SHYNESS author Christopher Lane interviews Philip Dawdy in Psychology Today "Side Effects"

"The bipolar child is a purely American phenomenon": An interview with Philip Dawdy

By Christopher Lane, Ph.D.
April7, 2009

Philip Dawdy, a prize-winning investigative journalist, has for several years written a powerful, well-researched, and well-regarded weblog, Furious Seasons, which focuses on American psychiatry, mental health, and the way we think about treatment options. Given his intensive work on the issues, I wanted to ask him several burning questions about ADHD, bipolar disorder, and other controversies in American psychiatry.

You've written extensively about the psychiatric diagnosis of teens and preschoolers. How do you account for the astonishing rise in the number of diagnoses we're seeing in these age groups, especially with regard to ADHD and bipolar disorder?

To me, you can lay all of this squarely at the feet of the pharma companies, which had a slew of newish drugs come online in the 80s and 90s and wanted them taken by as many humans as possible—consequences for the patients be damned—and a crew of child psychiatrists at Harvard/MGH who see deeply-flawed, ill-for-life children where other psychiatrists might see personality disorders and issues that will burn out over time. The pharma companies and the Harvard crew worked hand-in-hand to bring America a generation of ADHD kids and bipolar children, and their profound influence can be seen in the millions of children and teens who now carry lifetime diagnoses and take gobs of psychotropic drugs each day, often to their detriment.

That may sound extreme to some people, but it's worth noting that the rest of the world has not embraced these diagnostic and treatment paradigms—except Britain, where there was an initial embrace of ADHD and stimulants, but where there's now a significant backlash. Meanwhile, in France and Italy ADHD is rarely diagnosed and it's difficult to see where French and Italian culture have suffered as a result. As for bipolar disorder in kids (meaning pre-teens and younger), it's simply not an issue in the rest of the world. The bipolar child is a purely American phenomenon, as big a metaphor of our times as credit swaps, subprime loans, and government bailouts.

Why do you think so many more teenage and younger boys than girls are being diagnosed with ADHD, and what does that say about our culture, education system, parental expectations, and so on?

The data I'm familiar with pegs the boy-to-girl ADHD ratio at 3 to 1, which is pretty dramatic. I suspect that boys get pegged with the diagnosis more than girls do for two reasons: One, boys have always been far more energetic and physically exuberant than girls, a point going back through history, perhaps because they are developing their hunter-gatherer beings. And, two, the hyperactivity piece of ADHD is quite easy to spot and probably leads to greater pressure for kids to be diagnosed because hyperactive boys can be disruptive, especially in school environments.

As out there as this may sound, I think we are as a culture cheating boys of their inherent natures and I have real questions about how that affects their psychosocial development long-term and what it will all mean for manhood a couple of generations down the road (I'm concerned about comparable issues with girls as well). What's more, I think the educational system places too much emphasis on having quiet, compliant kids—far more so than in the past. When I was a kid in the 1970s, boys were pretty much allowed to engage in all kinds of wildness at recess in elementary school and after school, but from what I hear that's being discouraged today. Why the change I couldn't say, but I do know that there's been a real push in our culture to silence outward signs of male aggressiveness, both in kids and adults.

As for parents, I think they are under a lot of self-imposed pressure to have perfect kids with high grades who get into top universities or they've somehow failed as parents. The ADHD drugs and the diagnosis itself have been foisted on them as a way to have their kids better liked among school peers and to achieve higher grades and perform better on the many, many standardized tests kids must take these days. What's interesting to me is that parents and our culture may well have been sold a bill of goods here, as the recently released MTA study (a long-term tracking study of kids through teens with ADHD, both on and off-meds) showed that long-term treatment with stimulants didn't appreciably improve GPAs and other test scores.

For the full interview, click here.

SHYNESS author Christopher Lane ask Psychology Today "Side Effects"

Should overuse of the Internet become a mental disorder?

By Christopher Lane, Ph.D.
March 25, 2009

The next time your son begs to continue playing Nintendo Wii over dinner, your daughter texts her friends for the umpteenth time that day, or you find yourself lost online, madly pursuing links to new websites, consider this: American psychiatrists are busy debating whether such activities should soon be known as "Internet addiction."

One year ago, the American Journal of Psychiatry published an editorial calling for recognition of internet addiction as a "common disorder." A crop of almost surreal newspaper articles followed, with titles such as "Net Addicts Mentally Ill, Top Psychiatrist Says."

