Shyness: How Normal Behavior Became a Sickness


Buy It Now!

‘Must read’ book likely to stir debate
(March 2009 Issue)

“Shyness: How Normal Behavior
Became a Sickness”
By Christopher Lane
Yale University Press
New Haven, Conn., 2007

By James K. Luiselli, Ed.D., ABPP, BCBA

Critics of psychiatry abound, be it Thomas Szasz ("The Myth of Mental Illness"), Jeffrey Moussaieff Masson ("The Assault on Truth") or Peter Berger ("Listening to Prozac"), to name a few.

"Shyness: How Normal Behavior Became a Sickness" continues in this vein with a penetrating look at how psychiatric professionals have approached diagnostic formulation, mental illness classification and pharmacological treatment. It is a controversial book sure to promote passionate debate.

Author Christopher Lane, a research professor at Northwestern University, takes to task the work groups responsible for the "Diagnostic and Statistical Manual of Mental Disorders" (DSM), now in its fourth edition. Through interviews with DSM creators and analysis of previously unreleased internal documents, he tells a not so complimentary tale of miscommunication, ego-driven decision making, non-empirical problem solving and in some case, shameless self-promotion.

One outcome from the many problems with the DSM work groups was a plethora of new diagnoses. Whereas DSM-II in 1968 listed 180 categories of mental illness, the DSM-IV published in 1994 featured 350! Social phobia, Lane contends, was one psychiatric disorder that transformed into social anxiety disorder, which then made "shyness, self-consciousness, and even introspection" the focus of mental health professionals. Lane's central thesis is that by creating new psychiatric disorders, exemplified by social anxiety, "the DSM task forces significantly lowered the bar for the FDA and drug manufacturers."

With exacting detail aided by reproduced advertisements from psychiatric journals, Lane explains how pharmaceutical companies rushed to corner the "shyness market." Pun not intended, his account is a bitter pill to swallow because it reveals corrupt business practices, disguised motives and withholding of non-supportive research data.

In addition to in-fighting within the DSM work groups, Lane says that neuropsychiatry is at fault for "pathologizing" what he considers normal human behavior. He writes, "Are we really willing to attribute our complex moods and emotions to neurotransmitters and their alleged imbalance?" Instead, he argues (not always persuasively) that Freudian psychoanalysis and related disciplines offer a better explanation of mild behavioral idiosyncrasies and diagnosed psychopathology.

Lane has given us a powerful indictment of psychiatry and the drug manufacturing industry. Without qualification, the book is a wholesale attack on biological psychiatry and, in his words, "its Faustian pact with its pharmaceutical sponsors." The challenge for readers is to determine whether his conclusions and pronouncements are sufficiently supported or represent a biased perspective. Other books have advanced the opinion that we are an "overdiagnosed and overmedicated" society. "Shyness: How Normal Behavior Became a Sickness" starts with that premise and then works backward to examine causal factors. In doing so, it considers the historical context of DSM and the complex process of defining and treating mental illness. This is a book that shouldn't be missed.

James K. Luiselli, Ed.D., ABPP, BCBA, is senior vice president, applied research, clinical training and peer review at the May Institute in Norwood, Mass.