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They Say You're Crazy: How The World's Most Powerful Psychiatrists Decide Who's Normal
How are decisions made about who is normal? As a former consultant to those who construct the “bible of the mental-health professions,” the DSM (Diagnostic and Statistical Manual of Mental Disorders), Paula Caplan offers and insider’s look at the process by which decisions about abnormality are made. Cutting through the professional psycho-babble, Caplan clearly assesses the astonishing extent to which scientific methods and evidence are disregarded as the handbook is developed. A must read for consumers and practitioners of the mental-health establishment, which through its creation of potentially damaging interpretations and labels, has the power to alter our lives in devastating ways.
382 pages, Paperback
First published June 9, 1995
11 people are currently reading
383 people want to read
About the author
Paula J. Caplan
22 books30 followersPaula J. Caplan, Ph.D., is a clinical and research psychologist, author of books and plays, playwright, actor, and director. She was born and raised in Springfield, Missouri, received her A.B. with honors from Radcliffe College of Harvard University, and received her M.A. and Ph.D. in psychology from Duke University. She is currently an Affiliate at Harvard University's DuBois Institute, working on their Voices of Diversity project, and a past Fellow at the Women and Public Policy Program of the Kennedy School of Government at Harvard. She has given more than 400 invited addresses and invited workshops and has done more than 1,000 media interviews as part of her work in public education and activism.
She is former Full Professor of Applied Psychology and Head of the Centre for Women's Studies in Education at the Ontario Institute for Studies in Education, and former Lecturer in Women's Studies and Assistant Professor of Psychiatry at the University of Toronto. Her twelfth and latest book is When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans.
She is former Full Professor of Applied Psychology and Head of the Centre for Women's Studies in Education at the Ontario Institute for Studies in Education, and former Lecturer in Women's Studies and Assistant Professor of Psychiatry at the University of Toronto. Her twelfth and latest book is When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans.
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Displaying 1 - 9 of 9 reviews
January 4, 2015
Very good book for therapists, counselors, psychologists/psychiatrists to read- and consider their own bias and power (abusing their own roles/authority) while deciding on diagnosing and treatments for clients/consumers, relying on DSM-IV (now DSM-V) decided on a small group of psychologists- Very uncomfortable reading, nevertheless helping one analyze oneself's purpose in helping people.
March 28, 2009
Definitely an important book for anyone going into the profession of psychology or psychiatry to read, no matter whether you agree with her or not.
March 31, 2015
I skimmed the first three chapters. Being someone who's involved with Mad Pride, antipsychiatry, the psychiatric survivor movement, and the neurodiversity movement, I naturally agree with 90% or more of Caplan's criticism of psychiatry. She has some good points and wrote a recent article about psychiatrist Allen Frances with revealing information.
However, her writing style in this book is rambling, too personal to sound objective, and she repeats points over and over by just saying them in different ways or with different examples. Also the citation style is difficult to interpret due to the lack of footnotes or other citation information within the text. Instead, the reader is left to jump to the Bibliography at the back and try to find the unnumbered phrase she referred to.
However, her writing style in this book is rambling, too personal to sound objective, and she repeats points over and over by just saying them in different ways or with different examples. Also the citation style is difficult to interpret due to the lack of footnotes or other citation information within the text. Instead, the reader is left to jump to the Bibliography at the back and try to find the unnumbered phrase she referred to.
August 24, 2012
I've always been upset with the process of who determines normal and crazy. This just riled me up all over again.
February 12, 2023
This is not a book about the flawed construction of the DSM. It is the story of a female scientist and medical professional who is dedicated to creating high quality medical practice that is untouched by the bias imposed by the governing body for psychiatry. While a valid, thought-provoking, and sometimes shocking look at the blatant mistreatment Dr. Caplan suffered at the hands of the DSM conglomerate… it is not what was advertised on the tin.
After a well-written chapter regarding ‘normality’ and the pitfalls of attempting to define it, Caplan descends into a personal account of her experience working with the American Psychiatric Association (APA). She then peppers the reader with dates and times, “he said, she said” accounts of interviews, and even meeting agendas. At this point, Caplan seemed to care less about informing the reader about the flaws of the DSM and more about getting her story out at all costs. Her arguments are often reiterated to a point where it becomes fatiguing and while she attempts to keep her argument chronological it ends up crisscrossing its way across time and DSM editions which make it difficult to place it into context.