But the response from our medical and mental-health communities was closer to a collective yawn. True, a skeptical reply came from the Harvard Mental Health Letter, whose editor, Michael Craig Miller, warned that it's "probably not helpful to invent new terms to describe problems as old as human nature." Other than him, few experts seemed to notice—much less mind—that the flagship journal of American psychiatry was arguing quite seriously that overuse of the internet might be a psychiatric illness, on a par with, say, schizophrenia.

The anniversary of the editorial seems like a good moment to revisit its controversial claims and see whether they have any merit.

Jerald J. Block, the Portland-based author of the piece, argued that the disorder presents three subtypes: "excessive gaming, sexual preoccupations, and email-text messaging." Given the opening scenario I described of mayhem at dinnertime, it's not a wild guess to say that the last one applies to quite a few teenagers. Nor is it a surprise to news junkies like me that the middle one turns out to apply to a sizable number of former senators, governors, and mayors.

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Christopher Lane's SHYNESS in Chicago Tribune

Psychiatric manual's update needs openness, not secrecy, critics say
Edition is being prepared with strict oversight, officials counter

By Ron Grossman | Tribune reporter
December 27, 2008

Whether revisions to the "bible" of mental illness should be carried out in secret might seem like an academic question.

But the issue carries real weight for parents desperate to address children's difficult behavior or people in distress over their mental state. It also speaks to citizens' concerns over news accounts of an overmedicated America and the troubling financial links between the pharmaceutical industry and some psychiatric researchers.

An update is under way for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, which defines the emotional problems for which doctors prescribe drugs and insurance companies pay the bills. Psychiatrists working on the new manual were required to sign a strict confidentiality agreement.

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Christopher Lane's SHYNESS reviewed in the New York Review of Books

Volume 56, Number 1 · January 15, 2009, The New York Review of Books
Drug Companies & Doctors: A Story of Corruption
By Marcia Angell

Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial
by Alison Bass

Algonquin Books of Chapel Hill, 260 pp., $24.95
Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs
by Melody Petersen

Sarah Crichton/Farrar, Straus and Giroux, 432 pp., $26.00
Shyness: How Normal Behavior Became a Sickness
by Christopher Lane

Yale University Press, 263 pp., $27.50; $18.00 (paper)

Recently Senator Charles Grassley, ranking Republican on the Senate Finance Committee, has been looking into financial ties between the pharmaceutical industry and the academic physicians who largely determine the market value of prescription drugs. He hasn't had to look very hard.

Take the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard's Massachusetts General Hospital. Thanks largely to him, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the Food and Drug Administration (FDA) for that purpose and none of which were approved for children below ten years of age.

Legally, physicians may use drugs that have already been approved for a particular purpose for any other purpose they choose, but such use should be based on good published scientific evidence. That seems not to be the case here. Biederman's own studies of the drugs he advocates to treat childhood bipolar disorder were, as The New York Times summarized the opinions of its expert sources, "so small and loosely designed that they were largely inconclusive."[1]

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Christopher Lane Op-Ed in the LA TIMES

Wrangling Over Psychiatry's Bible
Christopher Lane
LA Times, November 16, 2008

Over the summer, a wrangle between eminent psychiatrists that had been brewing for months erupted in print. Startled readers of Psychiatric News saw the spectacle unfold in the journal’s normally less-dramatic pages. The bone of contention: whether the next revision of America’s psychiatric bible, the “Diagnostic and Statistical Manual of Mental Disorders,” should be done openly and transparently so mental health professionals and the public could follow along, or whether the debates should be held in secret.

One of the psychiatrists (former editor Robert Spitzer) wanted transparency; several others, including the president of the American Psychiatric Assn. and the man charged with overseeing the revisions (Darrel Regier), held out for secrecy. Hanging in the balance is whether, four years from now, a set of questionable behaviors with names such as “Apathy Disorder,” “Parental Alienation Syndrome,” “Premenstrual Dysphoric Disorder,” “Compulsive Buying Disorder,” “Internet Addiction” and “Relational Disorder” will be considered full-fledged psychiatric illnesses.

This may sound like an arcane, insignificant spat about nomenclature. But the manual is in fact terribly important, and the debates taking place have far-reaching consequences. Published by the American Psychiatric Assn. (and better known as the DSM), the manual is meant to cover every mental health disorder that affects children and adults.

