The Great “Crazy” Cover-up:
Harm Results from Rewriting the History of DSM


I have been immersed in the field of psychiatric diagnosis – and resistance to it – for more than a quarter of a century. In the late 1980s, I was a consultant to two committees appointed by DSM-IV Task Force head Allen Frances to decide what DSM-IV should contain. I resigned from those committees after two years because I was appalled by the way I saw that good scientific research was often being ignored, distorted, or lied about and the way that junk science was being used as though it were of high quality . . . if that suited the aims of those in charge. I also resigned because I was increasingly learning that giving someone a psychiatric label was extremely unlikely to reduce their suffering but carried serious risks of harm, and when I had reported these concerns and examples of harm to those at the top, they had ignored or even publicly misrepresented the facts. I wrote about what I learned from my insider’s position in my book, They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal (Caplan, 1995).

From about 2009 until DSM-5 was published in 2013, there was massive coverage in popular and professional media about outcries against DSM-5. The outcries were largely based on the assumption that it would represent a break with DSM-IV (published in 1994 and minimally altered for a 2000 edition), which was seriously misrepresented as having been solidly scientific, helpful, and – for all but a tiny number of its hundreds of categories —  not harmful.  The rewriting of history has continued in publications since DSM-5 appeared, so that there has been a massive and damaging rewriting of history, and it lends a legitimacy to DSM and other diagnoses in general, when, in fact, the recurring problem is that psychiatric disorders have never been validated, in fact not even shown to be reliable.

The rewriting has serious consequences, becoming the basis for wrong assumptions, misplaced outrage, lack of outrage where it would be justified, and failure to take action in order to prevent harm to currently uncountable numbers of human beings. The rewritten version of this history is used to justify depriving psychiatrically labeled people of their human rights on the grounds that it is good for them or society or both. It draws attention of professionals and the public away from the facts related to psychiatric diagnosis; draws energy and resources away from stopping, redressing, and preventing harm; draws everyone’s attention from the most important people, those who have suffered from being psychiatrically labeled; helps maintain damaging features of the status quo; and causes history to repeat itself in destructive ways.

Never highlighted and virtually never even mentioned in most writing about psychiatric diagnosis is that it is totally unregulated. As a result, the coverups and misrepresentations of truth and the harm to which they lead continue, because those who are harmed have no recourse, no way to hold accountable those who create and market the hugely profitable “first cause” of the trouble, the psychiatric diagnostic classifications.

I recently wrote a paper in which I documented this rewriting of history, because if professionals and the public know the historical facts, any critique of DSM-5 will be seen as part of a larger historical critique of the DSM since its beginnings, as well as of psychiatric diagnosis in general, for then we can see a larger history of harm done. You can download my paper here.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. Thank you so much for this inspiring and encouraging article. I have been struggling lately against an avalanche of disheartening feelings while attempting to wrap my thesis into a fifteen-minute presentation to my peers in a master’s psychology/counseling program.
    My thesis ran along the lines of providing counselors with sound reasons to hold hope for those clients presenting with the kinds of problems that usually land them a diagnosis of schizophrenia. I reviewed literature that examined diverse cultural considerations, validity/continuum issues, links to trauma and adverse experience, alternative models of psychosis, stories of recovery, and alternative approaches to psychosis. And while my thesis provides a hopeful outlook, it is clearly not a mainstream perspective, and therefore runs counter to powerful forces that restrict counselors’ authenticity and creative freedom, while simultaneously engendering a sense of hopelessness.
    There is no easy way, within current educational institutions, to discover (or uncover) the facts about psychiatry’s classification system. I was very fortunate to obtain my education at a very progressive school and had the opportunity to dig deeply into the history of the DSM, and specifically, into that of the classification of schizophrenia. It is only against great odds that a student would gain insight into the smoke and mirrors of psychiatry. In these times of “unavailable” research, many students are not given the opportunity to review the methodological, conceptual, and statistical bases of those primary studies upon which schizophrenia’s supposed legitimacy is built, and therefore, are easily “spoon-fed” psychiatry’s “knowledge” via textbooks. These then enter the workforce with a very specific “vision” about particular “symptoms.” I feel a strong sense of urgency regarding this, because that vision seems potentially very harmful to those individuals in extreme distress – distress that is both deeply personal and unique to their lives and experiences.
    But your words encourage me. While I can only guess about the conspiratorial deceit within psychiatry, you witnessed it first-hand and bravely share that insight. Thank you! I look forward to reading your work.

