275 companies were spending: Block, “Costs and Benefits of Direct-to-Consumer Advertising,” 513.

  275 Pfizer introduced a cartoon character: Aurthur, “Little Blob, Don’t Be Sad (or Anxious or Phobic).”

  276 “the science of arresting the human intelligence”: Gilbody, Wilson, and Watts, “Direct-to-Consumer Advertising of Psychotropics.”

  276 Hey you: Ad copy can be found in Williams, “Effexor XR Warning Letter,” http://www.fda.gov/cder/warn/2004/Effexor.pdf.

  276 “by failing to draw a clear distinction”: Ibid.

  277 “there is no clear”: Lacasse and Leo, “Serotonin and Depression,” e392.

  277 Ad industry research: Neslin, “RAPP Study,” http://www.rxpromoroi.org/rapp/index.html.

  277 “six percent of the increase”: Block, “Costs and Benefits,” 514.

  277 “treating everyone”: Ibid., 519.

  278 The team, led by Richard Kravitz: Kravitz et al., “Influence of Patients’ Requests for Direct-to-Consumer Advertised Antidepressants.”

  278 “Some things about the ad”: Ibid., 1997.

  281 “Depression doesn’t mean you have something wrong with your character”: Pfizer, “Myths and Facts about Depression,” http://www.zoloft.com/depr_myths_facts.aspx.

  281 “Like other illnesses such as diabetes”: Eli Lilly and Company, “Prozac Makes History,” http://www.prozac.com/disease_information/treatment_depression.jsp?reqNavId=1.1.4.

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  288 “caught up in the contagion”: Beck, “Evolution of the Cognitive Model of Depression,” 969.

  288 He dabbled: Beck, “Reliability of Psychiatric Diagnoses.”

  288 “that the dreams”: Beck and Ward, “Dreams of Depressed Patients.”

  289 therapist and patient work together: Rush et al., “Comparative Efficacy of Cognitive Therapy and Pharmacotherapy in the Treatment of Depressed Outpatients,” 17.

  292 Beck is going by the book: Beck, Cognitive Therapy.

  294 Therapeutic outcomes are dependent: Luborsky et al., “The Researcher’s Own Therapy Allegiances,” 65.

  298 Rafael Osheroff: This version of the story follows Klerman, “The Patient’s Right to Effective Treatment”; see also Shorter, History of Psychiatry, 309–10, and Healy, The Antidepressant Era, 245–50.

  299 “The case left the strong impression”: Shorter, History of Psychiatry, 310.

  299 If a pharmaceutical firm makes a claim: Klerman, “The Patient’s Right,” 416.

  300 “Everyone Has Won”: Rosenzweig, “Some Implicit Common Factors in Diverse Methods of Psychotherapy.”

  300 Luborsky subjected the dodo bird: Luborsky, Luborsky, and Singer, “Comparative Studies of Psychotherapies.”

  300 “The different forms of psychotherapy”: Ibid., 1006.

  300 Luborsky’s work got updated: Smith and Glass, “Meta-analysis of Psychotherapy Outcome Studies,” and Smith, Glass, and Miller, The Benefits of Psychotherapy.

  300 “convincing evidence that therapy”: Consumers Union, “Mental Health: Does Therapy Help?” 734. The report is available at www.consumerreports.org, but you have to sign up and pay for a membership to see it.

  301 “psychotherapies are not doing”: Klein, “Preventing Hung Juries about Therapy Studies.”

  301 “If clinical psychology is to survive”: American Psychological Association, “Training in and Dissemination of Empirically-Validated Psychological Treatment,” 21.

  302 Beck got a chance: Rush et al., “Comparative Efficacy.”

  303 “a profound effect”: DeRubeis and Beck, “Cognitive Therapy,” 293.

  303 Beck could then plausibly claim: Rush et al., “Comparative Efficacy,” 25.

  303 researchers replicated: See, for instance, Blackburn, “The Efficacy of Cognitive Therapy in Depression”; Blackburn, Eunson, and Bishop, “A Two-Year Naturalistic Follow-up”; Dobson, “A Meta-analysis”; Robinson, Berman, and Neimeyer, “Psychotherapy for the Treatment of Depression”; D. Shapiro et al., “Effects of Treatment Duration”; and D. Shapiro, “Meta-analysis of Comparative Therapy Outcome Studies.”

  303 “the most scientifically tested”: Spiegel, “More and More, Favored Psychotherapy Lets Bygones Be Bygones.”

  304 “the best-documented effectiveness”: American Psychiatric Association, “Practice Guidelines for the Treatment of Patients with Major Depressive Disorder,” 11.

  304 “the most widely practiced approach”: Spiegel, “More and More.”

  304 Critics complain: Westen and Morrison, “A Multidimensional Meta-analysis of Treatments for Depression.”

  305 “Psychotherapy is essentially”: Holmes, “All You Need Is Cognitive Behaviour Therapy?” 290.

  305 they also assert: Westen and Morrison, “A Multidimensional Meta-analysis,” 878.