Not only do mental health professionals use it routinely when treating patients, but the DSM is also a bible of sorts for insurance companies deciding what disorders to cover, as well as for clinicians, courts, prisons, pharmaceutical companies and agencies that regulate drugs. Because large numbers of countries, including the United States, treat the DSM as gospel, it’s no exaggeration to say that minor changes and additions have powerful ripple effects on mental health diagnoses around the world.

Christopher Lane, a professor of English at Northwestern University, is the author of “Shyness: How Normal Behavior Became a Sickness.”

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Christopher Lane's SHYNESS on LibraryJournal.com

LIBRARYJOURNAL.COM ANNOUNCES BEST SELLERS IN MEDICINE

Best Sellers in Medicine, October 2007–present, as compiled by YBP Library Services
(13-digit ISBNs in brackets)

1. Shyness: How Normal Behavior Became a Sickness
Lane, Christopher
Yale University Press
2007. ISBN 0300124465 [9780300124460]. $27.50

For the full article, click here.

Christopher Lane, Author of SHYNESS, article in The Scotsman

Sometimes anxiety is just a normal reaction
By CHRISTOPHER LANE
The Scotsman, April 5, 2008

IN THE US, almost half of the population is described as being in some way mentally ill, and 200 million prescriptions are written annually to treat depression and anxiety. These statistics have sparked a debate about whether people are taking more medication than is needed, for problems they may not have.
Those who defend such widespread use of prescription drugs insist a significant part of the population is under-treated and under-medicated. Those opposed note that, for example, diagnosis of bipolar disorder has rocketed by 4,000 per cent and that over-medication is impossible without over-diagnosis.

To help settle this dispute, I studied why the number of recognised psychiatric disorders has ballooned in recent decades. In 1980, the Diagnostic and Statistical Manual of Mental Disorders added 112 disorders to its third edition (DSM-III). Some 58 more appeared in the revised third and fourth editions. The manual is the bible of American psychiatry, and the addition of even one new disorder has serious consequences. So why add so many?

I was granted access to unpublished memos, letters, and voting data from 1973-1979 when the DSM-III task force debated each disorder. Some of the work was meticulous, but the overall approval process was more capricious than scientific.

DSM-III grew out of meetings that many participants described as chaotic. The expertise of the task force was limited to neuropsychiatry, and the group met for four years before it occurred to members that it might be biased.

Some lists of symptoms were knocked out in minutes and the field studies used to justify their inclusion sometimes involved a single patient. Experts pressed for the inclusion of illnesses as questionable as "chronic complaint disorder", whose traits included moaning about taxes and the weather.

Social anxiety disorder was given official recognition in 1980 and by the 1990s experts insisted as many as one in five Americans suffered from it. Yet Isaac Marks, the specialist who originally recognised social anxiety in the 1960s, resisted its inclusion as a se
parate disease. The list of behaviours associated with the disorder, such as avoidance of public toilets, gave him pause. By the time a revised task-force added dislike of public speaking to the symptom list in 1987, the disorder seemed sufficiently elastic to include virtually everyone on the planet.

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Christopher Lane's Shyness mentioned in BBC News Magazine

Is being shy an illness?

By Anna Buckley
BBC News Magazine, Tuesday, 4 March 2008

Most of us are shy to some degree, but acute shyness is one of the most under-recognised mental health problems of the modern age, say some. So when is being shy an illness?

Walking down a busy high street with your cheeks painted like a clown isn't normal behaviour for most people. But it's precisely what is being prescribed for one group of people who desperately want to feel more normal.

People suffering from acute social embarrassment are encouraged to wear ridiculous amounts of blusher in public as part of their treatment at one hospital. It's an unlikely cure for a condition called social phobia. ...

But while some health care professionals argue the condition is under-recognised, others worry the problem is psychiatry itself - labelling people who are just plain shy as having a mental illness.

"Social phobia is yet another example of normal behaviour being re-branded as an illness," says English professor Christopher Lane, author of Shyness: How Normal Behaviour Became a Sickness.

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Christopher Lane's SHYNESS in New England Journal of Medicine

New England Journal of Medicine, Book Review, Volume 358:539-540, January 31, 2008, Number 5

Shyness: How Normal Behavior Became a Sickness
By Christopher Lane. 263 pp., illustrated. New Haven, CT, Yale University Press, 2007. $27.50. ISBN 978-0-300-12446-0.