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    • Thank you for your courageous voice of reason. This paragraph, especially, caught my attention:

      “The rewriting has serious consequences, becoming the basis for wrong assumptions, misplaced outrage, lack of outrage where it would be justified, and failure to take action in order to prevent harm to currently uncountable numbers of human beings. The rewritten version of this history is used to justify depriving psychiatrically labeled people of their human rights on the grounds that it is good for them or society or both. It draws attention of professionals and the public away from the facts related to psychiatric diagnosis; draws energy and resources away from stopping, redressing, and preventing harm; draws everyone’s attention from the most important people, those who have suffered from being psychiatrically labeled; helps maintain damaging features of the status quo; and causes history to repeat itself in destructive ways.”

      In my estimation, your analysis has captured the vital flaws in what is the basis of psychiatric beliefs and practices, in general. At the core, it is misleading and distracting from where we should be focused, if we want to resolve the issues which have been creating and embedding our collective confusion and chaos, in order to move forward toward clarity and the truth of the matter, for the purpose of relieving needless personal suffering and a potential loss of human and civil rights for those who turn to psychiatry for support. Creating distractions is what I find to be psychiatry’s strong suit, they’re quite masterful at it. Many others have taken this example, society at large, in fact.

      What we have now, and how you describe it, is, in my calculation, the product of corruption, deceit, avoidance, and incompetence. The goal is to help people heal, not to drive them insane. Sounds like an obvious statement, but I like to reiterate it, given the irony of today’s mental health care, and its increasingly growing negative reputation.

      As far as solutions go, I imagine we’d have to go outside of mental health for answers. This field can’t seem to find solutions for anything; all I see are the same conflicts, repeatedly. I call that being stuck.

      I agree wholeheartedly with what Kris says, above, that “it is only against great odds that a student would gain insight into the smoke and mirrors of psychology.” I couldn’t help but notice how much avoidance, defensiveness, and overly rationalized justifications were part of the faculty-student relationships when I attended graduate school to study psychology. Seems to be ingrained in the field, and it starts in education. That was my experience, at least.

      Thank you again, Paula, I really appreciate your clarity and the very sound reasoning of your article.

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  2. I’ve got Pages on my Mac, but when I open the document, I get an error stating:

    “Unable to open “The Great _Crazy_Coverup.pages” because the document is invalid. The index.xml file is missing.”

    You should be able to use the “Save as PDF…” option in the “Print” dialog to save the document as a PDF, which is much more portable…

    thanks! – bonzie anne

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  3. Whenever in America there is money to be made, nothing else matters much. Not even family. So whatever it takes to enhance the bottom line. Naturally scientists are not immune to these considerations. The DSM makes money. The more ailments they can dream up the better. This is the unfortunate fate of a nation that has made money its highest value. Only by living through the consequences will America discover other higher and better values. In the meantime one will not need to die and go to hell to know hell, one can just live in this nation day after day.

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    • AgniYoga,

      I watched you’re movie. I’m not a tattooed lady, however I am a woman who had a dream the red dragon has been sent to the lake of fire. And I am a nice suburban mom who was “crucified” by the historically German ELCA Lutherans and a Jewish Rabin (rabbi) and Kohn (kohen), for belief in the Holy Spirit and God.

      So obviously, I do have a religious story, a religious story of an ethical Lutheran woman who was betrayed by the ELCA, after they defrauded her family out of millions claiming to be Christians, and a couple of unethical Jewish doctors. Who betrayed me, so my ex-religion could defame and whack me out of my mind on major tranquilizers and “not pay” me, due to their cover up of the documented medical evidence of the sexual molestation of my little child by an ELCA pastor or his best friend. It’s an on-going ELCA cover up.

      Numerous pastors within my new Christian religion have told me the ELCA’s crimes against my family are “unforgivable” (denial of the Holy Spirit), acccording to the bible, so I should tell my story. A new bible study leader / judge by profession was really embarrassed to hear my story just the other day. I have medical evidence of the crimes committed against my family, so feel it’s appropriate to tell the story, but no lawyer has yet agreed to take my case.

      But in a way you are right. I am a woman who was chemically raped based upon a pastor and his therapist friend’s lies to her psychiatrist friend. A stupid Jew, who thought I wouldn’t fight back, screwed me over. But the ELCA defrauded my family out of way too many millions, prior to my being chemically raped based upon lies from a “bad joke” of a pastor. And covering up child sodomy is not, in my opinion, what the religions should actually be in the business of doing.

      And I’ve noticed I now have a life mirroring that of the woman in Revelations 12. And since I do not innately assume the worst of most other “Christians.” I now have a theory that my ex-religion may have betrayed my generous family and I, so they may try to bring about judgement day by giving a nice and ethical lady a life mirroring that of the woman in Revelations 12.

      I’m still trying to figure out what to believe.

