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In the 1970s, a small group of leading psychiatrists met behind closed doors and literally rewrote the book on their profession. Revising and greatly expanding the Diagnostic and Statistical Manual of Mental Disorders (DSM for short), they turned what had been a thin, spiral-bound handbook into a hefty tome. Almost overnight the number of diagnoses exploded. The result was a windfall for the pharmaceutical industry and a massive conflict of interest for psychiatry at large. This spellbinding book is the first behind-the-scenes account of what really happened and why.
With unprecedented access to the American Psychiatric Association archives and previously classified memos from drug company executives, Christopher Lane unearths the disturbing truth: with little scientific justification and sometimes hilariously improbable rationales, hundreds of conditions—among them shyness—are now defined as psychiatric disorders and considered treatable with drugs. Lane shows how long-standing disagreements within the profession set the stage for these changes, and he assesses who has gained and what’s been lost in the process of medicalizing emotions. With dry wit, he demolishes the façade of objective research behind which the revolution in psychiatry has hidden. He finds a profession riddled with backbiting and jockeying, and even more troubling, a profession increasingly beholden to its corporate sponsors.
Lane (English, Northwestern Univ.; Hatred and Civility: The Antisocial Life in Victorian England) takes on the American Psychiatric Association (APA) and big pharma, asserting that for self-serving reasons involving control and profit they have colluded to create new psychiatric diagnoses demonizing shyness and demanding treatment by drugs such as Paxil. 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, along with the equally unscientific procession of drug studies funded by the very pharmaceutical companies that most stand to profit from endorsement of those drugs by the investigating psychiatrists. This superb, iconoclastic cultural study might well be compared to Discipline and Punish: The Birth of the Prisonand Madness and Civilization: A History of Insanity in the Age of Reason, two major works by Michel Foucault exploring the social construction of ideas and institutions. Highly recommended for university and large public libraries.
More Reviews and RecommendationsChristopher Lane is the Pearce Miller Research Professor, Northwestern University, and the recent recipient of a Guggenheim fellowship to study psychopharmacology and ethics.
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June 18, 2008: I found Shyness to be a very good book, authoritative and well researched, and adroitly written to boot. The frequent musings and interesting citations keep the text flowing at a good clip--no small feat given the amount of ground covered. A satisfying read for the professional, patient, and general reader.
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March 28, 2008: If you believe that mental illness should not be marketed like toothpaste or tampons... If you wonder how a medication with side effects such as disinhibition, unpredictable mood swings, hostility, aggression, and suicidal ideation can be prescribed for anxiety about going to parties or fear of being criticized ... If it troubles you that the FDA has approved such medications ... If you're outraged that the companies making the medications have been allowed to remain silent about their side effects in some cases for years ... Or, if you're just looking for a support group to help you deal with your withdrawal symptoms ... ... then read this book. Christopher Lane's indictment of the psychological establishment, the pharmaceutical industry and the government regulators who neither regulate nor govern could easily be titled 'How To Pathologize Almost Everybody and Make a Billion Dollars Doing It.' The book is a bluntly honest expos? of the redefinition, expansion, and sometimes pure invention of mental illness. It is breathtaking, frightening and starkly detailed. In it the author lays bare the hubris, maneuvering and outright chicanery that accompanied the writing of the third edition of the Diagnostic and Statistical Manual (DSM-III), psychology's comprehensive listing of anxieties, phobias, disorders and syndromes which provides the theoretical as well as the legal justification for finding something wrong with just about anybody. Not coincidentally, the book also traces the psychiatrists' hidden and not-so-hidden links to and support from the pharmaceutical industry, which today rakes in billions making and selling the drugs that treat the new found illnesses in the Manual. Robert G. Chester Author of 'Asperger's Syndrome and Psychological Type,' J. Psych Type, Dec. 06.