This well-written book is a thoughtful examination of shyness and its relation to psychopathology. It reminds me of earlier books in this area, including Richard McNally's Panic Disorder: A Critical Analysis (New York: Guilford Press, 1994) and Isaac Marks's Fears, Phobias, and Rituals (New York: Oxford University Press, 1987). In fact, Marks receives an official acknowledgment in Christopher Lane's book. Although Lane claims to tackle mainly the topic of shyness and mental health, he also sheds light on recent developments in the official classification and nature of the field of anxiety disorders, dating back to the landmark changes that were . . .

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Christopher Lane's SHYNESS Reviewed in the Telegraph

Who needs Seroxat? A better drug's at hand
By Harry Mount
The Telegraph.co.uk, Last Updated: 12:01am GMT 21/12/2007

The Christmas party season is upon us and so is the hell of being at a Christmas party and knowing nobody.

I've already been to a couple this year where I've honed my techniques for looking as if I'm perfectly happy on my own. First, I take several slow circuits round the room, making a determined beeline towards a non-existent friend. Then I stand next to a wall, convincing myself that I'm happier observing than being part of the crowd - what a red-faced lot, laughing at nothing.

None of this is very sophisticated, but it's better than what I used to do until I was 17, which was head for the exit, miserable and cripplingly shy.
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Nowadays, I'd be diagnosed with social phobia, and be prescribed Seroxat, which boosts your serotonin, the naturally occurring happiness-enhancer in the brain. All this is in Shyness: How Normal Behaviour became a Sickness, a new book by Christopher Lane, a Chicago professor.

In the past decade, the NHS has spent £1.5 billion on drugs for shyness - or "social anxiety" and "avoidant personality disorder" (I still suffer from that one). There are now apparently six million sufferers in Britain.

Thank God I've got over my shyness since Seroxat took off. The best shyness cure is a long, brutal slog - learning how to talk to other people and not to mind too much being on your own.

The consolation is that former shyness sufferers spend so long learning how to fill dreaded silences that they tend to become good conversationalists in the end.

It's easy to spot the difference between the eager-to-please, once-shy person and the I-know-I'm-pleasing-you type who's never been shy. The once-shy ask questions and frantically tailor their conversation to the other person's character; the always confident bang on regardless. Stephen Fry was clearly shy once; Tony Benn, never.

Using drugs as a buffer to avoid learning these things is disastrous. You remain in a perpetual zombie state of zonked-out shyness, never forced to learn the benefits of how to talk to new people.

In any case, it's several thousand years since humans developed an excellent drug to deal with the inevitable awkwardness of being trapped in a strange room between the hours of 6.30 and 8.30pm with people you don't know or like.

You don't need prescriptions, you choose the dose, and hosts provide the drug in various forms and strengths on prominent display. It's called a drink.

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Christopher Lane's SHYNESS Reviewed in Spiked Review of Books

Humanity, thou art sick
With shyness diagnosed as ‘social phobia’, and dissent as Oppositional Defiant Disorder, more and more emotions are being psychologised. Or perhaps I’m just suffering from Book Review Hyperactivity Dementia?
by Helene Guldberg, spiked review of books

‘In my mother’s generation, shy people were seen as introverted and perhaps a bit awkward, but never mentally ill.’


So writes the Chicago-based research professor, Christopher Lane, in his fascinating new book Shyness: How Normal Behaviour Became a Sickness. ‘Adults admired their bashfulness, associated it with bookishness, reserve, and a yen for solitude. But shyness isn’t just shyness any more. It is a disease. It has a variety of over-wrought names, including “social anxiety” and “avoidant personality disorder”, afflictions said to trouble millions’, Lane continues.

Lane has taken shyness as a test case to show how society is being overdiagnosed and overmedicated. He has charted - in intricate detail - the route by which the psychiatric profession came to give credence to the labelling of everyday emotions as ‘disorders’, a situation that has resulted in more and more people being deemed to be mentally ill.

Some claim that up to 50 per cent of the population will suffer from mental illness some time in their lives. A 2001 report titled Mental Health: New Understanding, New Hope, published by the World Health Organisation (WHO), claims that today between 10 and 20 per cent of young people suffer from mental health or behavioural disorders. Hans Troedsson, WHO director for child and adolescent health, has expressed grave concern about the mental health status of the world’s young. ‘It is a time-bomb that is ticking and without the right action now millions of our children growing up will feel the effects’, he warned. In the WHO report, it is claimed that mental disorders can be diagnosed ‘as reliably and accurately as most of the common physical disorders’.

