Monday, September 20, 2021

Comments by Paula J. Caplan, PhD

Showing 182 of 182 comments.

  • Steve McCrea, Sam Plover, and lcostanzo, I am so glad that you like the idea of the brochure. I have a lot on my plate right now, but if I did set up a gofundme page to raise the few thousand dollars that would be needed to create the brochure, write the text, get artwork created, and pay for a website and domain name to “house” the brochure, can each of you please write to me through my website, sending me your email addresses if I don’t have them, and I will let you know once the link is up. It would be great if you could help spread the word, because I cannot do it through MIA, so if you know anyone else who might chip in (donations will be tax deductible), please ask them, too, to contact me and send me their email addresses. I will post about it on Facebook and Twitter and Instagram, too. It’s so good to feel so supported. And I really think this little project could have considerable impact, because people can do a lot if they have the right information.

  • It is wonderful that in Peter Simons’ article he writes about the wonderful Power Threat Meaning framework (though he mistakenly described it as a diagnostic system) created by Dr. Lucy Johnstone.
    However, please note the following:
    Re the reference to people who are now criticizing the DSM as “major figures in psychiatry, such as Allen Frances, the chair of the fourth edition Task Force and a key figure in the creation of modern psychiatric diagnoses, and Thomas Insel, director of the National Institute of Mental Health (NIMH) from 2002 to 2015,” and later to “two of the biggest names in psychiatry, Thomas Insel and Allen Frances.”
    (1)Insel uttered not a peep against the DSM until years into his tenure at NIMH, after overseeing the giving of grants for research based on DSM categories. Did Insel suddenly realize how bad it was at that late moment? Insel’s credibility must be challenged, given that when trashing the DSM, he proposed the hugely expensive (and ultimately fruitless, as Insel admits now that it is too late) RDoC, which was based on the biological/medicalized model of so-called “mental illness.” Where is the heroism in that?
    (2) Relevant to the mentions of Allen Frances, while royally trashing DSM-5, Frances has consistently and falsely claimed that HIS DSM-IV was “scrupulously scientific.” A great many people have shown that nothing could be farther from the truth about the DSM-IV. Readers would be helped by knowing to take whatever Frances says with a grain of salt (or a ton of salt), given that he so blatantly misrepresents what he did with DSM-IV (as documented, often with quotations directly from Frances himself, in
    (3) Also relevant is that Gary Greenberg, in his excellent, The Book of Woe, as in his article in Wired magazine, reported his conversation with Frances in which Frances acknowledged freely that psychiatric diagnosis “is bullshit.” In light of this, it makes no sense to consider Frances as a reliable authority in the light of Frances both claiming that his DSM was scientific and admitting that psychiatric diagnosis is bullshit. (4)Further of relevance is Frances’s key role in the biggest conflict of interest scandal in the history of the modern mental health system, which has actually been written about here in MIA as well as initially in This scandal resulted in the pseudoscientific and clearly false but vigorous marketing campaign Frances and two colleagues designed — and were paid nearly $1 million for by Jansen (of Johnson & Johnson) — to sell the exceedingly dangerous drug Risperdal. This omission is all the more disturbing, given the extensive inclusion in this article of Frances daring to attack the APA for ITS conflict of interest in selling the DSM-5. (Simons writes: “Frances also called out a massive financial conflict of interest—the DSM is the APA’s biggest money-maker since every professional in the mental health field must purchase the expensive, massive manual each time it is updated in order to stay abreast of the newest diagnoses and criteria changes.”) Yet Frances breathes not a word about such a conflict of interest during the many years he was heading the DSM-IV Task Force. It’s not believable that Frances somehow evaded his own conflict of interest when he was in that role. Does anyone believe that Frances suddenly, as soon as DSM-5 was in the works, was struck by the realization that there was such a conflict of interest and that he had been in that very position as head of DSM-IV? And given Frances’s scandalous conduct with the Risperdal conflict of interest, he certainly should not be assumed to speak from expertise and from the integrity that warrants paying attention when he calls out someone else’s conflict of interest.
    People who would like to read my future essays may want to friend me on Facebook or follow me on Twitter, where I will be announcing my publications, or on my Authors Guild website, which is, since I no longer write for MadInAmerica.

  • Lcostanzo, your kind words mean the world to me — and I am sure also to Peter and Steve. This is what we hope will happen increasingly if we (this includes you) all keep trying to get the truth out. What is so tragic is that most people who turn to the System for help don’t even have enough of the facts to know what questions to ask or how/when to challenge what some professional says. I have long wanted to get a small grant to put together a brochure that would summarize some of the crucial info and have a list of questions to ask/things to consider when seeing a mental health professional AND some alternatives to seeing professionals…and then make it available at no cost online for people to download.

  • Thank you for the kind words, Sam Plover! And you are so right to say the diagnosis itself constitutes iatrogenic harm!

    To l_e_cox, I want to say a couple of things. One is that the diagnosis is THE FOUNDATION STONE of everything bad in the mental health system. It is getting someone labeled “mentally ill” that makes it possible for the professionals to do almost anything to the person in the name of “treatment.” And although some of the professionals may be guilty of intent to harm, in a way what I find more disturbing is that the vast majority actually think they are helping…and are so invested in seeing themselves as helpful and caring that they are not open to seeing when the truth is that they are causing harm (so they think things like, “She just needs to be on a higher dose of meds” or “Maybe I gave her the wrong label, and she is not bipolar but is schizoaffective, and thus I should stop doing X and do Y instead).
    Incidentally, for those who want to keep up with my essays in the future, I will not be writing for MadInAmerica, but I will announce and/or post my work at and on my Facebook and Twitter and Instagram pages.