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  4. Thanks, Paula. You are absolutely correct about the dangerousness of the DSM-5 and the “risk of harm” (to the patient) that is a built-in feature of ALL psychiatric diagnostic activity. Sadly, this risk will affect or destroy the lives of countless patients and targets until lawsuits such as Blackhouse v. TLC Properties, et al. are rescued from the morass of the U.S. judiciary’s pile of cases that were actionable but criminally shunted as too condemning of the medical oligarchs and their colleagues at DHHS. The actions against the torture facilities — now, more than ever — MUST find their ways to the appeals courts; they also must be adjudicated by upstanding justices eager to protect individual choices and the Bill of Rights. Keep fighting!

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  5. Well, psychiatry has become an instrument of the state. You might wonder what putting children on these powerful drugs, whose effects over a lifetime are not known, is doing to this nation. Along with that what kind of parents these children have who perhaps also are using some drug themselves. Years ago science fiction presented this when the only nation with such low minded intentions was supposedly the Soviet Union–which did use Haldol to subdue dissidents. And what worse dissidents than children?
    Corruption seems to have permeated all the institutions now. But then institutions have no souls and are therefore amoral even though the Supreme Court seems to think corporations are Persons. But persons without ethics thus much like the psychopath.
    I see things like DMS as not only absurd but as also the mentations of these corporations. You see if people were machines, even very very subtle and intricate ones, then aberrant behavior would simply mean that some part was malfunctioning. So either replace the part or fine tune it.
    But if people are not machines then there are no accidental behaviors. Every move is meaningful even if no one can find that meaning. And to destroy the behavior is to lose the meaning. But meanings make a life. R.D.Laing had the right idea. But there was no money in it. And money makes the world go round. Sorry to those who thought it was love. Love is in second place and in danger of slipping into third presently.
    However, once one starts throwing out things like the DMS it can begin to get scary as the debris of civilization is deep and dangerous.

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  6. Thanks, Paula, for your ongoing crusade against this destructive nonsense; as always, you outline the issues with clarity and passion. As you know, I’ve been in the front lines myself on the issue with The Insanity Hoax: Exposing the myth of the mad genius as well as other writings, including being part of the backstage (and ultimately futile) protests about the newest DSM to be inflicted on the American public.

    Perhaps the NIMH is actively seeking a more “scientific” alternative to the DSM, as they claim. But meanwhile, it’s dismaying to watch the government gulping down the psychiatric Koolaid and embrace the notion of “parity” with physical illness.

    By bestowing government legitimacy on the fiction that mental “illness” has a known biological basis and cure, the “parity” illusion enables the money to keep flowing, which is the primary motivation for all this frenetic diagnosing and prescribing in the first place.

    It doesn’t matter that it’s unscientific hooey. It doesn’t matter that powerful drugs are being prescribed despite their unknown long-term consequences to the developing bodies and brains of children. It doesn’t matter how many people have already suffered under this system, and how many have put the real truth in front of the American public and its supposed guardians.

    I have to agree with AgniYoga on this one, as the song from “Cabaret” starts to roll around in my head: “Money makes the world go around/the world go around…”

    We can’t stop that reality, but we can change and open minds, even if only one at a time.

    Creative does not mean crazy.

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    • I have 20 years worth of paintings and sculptures that have culminated in an art portfolio that collectively tells the story of painting iatrogenic bipolar, and subsequent research. They also tell a religious story of two (not yet completed) reassurections, and the travails of a woman who ends up with a life mirroring that of the woman in Rev 12.

      And it’s a story about how the function of psychiatric “diagnosis” is to take away human rights, poison, torture, defame, hopefully murder a nice, intelligent, and creative mommy so psychiatry can cover up “bad fixes” on broken bones for doctors and cover up sodomy of little children for the religions. Outrage is appropriate.

      I disagree with those within the medical community that, without knowing anything about me personally, declared me to be “w/o work, content, and talent,” “irrelevant to reality,” and took legal liability for declaring my entire life a “credible fictional story” – so they could rationalize their anticholinergic intoxication poisoning of me to cover up the “bad fix” and child sodomy.

      Thank you to all others who agree, and are working to point out that we should be outraged at the completely fraudulent and morally bankrupt psychiatric industry. Thank you for acknoweding the fact that creative does not mean crazy. I was force medicated initially because I thought God was inspiring a story, but now I have a religious story. And a story about how the psychiatric drugs make people crazy.

      And I’m quite certain part of the story is that psychiatry needs to stop defaming and torturing children, especially with their neuroleptics. I’m sure God doesn’t want all the children to be chemically lobotomized by the psycho / pharmaceutical industries, merely because this is profitable for them in the short run. Since doing this is not going to be beneficial for all of humanity in the long run. The inmates are running the asylums, and we need a return of wisdom and common decency.