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Christopher Lane Q&A in Atlanta Journal-Constitution

Q&A / CHRISTOPHER LANE, author: Experts play with people's emotions

The Atlanta Journal-Constitution, 12/09/07

Christopher Lane is the Miller research professor at Northwestern University and the author of the newly published "Shyness: How Normal Behavior Became a Sickness."

His last book, "Hatred and Civility: The Antisocial Life in Victorian England," explored misanthropy, or people-hating, in the 19th century. "One of the things I was trying to do in this new book was think about what happened to misanthropes in the 20th and even 21st century," Lane said.

"As one psychiatrist that I interviewed put it, 'Well, they probably all got medicated, right?' Although his response was a bit glib, the risk is that indeed a lot of these emotions have been distorted or interfered with through medication."

Lane's book focuses on the process by which the psychiatric "bible" —- the Diagnostic and Statistical Manual of Mental Disorders" —- was revised in the 1970s and '80s by a task force of specialists appointed by the American Psychiatric Association.

The AJC spoke with Lane recently by phone. Here is an edited transcript of that conversation:

Q. You were able to review hundreds of documents pertaining to the 1980 revision of the Diagnostic and Statistical Manual —- documents that offered a glimpse of the process that few people had ever had before. What were some of the things that surprised you most in those files?

A. I was astonished at the carelessness of the psychiatrists and the degree to which their own self-interest often trumped scientific rigor. There are tremendous revelations of their own ambition and their willingness to sacrifice scientific rigor on the altar of expediency.

For the rest of the Q&A, click here.

Christopher Lane, Author of Shyness, Article in Washington Post

Shy? Or Something More Serious?

By Christopher Lane
Special to The Washington Post, Tuesday, November 6, 2007; Page HE01

If anyone in my parents' generation had argued that shyness and other run-of-the-mill behaviors might one day be called mental disorders, most people would probably have laughed or stared in disbelief. At the time, wallflowers were often admired as modest and geeks considered bookish. Those who were shy might sometimes have been thought awkward -- my musically gifted mother certainly was -- but their reticence fell within the range of normal behavior. When their discomfort was pronounced, the American Psychiatric Association called it "anxiety neurosis," a psychoanalytic term that encouraged talk-related treatment.

All that changed in February 1980, when the APA classified the broadly defined "avoidant personality disorder" and "social phobia" (later dubbed "social anxiety disorder") as diseases. The professional group also listed 110 other new disorders in its revised diagnostic manual, with the result that the total number of mental illnesses on the books almost doubled overnight. It was a dramatic example of the modern medicalization of behavior.

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Christopher Lane's Shyness Mentioned in LA Times

Are we too quick to medicate children?
Parents who seek help for behavioral problems are increasingly likely to walk away with a prescription for powerful drugs. But some experts counsel caution.
By Melissa Healy
Los Angeles Times, November 5, 2007

Northwestern University's Christopher Lane, author of a new book, "Shyness: How Normal Behavior Became a Sickness," 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."

Some mental-health professionals are wary, too, of the implied promise of early intervention. In fact, whether, how or in how many cases a child's problematic behavior leads to full-blown mental illness -- what health professionals call the "progression" of the disease -- is in many cases not well understood, especially when the patient is not even a teenager yet.

As to the claim that early treatment will lessen symptoms or prevent mental illness later, there is growing evidence, but it is hardly a slam-dunk. And it doesn't address which kids will benefit from pharmacological treatment and which won't.

As the mental-health profession begins debate over how to update its diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which is set for reissue in 2012, it is debating whether it has gone too far. The recent publication of two books critical of the expansion of psychiatric diagnoses -- Lane's "Shyness" and "The Loss of Sadness," by Allan V. Horwitz and Jerome C. Wakefield -- have touched off a flurry of discussion.

