Shyness

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How Normal Behavior Became a Sickness

Christopher Lane

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How a handful of psychiatrists, with the help of the pharmaceutical industry, turned the ordinary emotion of shyness into an illness

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.

Christopher Lane is the Pearce Miller Research Professor, Northwestern University, and the recent recipient of a Guggenheim fellowship to study psychopharmacology and ethics.

Read Christopher Lane's recent op-ed contribution to the New York Times, "Shy on Drugs."

"[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

"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

"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

"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

"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

"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

"[An] excellent new book. . . . Shyness is a welcome contribution to psychiatric discourse."—Juliet Lapidos, New York Observer

"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

"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

"[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

"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

"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."—Library Journal

"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."—Brian J. Cox, New England Journal of Medicine

"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

"Christopher Lane's polemical Shyness features the manipulations that promoted social anxiety disorder to a national emergency."—Frederick Crews, New York Review of Books

"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

"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)

"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

"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

"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

"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. In a fast-moving culture that heaps stress and high expectations on children, 'parents are in many cases under great pressure to ensure their child succeeds and is socially proficient. A child that doesn't negotiate rapidly those hurdles can look very quickly as if he or she is falling behind, or displaying behavior that warrants medical concern.'"—Melissa Healy, Los Angeles Times

"A provocative look at an important chapter in the history of modern psychiatry."—Judith Graham, Chicago Tribune

"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

"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)

"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

"A valuable book. . . . 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

2007 Top Seller in Psychology as compiled by YBP Library Services

A 2007 Top Seller in Medicine as compiled by YBP Library Services

Selected as a 2008 AAUP University Press Book for Public and Secondary School Libraries

Highly commended for the 2008 Medical Book Award in the category of Mental Health, sponsored by the British Medical Association

ISBN: 9780300143171
Publication Date: December 2, 2008

272 pages, 6 1/8 x 9 1/4
30 b/w illus.

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