Essay Review: Psychiatry Declares Consciousness an Illusion. Manufacturing Depression: The Secret History of a Modern Disease by Gary Greenberg

Abstract

Of course psychiatry is not asserting explicitly that consciousness is just an illusion; but Gary Greenberg demonstrates that this assertion underlies implicitly what has become standard psychiatric practice: the dispensing of pills to treat purported mental illness. So the title of this book does not do justice to the depth and breadth of its contents. Still, “depression” is the book’s explicit focus throughout.
History illustrates that the task of defining mental illness in general is impossible: What are the criteria for distinguishing frank “illness” from “normal” eccentricity and the huge range of human behavior under different social and environmental circumstances? The sociologist David Rosenhan showed—through an undoubtedly unethical experiment—that diagnosing schizophrenia (for example) is highly fallible, and that normal behavior is not recognized as non-pathological once such a diagnosis has been rendered (pp. 41–42). The obvious inference is catastrophic for the profession: “What kind of doctor doesn’t know the difference between sickness and health?” (p. 237). Homosexuality was officially said to be a mental disorder until 1973; since then it is not. Even as the Diagnostic and Statistical Manual of Mental Disorders (DSM) offers elaborately detailed guidance, psychiatrists often disagree over the diagnosis to be assigned in any given instance (e.g., pp. 234–236). Greenberg illustrates the profession’s attempts to cope with these circumstances by recounting the history of the several revisions of the DSM