Caplan chose to focus on two very specific disorders that are very close to her expertise – this is understandable. However, issues with the DSM’s construction range much farther than these two categories. And while cataloging the entire DSM would produce a tome as big as the DSM itself, including more diverse examples may have helped with the impression that Caplan’s book is more than just a biography of a her personal struggles against the APA.
Caplan is at her best when she is dissecting poor research practices, and commenting on the issue of how women are treated in psychiatry as both patients and professionals. Through this, her impassioned voice feels more at home. With so many references to Kirk and Kutchins’ The Selling of Dsm: The Rhetoric of Science in Psychiatry I wonder if I should have picked up that book instead...
After a well-written chapter regarding ‘normality’ and the pitfalls of attempting to define it, Caplan descends into a personal account of her experience working with the American Psychiatric Association (APA). She then peppers the reader with dates and times, “he said, she said” accounts of interviews, and even meeting agendas. At this point, Caplan seemed to care less about informing the reader about the flaws of the DSM and more about getting her story out at all costs. Her arguments are often reiterated to a point where it becomes fatiguing and while she attempts to keep her argument chronological it ends up crisscrossing its way across time and DSM editions which make it difficult to place it into context.
Caplan chose to focus on two very specific disorders that are very close to her expertise – this is understandable. However, issues with the DSM’s construction range much farther than these two categories. And while cataloging the entire DSM would produce a tome as big as the DSM itself, including more diverse examples may have helped with the impression that Caplan’s book is more than just a biography of a her personal struggles against the APA.
Caplan is at her best when she is dissecting poor research practices, and commenting on the issue of how women are treated in psychiatry as both patients and professionals. Through this, her impassioned voice feels more at home. With so many references to Kirk and Kutchins’ The Selling of Dsm: The Rhetoric of Science in Psychiatry I wonder if I should have picked up that book instead...
August 12, 2009
I organized an event for her to speak for Freedom Center @ Mt Holyoke, but never read the whole book...
October 9, 2016
Eye opener but repetitive.
August 23, 2024
A FORMER CONSULTANT TO THE DSM REVEALS "INSIDER" INFO
Clinical and research psychologist Paula Caplan wrote in the Preface to this 1995 book, "I have written this book ... to help people see how decisions are made about who is normal. I believe that knowing how such decisions are made can help a person overcome the damage that is done to so many who are called---or who consider themselves---abnormal... As a former consultant to those who construct the world's most influential manual of alleged mental illness, Diagnostic and Statistical Manual of Mental Disorders, DSM-III-R, I have had an insider's look at the process by which decisions about abnormality are made." (Pg. xv)
She says, "Much of what is labeled 'mental illness' would more appropriately be called problems in living... What IS important for this book is that, although some DSM diagnoses supposedly have some physical origin... ALL of that labeling is based on the DSM folks' choices about whom to declare abnormal." (Pg. xvii) She also adds, "I do intend this to be an anti-elitism book, since I want us all to be able to make an informed assessment of the people we allow to decide whether or not you and I and our loved ones are normal." (Pg. xxii)
She notes, "a team of researchers in the United States... found 'that nearly half of all Americans experience a psychiatric disorder at least once in their lifetime,' 14 percent have three or more, and 30 percent have had one in the preceding year alone... (And this study was based on only SOME of the many disorders included in the DSM.)" (Pg. 6) Later, she points out, "The DSM-IV includes Minor Depressive Disorder. Very few people would NOT fit that description, especially since it can be as brief as two weeks and does not have to meet any particular number of criteria." (Pg. 77)
She recalls, "I was asked to advise the DSM-IV committees on [Masochistic Personality Disorder] ... and the premenstrual category... as a result of that work, I got an inside look at how this august body decides who is normal, and what I saw disturbed me deeply. I was shocked to realize how little I, as a mental health professional, had known about how authorities in my own field went about choosing whom to classify as mentally ill." (Pg. 8) Later, she observes, "The very fact that the [American Psychiatric Association/APA] published a book of diagnoses gives it power, because there are so few competitors." (Pg. 28)
She argues that "When Sigmund Freud found that some women who had been diagnosed as hysterical had been sexually assaulted as children, he theorized... that the abuse had led to their physical and emotional problems... After first announcing the important point that sexual abuse in childhood could cause anguish and suffering, he later produced the appalling theory that the women had NOT been sexually assaulted by male relatives but simply WISHED they had been (the Oedipal/Electra theory)." (Pg. 37-38)
She asserts, "It was a disappointing surprise to me... to discover that a careful and sincere search for ... scientific support ... has played only a minor role in the entire process of constructing [DSM]... Many other factors did figure significantly, including APA personnel's worries about what the public and their patients would think of psychiatrists... and a host of other political and probably financial considerations." (Pg. 85)
This book contains a lot of fascinating information, and will be of keen interest to anyone interested in psychiatry.