  305 “empirically supported therapies”: Hollon, Thase, and Markowitz, “Treatment and Prevention of Depression,” 39.

  305 what happens when researchers try: Wampold, “Methodological Problems in Identifying Efficacious Psychotherapies,” 27.

  306 “unconditional support”: Foa et al., “Treatment of Post-traumatic Stress Disorder in Rape Victims,” 721.

  306 “that something intended”: Westen and Bradley, “Empirically Supported Complexity,” 267; see also Parker and Fletcher, “Treating Depression with the Evidence-Based Psychotherapies,” 354.

  306 Allegiances do matter: Robinson, Berman, and Neimeyer, “Psychotherapy for the Treatment of Depression”; see also Wampold, The Great Psychotherapy Debate, and Smith et al., The Benefits of Psychotherapy.

  307 two independent groups: Wampold et al., “A Meta-analysis of Outcome Studies Comparing Bona Fide Psychotherapies,” and Depression Guideline Panel, Treatment of Major Depression.

  308 Westen and Morrison acknowledge: Westen and Morrison, “A Multidimensional Meta-analysis,” 886–87.

  308 all the critics: See, for instance, Parker and Fletcher, “Treating Depression with the Evidence-Based Psychotherapies”; Wampold et al., “A Meta-analysis”; and Seligman, “The Effectiveness of Psychotherapy.”

  308 a group of loyal cognitive therapists: Jacobson et al., “A Component Analysis of Cognitive-Behavior Treatment for Depression.”

  309 according to the meta-analysts: See Parker and Fletcher, “Treating Depression with the Evidence-Based Psychotherapies,” for a review of this research.

  309 “How therapy is conducted”: Wampold, “Establishing Specificity in Psychotherapy Scientifically,” 197.

  313 “A person fails to live”: Peale, The Power of Positive Thinking, 173.

  313 “The world in which you live”: Ibid.; quotes, in order, from 166, 166, 173, 167.

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  316 “The DSM-IV . . . has 100 percent reliability”: Amen, Healing the Hardware of the Soul, xx-xxi. Amen says he transcribed this passage from a recording of Insel’s speech. The recording is not available. Insel told me that he did not keep a copy of this speech, but did not dispute the content of the quote.

  317 Brain imaging in clinical practice: Ibid., 20.

  317 “the basic pathophysiology”: Insel and Quirion, “Psychiatry as a Clinical Neuroscience Discipline,” 2223.

  318 “I was suspicious”: Amen, Healing the Hardware, 8–9.

  322 “One is often”: Ibid., 13.

  322 Johann Spurzheim, who had redrawn: Davies, Phrenology, 5–9.

  322 Orson Squire Fowler: Martin, “Saints, Sinners, and Reformers,” www.crookedlakereview.com/books/saints_sinners/martin12.html.

  323 “what they are ”: Davies, Phrenology, 38.

  323 “Would you become great mentally”: Fowler and Fowler, The Self Instructor in Phrenology and Physiology,” 11.

  323 a therapeutic empire: Martin, “Saints, Sinners.”

  323 President James Garfield: Martin, “Saints, Sinners.” Davies has his own list in Phrenology, 38.

  323 Horace Greeley published: Davies, Phrenology, 50.

  323 “the greatest discovery”: Martin, “Saints, Sinners.”

  323 “Phrenology…has assumed”: Davies, Phrenology, 121.

  324 “Phrenology, it must be confessed”: Mackey, “Phrenological Whitman,” www.conjunctions.com/archives/c29-nm.htm.

  324 The relationship between Whitman and the Fowlers: Davies, Phrenology, 123–25.

  324 I made a small test: Quoted in Martin, “Saints, Sinners.”

  325 “The equilibrium or balance”: Quoted in Finger, Minds behind the Brain, 166–67.

  325 he didn’t report the fact: Barker, “Phineas among the Phrenologists.”

  325 Broca’s area: Finger, Minds, 137–54.

  325 Wernicke’s area: Finger, Minds, 150; Shorter, History of Psychiatry, 80–81.

  325 David Ferrier: Finger, Minds, 155–75.

  326 At least that’s the story: See for example Finger, Minds, 135–36; Barker, “Phineas among the Phrenologists”; and Simpson, “Phrenology and the Neurosciences.”

  326 empathy: Preston and de Waal, “Empathy.”

  326 racial prejudice: Richeson et al., “An fMRI Investigation of the Impact of Interracial Contact on Executive Function.”

  326 sexual orientation: Fitzgerald, “A Neurotransmitter System Theory of Sexual Orientation”; LeVay, Queer Science.

  326 the October 16, 2008, issue of Nature: Krishnan and Nestler, “The Molecular Neurobiology of Depression.”

  327 a team of French doctors reported: Bejjani et al., “Transient Acute Depression Induced by High-Frequency Brain Stimulation.”

  330 subjectivity is a forbidden topic: For a discussion of the religious proportions of the banishment of subjectivity from talk about consciousness, see Wallace, The Taboo of Subjectivity.

