Shyness

Shyness: How Normal Behavior Became a Sickness

Christopher Lane
Copyright Date: 2007
Published by: Yale University Press
Pages: 272
https://www.jstor.org/stable/j.ctt1nphr3
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  • Book Info
    Shyness
    Book Description:

    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 theDiagnostic and Statistical Manual of Mental Disorders(DSMfor 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.

    eISBN: 978-0-300-15028-5
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. [i]-[vi])
  2. Table of Contents
    (pp. [vii]-[viii])
  3. INTRODUCTION: BASHFUL NO MORE
    (pp. 1-10)

    When my mother was six years old, she often pretended she was a horse. Painfully shy, she preferred galloping around on “four” legs to the ordeal of talking to strangers on two. The Germans were bombing London and southern England at the time, a source of terror for many children, and my grandparents—concerned about her safety—heightened her anxiety by sending her off to boarding school. Once there, my mother would cavort outside for hours. When that wasn’t feasible, she withdrew to a practice room and played the piano with quiet intensity.

    No one found her especially odd or...

  4. 1 THE HUNDRED YEARS’ WAR OVER ANXIETY
    (pp. 11-38)

    Anxiety, a famous psychoanalyst once observed, is one of the few things that never deceives.¹ It is also one of those rare elements of psychology that seem constant as it ripples through the ages, tormenting its sufferers with persistent, sometimes grinding dread. Those familiar with the sensation know it feels dreadfully tangible even when the fear in question is often imaginary. But has anxiety always been tied to shyness, or is the connection more recent?

    In listing the first recorded use of the wordanxiety,theOxford English Dictionarynames an emotion we’re likely to recognize instantly, though its spelling...

  5. 2 THE DIAGNOSTIC BATTLES: EMOTIONS BECOME PATHOLOGIES
    (pp. 39-70)

    If you visit the Biometrics Department of the New York State Psychiatric Institute, as I did in the summer of 2005, you’ll spot a charming cartoon of Dr. Robert Spitzer on one of his office walls. The handsome psychiatrist is pictured leaning over a neatly stacked house of cards. Half-winking to his audience, as if performing a magic trick for them, the maestro declares, “Now if we just remove this card . . . ” As Spitzer takes one from the bottom tier, thereby removing part of its foundation, his figure breaks into a smile. The pleasure seems fitting because,...

  6. 3 A DECISIVE VICTORY: SHYNESS BECOMES AN ILLNESS
    (pp. 71-103)

    Robert Spitzer’s task force obviously thought it was perfecting American psychiatry by representing mental disorders in such a clear-cut way. Its critics charged that the group was opening up vast, complex issues it was ill equipped to resolve. Even now, Spitzer has few regrets and insists the task force was right to undertake such sweeping changes. But the incidents leading to social phobia’s inclusion inDSM-IIIbetray so much guesswork that the splitting of anxiety into seven distinct illnesses seems more the result of accident than of careful design or scientific deliberation.

    According to David Healy, the termsocial phobia...

  7. 4 DIRECT TO CONSUMER: NOW SELL THE DISEASE!
    (pp. 104-138)

    Before you sell a drug, you have to sell the disease. And never was this truer than for social anxiety disorder, which by the 1990s encompassed shyness, fear of urinating in a public lavatory, and concern about saying the wrong thing.¹

    The moment the American Psychiatric Association grouped these fears, calling them elements of a troubling, underreported problem, it not only defined a new segment of the population as ill but also cast their woes in an entirely different form. A signal therefore went out that researchers, mental health professionals, and the drug companies should unearth fresh remedies. These had...

  8. 5 REBOUND SYNDROME: WHEN DRUG TREATMENTS FAIL
    (pp. 139-168)

    Robert Spitzer’s task forces paved the way for the drug companies, creating seven new anxiety disorders that supposedly required medical attention. But the drugs approved to treat these disorders turned out to be as indiscriminate in their effects as Spitzer’s colleagues were in their initial judgments.

    By failing to distinguish clearly between shyness and social anxiety disorder, the task forces made every anxiety reaction fair game for medical attention. They lumped together routine traits that do not belong in a manual of mental disorders. And they quietly ignored the fact that shyness was once thought a positive characteristic, whereas anxiety...

  9. 6 A BACKLASH FORMS: PROZAC NATION REBELS
    (pp. 169-193)

    It would be naive to think the wrangles we’ve observed in psychiatry had no effect on the wider culture. The conflicts troubling psychiatrists in the 1970s and 1980s have in fact saturated popular culture, especially in America, where writers, artists, and filmmakers have wrestled for years with the perils and opportunities of biotechnology. How, they wonder, should they convey inner turmoil in a climate that urges us to medicate it away? And can they portray character conventionally when drugs may have such transformative effects on our personalities that they can, for better or worse, render us quite different from ourselves?...

  10. 7 FEAR OF OTHERS IN AN ANXIOUS AGE
    (pp. 194-212)

    Now that shyness has become a disease, which emotion will be next? The April 2005 issue ofNeuroPsychiatry Reviewsfeatures two colleagues debating quite seriously whether the next edition ofDSMshould include criteria for a new psychiatric problem:apathy.According to James Duffy, a tenured professor at the University of Connecticut, apathy isn’t just a state of mind; it’s a “common” illness that “can occur alone and in conjunction with other disorders, [and] in percentages that translate into millions of people.” The clincher for apathy’s inclusion in the manual of mental disorders, he says (as if rehearsing a a...

  11. NOTES
    (pp. 213-248)
  12. ACKNOWLEDGMENTS
    (pp. 249-252)
  13. INDEX
    (pp. 253-264)