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They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal

The DSM (Diagnostic and Statistical Manual of Mental Disorders) IV is the official diagnostic “bible” used by the American Psychiatric Association and mental health professionals.  But so much of the general population doesn’t know how these “illnesses” are determined, since they are not the same as medical diagnoses, which can be determined with the clear-cut scientific method.  That is where psychologist and author Paula J. Caplan comes in with her book, They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal.  Caplan is a former consultant to the DSM, and has served as an adviser to various related APA committees.

In total, there are 400 mental illness labels listed in the DSM IV.  This includes everything from “self-defeating personality disorder” to “nicotine dependence” to “premenstrual dysphoric disorder”.  “Homosexuality” was once listed in an earlier publication of the DSM as a mental illness, but not in the current DSM IV. This should be a cause for widespread concern, because since when can a disease stop being a disease?

Caplan gives an eye-opening look into the lack of scientific methods and evidence, bias and close-mindedness that was involved in the process of developing the DSM IV handbook.  She questions whether the creators of the book have the authority to determine what is “normal” and “not normal.”  She cuts through the mental health industry jargon to expose to the everyday laymen the danger of these official labels that are being put on people and dramatically impacting the course of their lives.  She also points out how the book is very thorough in listing symptoms of these illnesses, but not treatments or solutions.

About the Author

Paula J. Caplan is a clinical and research psychologist, as well as an award-winning nonfiction author, playwright, actor, activist, advocate and director.  She grew up in Springfield, Missouri, and then went on to graduate from the Radcliffe College of Harvard University.  Following that, she attended Duke University, where she received her M.A. and Ph.D. in psychology.

Caplan is currently an Associate at the Dubois Research Institute of the Hutchins Center at Harvard University, where she works on their Voices of Diversity Project.  She is also a past fellow at the Women and Public Policy Program of the Kennedy School of Government at Harvard.  She is a 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.  She was also a former Assistant Professor of Psychiatry, and former Lecturer in Women’s Studies at the University of Toronto.

Caplan has published a total of twelve books so far, which include Lifting a Ton of Feathers: A Woman’s Guide to Surviving in the Academic WorldBias in Psychiatric DiagnosisDon’t Blame Mother: Mending the Mother-Daughter Relationship, and her most recent publication, Johnny and Jane Come Marching Home: How All of Us Can Help Veterans.


Psychotherapist Bryan Knight, from

“Read Dr. Caplan’s book and weep for the thousands of people (mostly women, of course) whose lives have been damaged by being labelled with the stigma of a mental illness, when in reality their only problem was that, like [like psychiatrist and author] Dr. Siebert, they dared to be different.  Or human.”

Ablechild, DSM, DSM IV, mental health labelling, Mental Illness, psychiatric labelling