all sure we are up to it. References 1. OFFER D, MARCUS D, OFFER 3: A longitu-
dinal study of normal adolescents. Am I Orthopsychiatry 126: 917, 1970 2. LEVINE SV: The urban commune: fact or fad - promise or pipedream. Am I Orthopsychiatry 43: 149, 1973 3. LEIGHTON D: The Empirical Status of the Integration-Disintegration Hypothesis in Psychiatric Disorder and the Urban Environment, edited by KAPLAN B, New York, Behavioral Pubns, 1971 4. SEaMAN M: On the meaning of alienation. Am Soc Rev 24: 783, 1959 5. KasusTON K: The Uncommitted: Alienated Youth in America, New York, Harcourt Brace World, 1965
15. 16. 17. 18. 19. 20.
SV,
LLOYD
D,
LONGOON
W:
The
speed user: social and psychological factors in amphetamine abuse. Can Psychiatr Assoc 1 17: 229, 1972 LEVINE SV, SALTER NE: Youth & contemporary religious movements: a social & psychological study. Paper to be presented at Canadian Psychiatric Association annual meeting, Banff, Alta, Sept 24-26, 1975 LEVINE SV: Draft dodgers: coping with stress; adapting to exile. Am I Orthopsychiatry 42: 431, 1972 HAMBURG D, ADAMS 1: A perspective of coping behaviour: seeking and utilizing information in major transitions. Arch Gen Psychiatry 17: 277, 1967 NovEs JH: Strange Cults and Utopias of 19th Century America, New York, Dover, 1966 TAYLOR T (ed): Altered States of Awareness, San Francisco, Freeman,1971 (Sci Am special issue) FRANK 1: Persuasion and Healing: A Comparative Study of Psychotherapy, Baltimore, MD, Johns Hopkins, 1973 TORREY EF: The Mind Game: Psychiatry & Witchcraft, New York, Emerson, 1972 PRINCE R, LEIGHTON A: The therapeutic process in cross-cultural perspective. Am / Psychiatry 124: 9, 1968 RAKOFF V: Perennial Man and the Slowed Machine. Delivered as part of a series of Massey College lectures, University of Toronto, Oct 1974 GOODMAN P: Growing Up Absurd, New York, Random, 1960 BRONFENBRENNER P: The Origins of Alienation. Sci Am 231: 53, 1974
Postgraduate courBes INAUGURAL SYMPOSIUM of new division of community health, faculty of medicine, University of Toronto. All sessions: Medical sciences auditorium, University of Toronto. Oct. 22 to 24, 1975. Topics will include cancer, occupational diseases, urban environment, health care delivery, population problems, lifestyle, health care for Canadian Indians and schemic heart disease. Information: Dr. T.W. Anderson, Chairman of program committee, FitzGerald Building, University of Toronto, Toronto, Ont. MSS IAl CIVIL AVIATION MEDICAL ASSOCIATION AN. NUAL MEETING. Montreal. Oct. 19 to 23, 1975. information: Albert Carriere, BOl Green Bay Rd., Lake Bluff, IL 60044, USA ONTARIO THORACIC SOCIETY ANNUAL SCIENTIFIC MEETING. Royal York Hotel, Toronto. Oct. 31 and Nov. 1, 1975. information: Ontario Thoradc Society, 157 Wiliowdale Ave., Willowdale, Ont. M2N 4Y7 BETA-BLOCKER SYMPOSIUM. Toronto. Oct. 31, 1975. information: Postgraduate medical education, Faculty of medicine, University of Toronto, Toronto, Ont. M5S 1A8 OTOLARYNGOLOGY FOR FAMILY PHYSICIANS. Toronto. Nov. 8 and 9, 1975. Information: Postgraduate medical education, Faculty of medicine, University of Toronto, Toronto, Ont. M5S lAB MENTAL RETARDATION. Toronto. Nov. 20 and 21, 1975. information: Postgraduate medical education, Faculty of medicine, University of Toronto, Toronto, Ont. M5S lAB DEFENCE MEDICAL ASSOCIATION OF CANADA ANNUAL MEETING. Canadian Forces Base Petawawa (Ont.). Nov. 20 to 22, 1975. Information: It. Col. C.P. Smith, 2111 Niagara Dr., Ottawa, Ont. K1H 6G9 SYMPOSIUM - LES ULC.RES GASTRODUOD.NAUX. Universial Laval. Lea 21-22 novembre 1975. Renseignements: Dr Robert Gourdeau, Facult6 de m6decine, Universit6 Laval, Ou6bec, 0u6. KiK 7P4 GREY CUP MEDICAL SYMPOSIUM. Calgary. Nov. 22, 1975. Information: Dr. G. Halgh, 3630 Morley Trail NW, Calgary, Aita. T2L 1KB MANAGEMENT OF BURNS. Sheraton-Caswell Hotel, Sudbury, Ont. Nov. 26, 1975. Information: Mrs. Deborah Button, Secretary, Evaluation of continuing medical education, Ontario Medical Foundation, 242 St. George St., Toronto, Ont. MSR 2P4
504 CMA JOURNAL/SEPTEMBER 20, 1975/VOL. 113
L.esf1.6/30 Ly.st®1/60 CONTRAINDICATIONS. Thrombophlebitis, thromboembolic disorders, cerebral apoplexy, or a past history of these conditions; markedly impaired liver function; known or suspected carcinoma of the breast or genital tract; known or suspected estrogen dependent neoplasia; undiagnosed abnormal genital bleeding; during the period a mother is breast feeding an infant; any ocular lesion such as partial or complete loss of vision, defect in visual fields or diplopia arising from ophthalmic vascular disease; when epiphysial closure is not complete; when pregnancy is suspected; classical migraine; history of cholestatic jaundice; coronary thrombosis. WARNINGS. Should any thrombotic disorder occur or be suspected, the drug should be discontinued immediately. The pretreatment and periodic physical examinations should include special reference to breast and pelvic organs. Pre-existing uterine fibromyomata may increase in size. Conditions influenced by fluid retention, such as epilepsy, migraine, asthma, cardiac or renal dysfunction, require careful observation. PRECAUTIONS. A number of precautionary statements are associated with oral contraceptive usage. These include: endocrine, possibly liver function tests and thyroid function tests may be affected by treatment with oral contraceptives. Altered bleeding patterns may be induced. Diabetic patients or those with a familial history of diabetes should be carefully observed while receiving oral contraceptives. Oral contraceptives may mask the onset of the climacteric. Susceptible women may experience an increase in blood pressure. Patients with a history of jaundice should be given oral contraceptives with great care. ADVERSE REACTIONS. Oral contraceptives have been associated with a number of adverse reactions, including thrombophlebitis, pulmonary embolism, cerebral thrombosis, nausea, altered bleeding patterns, edema, breast soreness, changes in weight, headache, acne, depression, premenstrual tension and hirsutism. SUPPLIED. LOGEST 1.5/30, 21 blue tablets for 21-day on, 7-day off administration. LOGEST 1/50, 21 green tablets for 21-day on, 7-day off administration. PRODUCT MONOGRAPHS giving further information are available on request.
LEDERLE PRODUCTS DEPARTMENT Cyanamid of Canada Limited P.O. Box 1039 Montreal, Quebec H3C 2X4