  330 “the mind is a set of operations”: Kandel, “The New Science of Mind,” 69.

  331 Empirical reductionism: Woese, “A New Biology for a New Century,” 174.

  331 With the progress: Popper and Eccles, The Mind and Its Brain, 97.

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  342 Various critics of the current diagnostic system: Regier, “State-of-the-Art Psychiatric Diagnosis,” 26.

  343 “clinical significance”: American Psychiatric Association, Diagnostic and Statistical Manual, 4th ed., text revision, xxxi.

  343 Despite the prominence of clinical significance: Narrow et al., “Revised Prevalence Estimates of Mental Disorders in the United States,” 118.

  344 the prevalence of depression is cut nearly in half: Narrow et al., “Revised Prevalence Estimates,” 120.

  344 the current categorical approach: See, for example, Goldberg, “A Dimensional Model for Common Mental Disorders”; also Kessler et al., “Prevalence, Correlates, and Course of Minor Depression and Major Depression in the National Comorbidity Survey.”

  344 These doctors have already struck back: Kessler et al., “Mild Disorders Should Not Be Eliminated From the DSM-V.”

  344 “should be addressed”: Ibid., 1121.

  345 The major problem for mental disorders: Kupfer, First, and Regier, A Research Agenda for DSM-V, 208.

  345 the pathophysiologically based classification system: See Kupfer, First, and Regier, Research Agenda, chapter 1.

  346 Fink thinks: Taylor and Fink, “Restoring Melancholia in the Classification of Mood Disorders,” and Fink, “The Medical Evidence-Based Model for Psychiatric Syndromes.”

  347 “that what is now considered”: Taylor and Fink, “Restoring Melancholia,” 4.

  347 a highly effective treatment for melancholia: See Shorter and Healy, Shock Therapy, especially 83–102 and 164–80.

  348 “on, or shortly after, penetration”: American Psychiatric Association, Diagnostic and Statistical Manual, 4th ed., text revision, 552.

  348 repeated studies: For a review, see Waldinger, “Premature Ejaculation.”

  349 “focusing on the ejaculation-delaying effects”: Ibid., 553.

  349 the package insert for Paxil: GlaxoSmithKline, “Prescribing Information,” http://us.gsk.com/products/assets/us_paxil.pdf.

  349 researchers gave Viagra: Nurnberg, “Sildenafil Treatment of Women.”

  350 female sexual dysfunction: American Psychiatric Association, Diagnostic and Statistical Manual, 4th ed., text revision, 543.

  351 “for the vast majority of . . . the walking wounded”: Shorter, Before Prozac, 201.

  352 “proves to be a sort of instant super-Prozac”: Kramer, Listening to Prozac, 290.

  352 a “neutral technology”: Parens, “Kramer’s Anxiety,” 26–27.

  352 “low self-worth”: Kramer, Listening to Prozac, 8.

  352 socially capable: Ibid., 11.

  355 “as many as 50 percent of the patients”: For a review, see Fava, “Prospective Studies.”

  356 Prozac poop-out: Glenmullen, Prozac Backlash, 91–94.

  356 tachyphylaxis: Solomon et al., “Tachyphylaxis in Unipolar Major Depressive Disorder.”

  357 a good working definition of disease: For a brilliant discussion of this idea, see Sedgwick, “Illness—Mental and Otherwise.”

  360 decreasingly sympathetic support systems: For a devastating critique of this response, see Wallace, “The Depressed Person.”

  361 “modern opiate”: Ibid, 272.

  361 “induces conformity”: Kramer, “The Valorization of Sadness,” 52.

  361 “on balance a progressive force”: Kramer, Listening to Prozac, 272.

  362 “so-what drugs”: Shorter, Before Prozac, 199.

  362 “facilitat[ing] better performance”: Parens, “Kramer’s Anxiety,” 415.

  364 “A nation that asks”: Tocqueville, Democracy in America, vol. 2, 142.

  Bibliography

  Alloy, L. B., and L. Y. Abramson. “Judgment of Contingency in Depressed and Nondepressed Students: Sadder but Wiser?” Journal of Experimental Psychology 108, no. 4 (1979): 441–85.

  Amen, D. G. Healing the Hardware of the Soul. New York: Free Press, 2002.

  American Psychiatric Association. Diagnostic and Statistical Manual: Mental Disorders. Washington, DC: American Psychiatric Association, 1954.

  ———. Diagnostic and Statistical Manual of Mental Disorders. 2nd. ed. Washington, DC: American Psychiatric Association, 1968.

  ———. Diagnostic and Statistical Manual of Mental Disorders, 3rd. ed. Washington, DC: American Psychiatric Association, 1980.

  ———. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision, Washington, DC: American Psychiatric Association, 2000.

  ———. “Practice Guidelines for the Treatment of Patients with Major Depressive Disorder.” American Journal of Psychiatry 157, suppl. (2000): 1–45.

 

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