"Before you sell a drug, you have to sell the disease. And never was this truer than for social anxiety disorder," concludes English professor and Guggenheim fellow Lane in this scathing indictment of the American Psychiatric Association and the psychopharmacological industry. In 1980, a massive overhaul of the psychiatry bible, the Diagnostic and Statistical Manual of Mental Disorders, added a host of conditions (social phobia among them) to the roster of mental disorders, creating a boon for the pharmaceutical industry, which, in the decades since, has brought to market a cornucopia of drugs to combat an ever-increasing number of mental illnesses. Lane finds a trove of troubling (and previously unpublished) material in the APA archive and in drug company memorandums, laying bare the APA's internal politics (as fierce as academia) and showing the growing influence of drug companies on psychiatry practice. Similarly alarming are Lane's dissections of big pharma's marketing of anti-depressants and description of how information about side-effects and withdrawal symptoms associated with popular prescription drugs such as Prozac and Paxil were withheld from the public. This controversial and well-documented book will spark its share of debates.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
--This text refers to an out of print or unavailable edition of this title.
"[A] fascinating behind-the-scenes look at the making of the bible of modern psychiatry [that] explains how a once-ordinary affliction became a profitable disease."—Michael Agger, Mother Jones
(Michael Agger
Mother Jones 20071101)
“This is not only an important account of the creation of a modern disease and its treatment, it is an explosive indictment of a system that is too simply materialist in both philosophy and behavior.”—Harold J. Cook, Wellcome Trust Centre for the History of Medicine at UCL
(Harold J. Cook )
“A marvelous book: disturbing and perturbing, a book that will be widely talked about and debated. It is extraordinarily well written, balanced, witty, and engrossing. Bravo!”—Arthur Kleinman, Esther and Sidney Rabb Professor and Chair of Anthropology, Professor of Medical Anthropology, and Professor of Psychiatry, Harvard University
(Arthur Kleinman )
“In Shyness, Christopher Lane outlines an apparatus that is one of the most powerful cultural forces in the world today. In pulling back the drapes and revealing the bumbling and hamfistedness of the new engineers of human souls, Chris Lane might help restore sanity to Oz.”—David Healy, M.D., author of Let Them Eat Prozac and The Antidepressant Era
(David Healy )
"Written with Chris Lane's brand of verve and scholarship, Shyness is a riveting book about how certain so-called illnesses are complex cultural artifacts and certain so-called doctors are casting spells called diagnoses. A smart and bracing book about shyness—not to mention a shrewd and subtle book about psychiatric classification—is long overdue; after reading Shyness it is clear that only Lane could have written it."—Adam Phillips, psychoanalyst, author of Side-Effects
(Adam Phillips )
"Lane finds a trove of troubling (and previously unpublished) material in the APA archive and in drug company memorandums, laying bare the APA's internal politics and showing the growing influence of drug companies on psychiatry practice. Similarly alarming are Lane's dissections of big pharma's marketing of anti-depressants and description of how information about side-effects and withdrawal symptoms associated with popular prescription drugs such as Prozac and Paxil were withheld from the public. This controversial and well-documented book will spark its share of debates."—Publishers Weekly
(
Publishers Weekly 20070924)
"[An] excellent new book. . . . Shyness is a welcome contribution to psychiatric discourse."—Juliet Lapidos, New York Observer
(Juliet Lapidos New York Observer 20071022)
"Having gained access to archival materials from the APA, Lane provides a behind-the-scenes look at the haphazard, unscientific process used to revise The Diagnostic and Statistical Manual of Mental Disorders. . . . [A] superb, iconoclastic cultural study. . . . Highly recommended for university and large public libraries."—Library Journal
(
Library Journal 20071015)
"There is a great deal that's interesting in this book. . . . I recommend this book as a thought-provoking and informative read."—John D. Mullen, Metapsychology
(John D. Mullen Metapsychology 20080108)
"[A] stunning and revelatory book. . . . For a book that's about the invention of a medical condition, Shyness is as riveting as a detective story. Lane writes elegantly and passionately about the need to maintain our consciousness about the maddeningly rich complexity of human emotion and thought."—Yasmin Nair, Windy City Times
(Yasmin Nair Windy City Times 20071128)
"This well-written book is a thoughtful examination of shyness and its relation to psychopathology. . . . I very much enjoyed reading Lane's thought-provoking book, and I would highly recommend it for psychiatry residents, graduate students in clinical psychology, and other mental health professionals in training who are interested in the field of anxiety disorders, and more broadly in psychopathology and general mental health."—Brian J. Cox, New England Journal of Medicine
