MIND GAMES: Author: Too many being treated for mental disorders they don’t have

Richard Halicks, The Atlanta Journal-Constitution
December 9, 2007
Editorial, Page: B1

Americans used to be sad. Now we are depressed. We used to be worried. Now we have anxiety disorder. We used to be shy. Now we are socially phobic.

Many people genuinely suffer from psychological disorders. And many find relief in psychotherapy and drugs. But author Christopher Lane believes psychiatry — and its fellow traveler, pharmacology — may have set the bar for mental illness so low that almost anyone can trip over it.

In his new book, “Shyness: How Normal Behavior Became a Sickness,” Lane tries to explain how this came to be by taking a close look at how psychiatrists rewrote their “bible” — the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM — during the past 30 years.

DSM II, published in 1968, listed 180 categories of mental illness. In the 1970s, the American Psychiatric Association appointed a task force of specialists to revise and update the manual. After years of discussion, they produced DSM-III (and a revision called DSM-IIIR), which added 112 new categories of mental illness. DSM-IV, published in 1994, tacked on 58 more.

As Lane writes: “In just 26 years . . . the total number of mental disorders the public might exhibit almost doubled.”

Lane, 41, is not a psychiatrist but a literature professor at Northwestern University with a keen interest in psychoanalysis. He spent three years on the English faculty at Emory University, where he also was director of psychoanalytic studies, and is a recent recipient of a Guggenheim fellowship to study psychopharmacology and ethics.

Until the DSM was revised in 1970s and ’80s, psychoanalysts — the Freudians and Jungians — had great influence over the diagnosis of mental illness. But 30 years ago, the neuropsychiatrists took over, Lane says, essentially freezing out the Freudians; they rewrote the book and changed the face of psychiatry.

This departure from Freud is part of what feeds Lane’s criticism of the doctors who rewrote the DSM. He believes that the neuro-camp is so fixated on the brain that it is neglecting the mind.

But he also 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.