Clinical and research psychologist Paula Caplan wrote in the Preface to this 1995 book, "I have written this book ... to help people see how decisions are made about who is normal. I believe that knowing how such decisions are made can help a person overcome the damage that is done to so many who are called---or who consider themselves---abnormal... As a former consultant to those who construct the world's most influential manual of alleged mental illness, Diagnostic and Statistical Manual of Mental Disorders, DSM-III-R, I have had an insider's look at the process by which decisions about abnormality are made." (Pg. xv)
She says, "Much of what is labeled 'mental illness' would more appropriately be called problems in living... What IS important for this book is that, although some DSM diagnoses supposedly have some physical origin... ALL of that labeling is based on the DSM folks' choices about whom to declare abnormal." (Pg. xvii) She also adds, "I do intend this to be an anti-elitism book, since I want us all to be able to make an informed assessment of the people we allow to decide whether or not you and I and our loved ones are normal." (Pg. xxii)
She notes, "a team of researchers in the United States... found 'that nearly half of all Americans experience a psychiatric disorder at least once in their lifetime,' 14 percent have three or more, and 30 percent have had one in the preceding year alone... (And this study was based on only SOME of the many disorders included in the DSM.)" (Pg. 6) Later, she points out, "The DSM-IV includes Minor Depressive Disorder. Very few people would NOT fit that description, especially since it can be as brief as two weeks and does not have to meet any particular number of criteria." (Pg. 77)
She recalls, "I was asked to advise the DSM-IV committees on [Masochistic Personality Disorder] ... and the premenstrual category... as a result of that work, I got an inside look at how this august body decides who is normal, and what I saw disturbed me deeply. I was shocked to realize how little I, as a mental health professional, had known about how authorities in my own field went about choosing whom to classify as mentally ill." (Pg. 8) Later, she observes, "The very fact that the [American Psychiatric Association/APA] published a book of diagnoses gives it power, because there are so few competitors." (Pg. 28)
She argues that "When Sigmund Freud found that some women who had been diagnosed as hysterical had been sexually assaulted as children, he theorized... that the abuse had led to their physical and emotional problems... After first announcing the important point that sexual abuse in childhood could cause anguish and suffering, he later produced the appalling theory that the women had NOT been sexually assaulted by male relatives but simply WISHED they had been (the Oedipal/Electra theory)." (Pg. 37-38)
She asserts, "It was a disappointing surprise to me... to discover that a careful and sincere search for ... scientific support ... has played only a minor role in the entire process of constructing [DSM]... Many other factors did figure significantly, including APA personnel's worries about what the public and their patients would think of psychiatrists... and a host of other political and probably financial considerations." (Pg. 85)
This book contains a lot of fascinating information, and will be of keen interest to anyone interested in psychiatry.
December 31, 2020
Read Christopher‘s well-put review of this book. Dr. Paula Caplan’s message would have greater impact if the writing was tighter, the research better integrated/cited (strange that this is even an issue given her professional background), and her own biases clearly named at the outset. Still, this book does illustrate the importance of remaining critical of using diagnostic mechanisms to describe human suffering.
Displaying 1 - 9 of 9 reviews