(Brian J. Cox New England Journal of Medicine 20080131)
"In his brilliant Shyness: How Normal Behaviour Became a Sickness, Christopher Lane painstakingly shows how the category of 'mental disorder' has been expanded in recent decades, so that what were once considered normal emotions or everyday foibles—shyness, rebelliousness, aloofness, and so on—have been relabelled as phobias, disorders and syndromes."—Brendan O'Neill, New Statesman and Society
(Brendan O'Neill
New Statesman and Society 20080201)
"An important new book. . . . The achievement of Shyness is to chart for the first time the events preceding the rise and fall of the SSRIs. Lane has marshalled a cache of unpublished data to explain the academic framework that allowed the rise to happen. [He] tells the complex story with impressive clarity. . . . Lane has done a valuable job in tracing the roots of the current crisis and he certainly isn’t calling for a reinstatement of Freudianism; what is needed now is another map to indicate a way out."—Jerome Burne, Times Literary Supplement
(Jerome Burne
Times Literary Supplement 20080201)
"Fascinating . . . persuasive . . . [and] painstaking, [Shyness] should be read by anyone interested in stopping the rot in the discussion of human emotion and thought."—Helene Guldberg, Spiked Review of Books
(Helene Guldberg Spiked Review of Books 20080201)
"Overall, Lane's scholarly account of this saga ensures that if you're not already concerned about the over-medicalization of our mental lives, you will be."—Christian Jarrett, BBC Focus
(Christian Jarrett BBC Focus 20080201)
"Christopher Lane's polemical Shyness features the manipulations that promoted social anxiety disorder to a national emergency."—Frederick Crews, New York Review of Books
(Frederick Crews
New York Review of Books 20080201)
"As Lane’s research reveals, the cost of blaming anxieties on brain chemistry imbalance goes beyond dollars, to drug dependency, debilitating side effects and consumers convinced they’re hamstrung by their physiology."—Robin Tierney, San Francisco Examiner
(Robin Tierney San Francisco Examiner 20080201)
"Lane charges that the task force, dominated by neuropsychiatrists, often used bad science or no science at all, that it turned ordinary human emotions into diseases and that it created a climate in which pharmaceutical companies could get rich creating cures for often nonexistent complexes."—Richard Hicks, Atlanta Journal-Constitution (op-ed)
(Richard Hicks Atlanta Journal-Constitution )
"Would Henry David Thoreau and Emily Dickinson be given drugs today? In the 1980s a small group of leading psychiatrists revised the profession’s diagnostic manual called the DSM for short, adding social anxiety disorder—aka shyness—and dozens of other new conditions. Christopher Lane . . . uses previously secret documents, many from the American Psychiatric Association archives, to support his argument that these decisions were marked by carelessness, pervasive influence from the pharmaceutical industry, academic politics, and personal ambition."—Scientific American
(Scientific American 20080201)
"Lane . . . notes that when psychiatrists diagnose the shy as suffering from social phobia, they mistake a variation in human temperament for a mental disorder; if anything, the diagnosis only adds to the sense of unease felt by shy people. He is also right in observing that the psychiatrists’ Diagnostic and Statistical Manual (DSM), the profession’s standard 900-page reference work, errs by designating other kinds of normal human variation as mental disorders and so exaggerates the incidence of mental illness. . . . [Shyness] provides vivid portraits of how DSM-III was constructed, over the course of six years."—Paul McHugh, Wall Street Journal
(Paul McHugh Wall Street Journal 20080201)
"Christopher Lane deconstructs the new psychiatric condition ‘social anxiety disorder’ as a creation of corporate psychiatry’s alliance with the pharmaceutical industry. He argues that shyness became a medical condition best treated by drugs as a result of battles between psychiatrists over diagnostic techniques. . . . This book compares best to Ray Moynihan and Alan Cassels’ Selling Sickness. Highly recommended for general readers, healthcare professionals and practitioners."—Choice
(Choice 20080201)
"Christopher Lane . . . calls psychiatry's growing focus on children 'the perfect storm' for overdiagnosis. 'You've got a constituency—children—who cannot make informed medical decisions for themselves,' Lane says. —Melissa Healy, Los Angeles Times
(Melissa Healy Los Angeles Times 20080201)
2007 Top Seller in Psychology as compiled by YBP Library Services
(
YBP Library Services 20071201)
"A provocative look at an important chapter in the history of modern psychiatry."—Judith Graham, Chicago Tribune
(Judith Graham
Chicago Tribune 20080330)
"Lane's authority in these matters is considerable since he had access to previously confidential documents for the American Psychiatric Association archives. . . . Highly recommended. All readers, but especially the general public and healthcare professionals and practitioners."—Choice
(
Choice 20080401)
A 2007 Top Seller in Medicine as compiled by YBP Library Services
(
YBP Library Services 20080601)
Selected as a 2008 AAUP University Press Book for Public and Secondary School Libraries.