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Christopher Lane's Shyness Reviewed in Wall Street Journal

Diagnosis: Diffident
Why psychiatry's field-guide approach sometimes mistakes temperament for illness
By PAUL MCHUGH
Wall Street Journal, November 3, 2007; Page W8

If you were anxious about speaking in public, would you prefer to be called (1) a "social phobic" needing a pill; (2) a "neurotic" needing psychoanalysis; or (3) a shy person needing practice and coaching? I'd opt for No. 3, but not everyone agrees. Certainly some people have been helped by pills for social phobia and would swear by No. 1. In "Shyness: How Normal Behavior Became a Sickness," Christopher Lane seems to favor No. 2 -- but that might have been expected, since he appears to have brought an affection for Freudian psychoanalysis to his investigations.

To his credit, Mr. Lane, a professor of literature at Northwestern University, 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.

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Christopher Lane Shyness Reviewed in Examiner

Phobia or faux-bia?
The Examiner, October 23, 2007
Robin Tierner

WASHINGTON— Shyness, fear of public speaking, reluctance to dine alone in restaurants — common discomforts or mental disorders?

Medicalizing ordinary emotions has generated big business for the pharmaceutical industry and psychiatric profession. In the new book “Shyness: How Normal Behavior Became a Sickness,” Christopher Lane examines the impact on health care and society when psychiatry’s bible, The Diagnostic and Statistical Manual of Mental Disorders (DSM), swelled from handbook into heavy tome detailing hundreds of new conditions such as social anxiety disorder, known as SAD.

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Christopher Lane's Shyness Receives Starred Review in Library Journal

From Library Journal, October 15, 2007

*Lane, Christopher. Shyness: How Normal Behavior Became a Sickness. Yale Univ. Oct. 2007. c.272p. photogs. index. ISBN 978-0-300-12446-0. $27.50. PSYCH

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 Prison and 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.-Lynne F. Maxwell, Villanova Univ. Sch. of Law Lib., PA

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Christopher Lane's SHYNESS reviewed in The New York Observer.

Blushing, Once a Virtue, Now a Symptom
by Juliet Lapidos
The New York Observer, October 16, 2007
SHYNESS: HOW NORMAL BEHAVIOR BECAME A SICKNESS
By Christopher Lane
Yale University Press, 263 pages, $27.50

Every student of medical history knows that the psychiatric establishment is not immune to fads and fallacies. A Victorian physician once estimated that a quarter of all women suffer from “hysteria”—a vague, catchall diagnosis modern psychiatrists have banished from clinical circles. Remember learning about “multiple personality disorder” from Primal Fear and Fight Club? That’s probably a canard, too. In his excellent new book, Shyness, Christopher Lane identifies another dubious mental illness. Perhaps you’ve read about it on highway billboards: It’s called social anxiety disorder.

Mr. Lane traces the discovery—or rather the creation—of social anxiety disorder to the late 1970’s, when the American Psychiatric Association updated its Diagnostic and Statistical Manual of Mental Disorders. A small group of leading psychiatrists deleted a few entries, tweaked others, and added dozens of new mental illnesses. The science behind these sweeping revisions was shockingly flimsy. Mr. Lane reveals that the task force members conducted little systematic research, and often based their conclusions on ambiguous studies.

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Christopher Lane's OpED on Shyness in 9/21 NYT

Shy on Drugs
By CHRISTOPHER LANE
New York Times, OpEd September 21, 2007

FEW children relish the start of a new school year. Most yearn for summer to continue and greet the onset of classes with groans or even dread. But among those who take the longest to adapt and thrive, psychiatrists say, are children trapped in a pathological condition. They are so acutely shy that they are said to suffer “social anxiety disorder” — an affliction of children and adolescents that, the clinicians argue, is spreading.

It may seem baffling, even bizarre, that ordinary shyness could assume the dimension of a mental disease. But if a youngster is reserved, the odds are high that a psychiatrist will diagnose social anxiety disorder and recommend treatment.

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Christopher Lane's Shyness Reviewed in Scientific American Magazine

Scientific American Magazine;
Reviews; October 2007;
by Michelle Press; 1 Page(s)

SHYNESS: HOW NORMAL BEHAVIOR BECAME A SICKNESS
by Christopher Lane. Yale University Press, 2007

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, Miller Research Professor at Northwestern University, 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. Lane shows how drug companies seized on the newly minted disorders to sell millions of dollars' worth of psychotropic drugs. Some have dangerous side effects; some were already developed-treatments looking for a disease. The next revision of the DSM is already under way, and Lane warns that without drastic reform many more common behaviors--excessive shopping, poorly controlled anger, defiance--can become pathologies for which drugs are already on tap.

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