The Nocebo Effect Overdiagnosis and Its Costs
The Nocebo Effect documents the transformation of normal problems into medical ones and brings out the risks of this inflationary practice. One notable risk is that people labeled as sick may find themselves living up to their label through the alchemy of
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The Nocebo Effect Overdiagnosis and Its Costs Stewart Justman
the nocebo effect Copyright © Stewart Justman, 2015.
Softcover reprint of the hardcover 1st edition 2015 978-1-137-52328-0 All rights reserved. Contains excerpts from Notes from the Underground and The Gambler by Fyodor Dostoyevsky, translated by Jane Kentish (1991). By permission of Oxford University Press. www.oup.com
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First published in 2015 by PALGRAVE MACMILLAN in the United States—a division of St. Martin’s Press LLC, 175 Fifth Avenue, New York, NY 10010. Where this book is distributed in the UK, Europe and the rest of the world, this is by Palgrave Macmillan, a division of Macmillan Publishers Limited, registered in England, company number 785998, of Houndmills, Basingstoke, Hampshire RG21 6XS. Palgrave Macmillan is the global academic imprint of the above companies and has companies and representatives throughout the world.
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Palgrave and Macmillan are registered trademarks in the United States, the United Kingdom, Europe and other countries.
ISBN 978-1-349-57677-7 ISBN 978-1-137-52329-7 (eBook) DOI 10.1007/978-1-137-52329-7 Library of Congress Cataloging-in-Publication Data Justman, Stewart. The nocebo effect : overdiagnosis and its costs / by Stewart Justman. pages cm Summary: “The Nocebo Effect documents the transformation of normal problems into medical ones and brings out the risks of this inflationary practice. One notable risk is that people labeled as sick may find themselves living up to their label through the alchemy of the nocebo effect”—Provided by publisher. Includes bibliographical references and index. 1. Placebos (Medicine) 2. Medicine and psychology. 3. Negativism. I. Title. RM331.J86 2015 615.5—dc23 2015007677 A catalogue record of the book is available from the British Library. Design by Amnet. First edition: August 2015 10 9 8 7 6 5 4 3 2 1
Contents
Acknowledgments
vii
Preamble: Indefinite Ailments and Inflammatory Messages
ix
1
DSM and the Shaping of Depression
1
2
The Ills of Health
39
3
Searching for Signs
71
Interlude: Medicalization and Magnetism
89
4
Overdiagnosis and Its Harms
93
5
Name Games
121
6
Beware What You Look For: Two Cases of Medical Activism
143
7
The Folly of Systems: The Satiric Tradition and Mental Disorders
169
The Malady of Awareness
195
8
Epilogue: Return to Sources
207
Notes
215
Index
269
Acknowledgments
The author is immeasurably indebted to Frederick Crews, John Haller, Barnett Kramer, John MacKinnon, and Derek Summerfield.
Preamble: Indefinite Ailments and Inflammatory Messages
I
n the course of Plato’s Republic Socrates distinguishes two kinds of medicine, one an art worthy of its founder Asclepius, the other a perversion. The true physician, the scion of Asclepius, treats definite ills in definite ways. He cures wounds, for example, his technical skills justifying the analogy of physicians to carpenters, pilots, and musicians elsewhere in the Republic. The sham physician flourishes in an unhealthy city by pretending to treat the more or l
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