(Best Book of the Year Selection
Association of American University Presses (AAUP) 20080708)
"Lane argues in this well-researched . . . controversial book that shyness [has been] pathologized, to the detriment, especially, of children and teenagers"—Elsa Dixler, New York Times Book Review (Paperback Row) (Elsa Dixler New York Times Book Review 20090120)
“Lane’s thorough trawling of the archives of the American Psychiatric Association, his discovery of unpublished internal memos from drug companies, and most especially his accounts of the deliberately obstructive activities of the companies’ marketing teams, make for compelling reading.” - Martin Guha, Journal of Mental Health
(Martin Guha
Journal of Mental Health 20090401)
Highly commended for the 2008 Medical Book Award in the category of Mental Health, sponsored by the British Medical Association.
(Medical Book Award British Medical Association 20090902)
Winner of the Prescrire Prize for Medical Writing (France, 2010)."Lane's book is worth reading because...he does such an admirable job of exposing how the psychiatric profession and the pharmaceutical industry together manage to develop and popularize new 'mental diseases' and the accompanying treatments apparently designed to increase profits...It is a solid book and one that is likely to remain current for several years, if not decades, to come."--Tana Dineen, Journal of Scientific Exploration
(Tana Dineen
Journal of Scientific Exploration )
See all Editorial Reviews
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Books with free ebook downloads available Shyness: How Normal Behavior Became a Sickness Paperback – December 2, 2008
- Paperback: 272 pages
- Publisher: Yale University Press; 1 edition (December 2, 2008)
- Language: English
- ISBN-10: 0300143176
- ISBN-13: 978-0300143171
- Product Dimensions: 9.4 x 6.3 x 0.8 inches
- Shipping Weight: 14.1 ounces (View shipping rates and policies)
- Amazon Best Sellers Rank: #783,254 in Books (See Top 100 in Books)
Skeptics often assume that the only reason that diagnostic criteria are changed is financial: to line the pockets of the pharmaceutical industry. But there are several other important factors in play. One has to do with the whole way in which illness is conceptualized and a second has to do with the consequences of inaction. Te criteria for treating blood pressure and cholesterol were driven by the realization that even small abnormalities carry significant mortality and morbidity. When we classify an illness, we can either think of it as a "category," like strep throat or a heart attack: an illness that has clearly defined margins. Or we can think about it as a "dimension." So instead of seeing illness as a separate entity, we think of health and illnesses as lying on a spectrum, running all the way from being healthy and well, through mild degrees of just not feeling "right," to being severely ill. Reimbursement requires categorical diagnoses, even if they do not reflect clinical reality.
This second - dimensional - way of thinking is particularly useful when we are thinking about psychological issues. The world is full of people who are a little bit obsessive, or who get bad mood swings. But they are not bad enough to be called an "illness:" They are part of human variation. In fact, having some of these traits can be enormously beneficial: they have continued in the population because they have a survival advantage. If I need to have surgery, I sincerely hope that my surgeon will be mildly obsessive, rather than discovering a few weeks later that he had forgotten to do something he should have. The point then becomes one of asking, "Where do we place the bar between variation and illness?
Somewhat by coincidence I was reading this book while also reading the The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. The theme of both books is essentially the same: that modern psychiatry has medicalized otherwise normal conditions. In the Loss of Sadness, the authors argue that normal sadness reactions to life's toils and troubles have been redefined as abnormal via the use of symptoms exclusively, without regard to context or proportionality. Similarly, Christopher Lane argues in his book that shyness and its variants have been stigmatized as conditions requiring pharmaceutical care. Lane focuses on the behind the scenes maneuvering during the process of revising psychiatry's bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM). The main protagonist in Lane's drama is Robert Spitzer, a psychiatrist who pretty much bulldozes his vision of psychiatry into the DSM. That vision is one that places psychoanalysis in the background and brings neuropsychiatry, or the primary use of drugs to deal with conditions, into the foreground. The result is the creation and inclusion of Social Phobia and Social Anxiety into the listing of conditions that require medication.
The role of the pharmaceutical industry is explored, as it takes full advantage of the identification of this new disease and brings its full force of marketing strategies into play. Lane demonstrates with actual ads how Big Pharma marketed their drugs as solutions to life's routine problems, like being shy or nervous at a party.
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