THE ROUGH GUIDE TO PSYCHOLOGYThe cognitive approach, on the other hand, considers the thought
processes that underlie anxiety. The person with panic disorder, for
example, might misinterpret benign bodily symptoms in catastrophic
terms, such as mistaking indigestion as a sign of an impending heart
attack. The nervous flier will listen intently to every whir and click of the
aircraft, convinced that innocent sounds are an indication of malfunc-
tion and danger.
The reality, of course, is that all these elements – biological, behav-
ioural and cognitive – are involved at once. The woman with social
phobia thinks to herself that she is boring her friend (cognitive); this
What is normal?
Just when does shyness become social phobia? When does sadness
become depression? These aren’t easy questions to answer, and
a great deal of controversy exists in psychology about where the
dividing lines should be, or if they should exist at all. There can be
little doubt that contemporary social values influence psychiatric
diagnoses – as can be seen by the fact that the American Psychiatric
Association only removed homosexuality from its list of mental
disorders in 1973. The critical psychiatrist Thomas Szasz has taken
this argument to extremes. The author of The Myth of Mental Illness
(1961), Szasz proposed that even the most serious conditions, such as
schizophrenia, are socially constructed – a way for society to label and
control awkward behaviour.
Another influential figure in the critical-psychiatry camp is the
psychologist David Rosenhan. He conducted a study in the early
1970s in which he and several others gained admission to psychiatric
hospitals merely by telling staff they could hear voices saying words like
“empty” and “thud”. Staff failed to realize the experimenters were frauds
and in fact began interpreting much of their behaviour in pathological
terms. Even after the impostors told staff they were feeling better, the
diagnoses were difficult to get reversed and some of them took up to
52 days to be discharged. Published in Science in 1973 as “On Being
Sane in Insane Places”, Rosenhan’s study has become a classic for those
wishing to argue that psychiatric diagnoses are unscientific.
Another criticism of psychiatric diagnoses is that they are too
strongly influenced by pharmaceutical companies, or “Big Pharma” as
the industry has been nicknamed. Part of the reason for this suspicion
is that the industry has a clear vested interest in the creation of new