Who is Normal?
They say you’re crazy; How the most powerful psychiatrists in the world decide who is normal by Paula J. Caplan, Ph.D.
Peaking: How My Mind Got Free of Delusions in Psychiatry by Al Siebert, Ph.D.
Practical Psychology
Here are two books by Ph.D. psychologists, one American and one Canadian, that ask the question, “Who decides who’s normal?”
Both authors strongly challenge the generally accepted view that psychiatrists are best placed to decide who is normal and who is not.
Are psychiatrists (and other therapists) themselves “normal”? Hardly. How can someone who chooses to listen to other people’s miseries day in and day out be considered normal, if by that we mean “average” or “typical”? Therapists are clearly not normal, we are a minority and we are unique. So are people in other professions. You too.
Normality is notoriously difficult to define. What we normally understand by “abnormal” is insane, psychotic, mentally ill. some authors [most notably psychiatrists Thomas Szasz (The Myth of Mental Illness) and Peter Breggin (Toxic Psychiatry)] attack the very concept of “mental” illness, saying that it is an erroneously concretized metaphor, or that pharmacological treatment only increases the ills of those who suffer from it, that the so-called mental illness is more appropriately called “problems in life” and “treated”. either by judicial means or with exceptional care, empathy and understanding.
Thirty years ago, Dr. Siebert was admitted to a hospital as a “paranoid schizophrenic.” He claims that he was sane, that he was going through a “developmental crisis” at the time. His book, captivatingly written as discussed with his colleague Sam Kimball, PhD., recounts his experience and insights that led to his (semi-voluntary) incarceration.
Clearly, Dr. Siebert, at the time about to start a postdoctoral fellowship, annoyed his fellow psychiatrists with his unusual ideas and his wife with his eerie silences. Dr. Siebert got caught up in his idea that basically we are all selfish, that even so-called altruistic behavior is based on self-interest. (This became the basis for his work and his book on The Personality of the Survivor.)
Peaking Out vividly describes life in a psychiatric ward. Though benevolent, his guardians labeled Dr. Siebert mentally deranged and could not see past the label. The authorities ignored his claim to cure by suspending the labeling and actually listening to a woman who heard the voice of God.
It is not clear why Dr. Siebert decided to publish this book now (and reveal “a secret that has been kept hidden for thirty years”). But his outrage at what he sees as an abuse of power by some psychiatrists over him is equaled, if not surpassed, by Dr. Paula Caplan’s anger at the audacity of psychiatrists to decide who is not normal, not to through science and evidence, but through bias and politics.
Dr. Caplan, a Canadian with equally impressive authorship and teaching credits as Dr. Siebert, attacks the process by which psychiatrists affix the motto to the content of the Diagnostic and Statistical Manual of Mental Disorders, popularly known as the DSM. .
This volume attempts to define mental illness with the same certainty and precision with which physical illness is described. It is an obvious attempt to achieve a degree of respect and scientific authority similar to that generally accorded to other physicians.
But the DSM IV, like its predecessors, is a farce. This is the only conclusion you can come to after reading Dr. Caplan’s very detailed account of the partisan bargaining (“horse plot”) that goes into determining what will and will not be included. will include in the volume.
Research expert Dr. Caplan points to the paucity of data on which DSM IV is based. She got involved a few years ago when the committee — all white men of a certain age — tried to make PMS a mental disorder. The fight was hard, the feminists lost, but not until furious arguments from both sides were aired in psychological journals and the media.
Only arrogance (or desperation) can explain how psychiatrists (and some women) dare to pretend that human mental disorders can be reduced to the type of specific disease data applicable to, say, measles.
Dr. Caplan goes to great lengths to be charitable to the motives of DSM IV perpetrators. However, one must suspect that power and money (DSM IV sells millions upon thousands of copies and is a necessary benchmark for many insurance claims, not to mention hospital funding etc., especially in the US) ) are the main motivations of the authors of the DSM. .
Perhaps, as Dr. Siebert asserts regarding their persecutors, the authors of the DSM have convinced themselves of their righteousness and of the need to force good upon those who suffer, even if the sufferers have not requested such a thing. help.
History, including the history of psychiatry and “mental health,” is replete with examples of well-meaning people forcing their bewildered victims to do what they thought was right. The perpetrators are deaf to any ideas that are not their own. Belief systems are notoriously difficult to change.
Look at Sigmund Freud’s absurd notion that little girls want to have sex with their fathers. I was astonished by Dr. Caplan’s assertion that many therapists still practice orthodox Freudianism: hiding behind a couch, refusing to believe their patients’ accounts of incest, etc. Perhaps this horror persists only in Toronto?
Two examples will suffice to demonstrate the arbitrary character of the DSM IV: over the years homosexuality has gone from being classified as a mental disorder to being included in a covert way, going on to not be included in the current DSM. Can a disease stop being a disease? Either homosexuality was never a mental illness, or psychiatrists caved in to public pressure. Obviously, however, the inclusion or exclusion of homosexuality was not based on science.
The other example is the pushback Dr. Caplan and her colleagues encountered when they tried to match the DSM’s stereotypical “female” descriptors with a description of typical male behavior as mental illness.
Undoubtedly, the greatest irony about the dangerous DSM IV is that while it purports to list all mental disorders in exhaustive detail, it offers no solutions or treatment guidelines. Could it be because we actually know very little about the mind, let alone how to cure its disorders?
Most of what we do as therapists is art, insight, relationship. Medicalizing life’s problems, as DSM disciples often do, is a disservice to clients and therapists. Clients, because they need attention, not categories. And therapists, because that illusory certainty leads us, like Dr. Siebert’s colleagues or Dr. Caplan’s detractors, to unite in a collective delusion of being scientists.
Read Dr. Caplan’s book and weep for the thousands of people (mostly women, of course) whose lives have been damaged by being labeled with the stigma of mental illness, when really their only problem was that, like the Dr. Siebert, dare to be different. Or human.