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  7. Paula,

    Excellent and very enlightening article, thank you. I should probably pick up your book, forgive me as I have not yet. I’ve been trying to get through Allen Frances’ book for months, to no avail; due to what I consider awe inspiring hypocrisy.

    Maybe I’ll be able to read it now, with the knowledge that others who haven’t been declared “irrelevant to reality” and “w/o content, work, and talent” and had their entire life declared a “credible fictional story,” because of a proven psychiatric misdiagnosis, share my “delusions” psychiatric stigmatization is insanity and not remotely beneficial to the patient. I’m a victim of Frances’ largely iatrogenic “bipolar epidemic.”

    And, in as much as I appreciate his too little, too late, guilt trip inspired, but incomplete confessions. I am disgusted by the fact blatant and continuing injustice to all those harmed by completely unscientific psychiatric stigmatization continues. The psychiatric professionals all have malpractice insurance, which garnered them trust from their patients initially, for a reason. Repentance, and utilization of their malpractice insurance for what it was intended, truly is what is appropriate in my opinion.

    Like you, I’ve gone to every appropriate government agency, with blatant and medically provable psychiatric misdiagnosis and malpractice, and not seen justice. One of my former doctors has now been arrested by the FBI for his similar crimes against many other patients. And just today I was once again told a law firm wouldn’t help me. Even a doctor being arrested by the FBI for egregious crimes committed against patients is not good enough evidence to get a medically provable falsely accused “psychiatric” patient, a lawyer.

    But the Dept of Prof Reg did tell me recently they would re-examine my case, since the doctor had been arrested by the FBI. We’ll see. It’s staggering the crimes and injustices being committed against those defamed with DSM “disorders.” Even my friends who are lawyers won’t take a blatantly provable case of malpractice. Who are the evil ones perpetrating these crimes against so many?

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    • In the UK child abuse seems to be the pursuit of the upper crust. I am sure it is mostly the wealthy that so indulge in the USA. There was the Franklin Case that pointed to the WH of George H. W.
      Some twist from somewhere. The prominent protect each other. Here a pedophile, there a murder, there some lucrative bank fraud. Etc. Good to have friends in high places. Keep in mind the perpetrator can never get away from him-or herself. The poison becomes stronger with time.

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  8. I read your online paper and have to agree that psychiatric diagnoses cause grievous harm. I went to see a psychiatrist because I had had a serious auto accident, was in pain and not sleeping. Little did I know I had entered a labyrinth to mulitple diagnoses and years of poly drugging. The diagnosis is in my open medical records and it has caused me to be denied referrals and delayed treatment. The kicker is the diagnosing psychiatrist said he’d been 100% wrong but he held fast to what he did because he feared losing his license. Later several other physicians and therapists said I was not mentally ill and never had been. I’m many years drug free and have reclaimed my life.

    From my stand point I have seen the ugly side of psychiatry and how labeling compounds and hinders the well being of the client. The DSM is full of nonsensical platitudes and it’s left to interpretation. When what is said is taken out of context and/or due to what psychiatrists may think they hear someone say. This is a bias for a diagnosis that has the potential to ruin your life?

    My thoughts are psychiatry has lost its way and only knows labeling and prescribing drugs.
    I’m so sorry it still continues to harm.

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  9. “What makes a hero? Courage, strength, morality, withstanding adversity? Are these the traits that truly show and create a hero? Is the light truly the source of darkness or vice versa? Is the soul a source of hope or despair? Who are these so called heroes and where do they come from? Are their origins in obscurity or in plain sight?”
    ― Fyodor Dostoyevsky, Notes from Underground

    Psychology! Billions of dollars each year. University classes, books, programs. Mental hospitals. Psychotherapists & psychiatrists. Many thousands of persons who earn their living in some way connected to psychology. The multitude of prescriptions for the magic drugs. This begins to sound like the military budget! So many drawing on so many for a livelihood. And like the military finding the enemy. The mental illness bugs. Strange and eerie. I try to put myself imaginatively in an apartment in some huge metropolis with my drugs and the TV remembering some anonymous psychotherapist encouraging me to stay alive. Why? A lot of great people have died. Why not go visit them? I might find a true friend among the dead.
    Anyway, tired of being a bio-machine. So many neurons to trouble about. Like birds in vast flocks darkening the sky of my mind. I turn off the TV. I resolve to get to the bottom of this mystery. I flush the drugs down the toilet. I would like to toss the TV out the window down 30 stories onto the street. It’s empty. Here goes.
    Now the adventure begins. Hours, days, weeks, months of fear . . . but it does not matter. Time to be a hero.

    “In a room where
    people unanimously maintain
    a conspiracy of silence,
    one word of truth
    sounds like a pistol shot.”
    ― Czesław Miłosz

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