6 ideas
Some patients on Prozac did more than lose their depressive symptoms: they became more confident, socially at ease, and resilient than they had ever been. This effect goes beyond treating an illness. It changes traits that had seemed to be fixed parts of who the person was, which blurs the line between curing disease and enhancing personality.
Kramer coined this term for the prospect of using mood drugs on people who are not ill, to make their temperament more socially valued, such as more assertive or less sensitive to rejection. The term frames prescribing as something like plastic surgery for the personality. The patient's preference, rather than a diagnosis, becomes the reason to treat.
Tess survived an abusive childhood and had a history of exploitative relationships. When she stopped the drug and started to slip, she said she was 'not myself.' Her case raises a hard question: can a medicated personality be more authentic than the one a person lived in for decades?
A drug's effects can be read as evidence about what a trait is made of. Watching how a person responds to medication therefore reshapes theories of personality after the fact.
Serotonergic drugs tend to push temperament toward traits a competitive, market-driven culture rewards: assertiveness, flexibility, and resilience to rejection. They move people away from traits like melancholy, caution, or sensitivity. Enhancement is therefore not value-neutral. It can quietly narrow the range of human temperaments that society tolerates or honors.
Kramer draws on the kindling model: repeated stress or depressive episodes leave lasting changes in the brain. After enough episodes, later episodes can arise with little or no external trigger. On this view, trauma becomes encoded as biology, so a 'psychological' history and 'biological' temperament are not separate categories but stages of one process.