  • I cannot see where to reply to jonathanledlarsen’s last comment, so I will do it here. I was not saying that I had tried to find out where to file complaints about harm from psych drugs. That is totally different. I was saying that I had tried to find out from the ICD people where to file complaints about harm from PSYCH DIAGNOSIS! Everything bad in the mental health system starts with diagnosis, since the diagnoses have no scientific validity, and they so often cause vast harm. But neither the WHO (re ICD) nor the APA (re DSM) has the least concern about the damage that their diagnoses cause. They have made that very clear. I think it is crucial not to write as though the only harm that comes from psych diagnosis is what psych drugs do. If you go to, you can see a number of very brief videos that are about various kinds of harm that all started with psych diagnoses. They are devastating. Please help spread the word. In addition, this might possibly be of some interest: It is a lecture about this with some performance.

  • Jonathanledlarsen, Steve McCrea is right when he says (below) that the ICD people try very hard to coordinate with the DSM people, and the ICD psychiatry section differs very little from the DSM. However, when you say that the ICD is not commercial, well, I tried to find out what they do with their profits from sale of the ICD, and they would not even reply to the question. I also asked them what is the route for people to file claims when they have been harmed by use of the psych labels in the ICD, and they did not reply to that either. We do know that Allen Frances’s DSM-IV brought in more than $100 million in sales, and there is no evidence that they spent a single penny of that money to redress any of the harm done by the labels in their manual. In fact, they dismissed with no attention to the merits the nine ethics complaints we filed about that harm. Not surprising.

  • Glad you wrote this essay, Megan! A few notes:
    (1)My first book was about the importance of women’s friendships with each other and what a misogynist society does to try to set us up against each other. It is
    (2)My most recent book is about military veterans and how isolated they often are from their wider communities.,aps,220&sr=8-1-fkmrnull&linkCode=li1&tag=whejohandja0d-20&linkId=1dbd7dedc192a717801d8a2ccc9ed082&language=en_US A major point of that book is that instead of sending vets to therapists who DIAGNOSE them as mentally ill with “PTSD” (which is, yes, in the DSM) and put them on drugs and say they will never get “well,” we should be telling them that the traumas of war, military rape, racism and homophobia in the military, etc., are upsetting, and that is a deeply human reaction, not a disorder, and I hosted a conference at Harvard in 2011 at which the more than two dozen NONPATHOLOGIZING, EFFECTIVE ways to help reduce their suffering were presented. Each of these is shown at in a video a few minutes long. They may seem too “easy” and ineffective because they are not part of the medical model of reducing suffering. But they work powerfully!
    (3)It is helpful to have a brief list of guidelines that tell how to distinguish someone from “just being angry” to actually being emotionally/psychologically abusive. That list is in the preface of this version of another book, which is
    Finally, I have been touched to receive many messages from readers of Mad In America saying kind things about my essays, so I want to mention that I will no longer be writing essays for MIA. People interested in keeping up with my essays can go to the home page of, where I will post links to new essays I write, and to the blog page of that same site, where I will post many of my essays. I am invited to publish on two other wonderful sites, and if I do that, I will post that information at also.

  • Hello, Evanhaar,
    I was supposed to write a series of articles for MadInAmerica but will not now be doing that. I appreciate your interest in my essays. The closest I got to a series was the two-part essay about suicidal thoughts and behavior being pathologized and what to do instead, so both of those were published on MIA. If you are asking if one can sign up for my blog on my Authors Guild website at, I actually don’t know the answer to that. It is so recently that the matter of publishing primarily on my own website (and I am exploring the possibility of publishing on a couple of other sites whose editors have kindly invited me) that I will need to check with the Authors Guild to see if there is a way for people to sign up to be notified when I post a new essay. Again, it is kind of you to care about this work. If you want to send me an email through my website, I will have your email address and can let you know what I find out.

  • Hello, Someone Else,
    I have greatly appreciated your comments on essays I have written here and on other people’s essays. I don’t know who you are, but I wanted to invite you to contact me (anonymously if you wish) via my Authors Guild website, which is I will no longer be writing essays for MadInAmerica but will from time to time be posting my essays on my own website (there is a Blog section) and have been invited to post them elsewhere. I would love to continue to learn from you.

  • This is such important work … and beautifully reported by Peter Simons. Thank you, Peter.

    What a shame that even in the context of doing such important work, the authors (according to Peter) wrote that outcomes for people with “severe mental illness” have worsened over the last 50 years and that people with schizophrenia continue to die up to 25 years younger than do their peers.

    So they are trying to make some important steps forward, yet even they erroneously use the terms “severe mental illness” and “schizophrenia” as though they were clearly defined, scientifically supported, and innocuous constructs. They most definitely are not! I continue to marvel at how so many otherwise progressive thinkers in this field either actively use such terms in ways that reify them, present them as though they were valid and as though they were not damaging terms that have destroyed people’s lives. Why do people think that is the case?

  • THANK YOU for writing this! Decades ago when I wrote the book, The Myth of Women’s Masochism, this was just the kind of reason I wrote it! And as you show, it is still all too relevant. It still sickens me when I hear an abuse victim described as having “brought it on herself, because she needs to suffer.” And if she says she hates the suffering and the fear, the traditional mental health professional (and too often, family and friends who are misguided) reply, “Well, if she doesn’t consciously enjoy it, then obviously UNCONSCIOUSLY she does, or it wouldn’t happen.” So the abuser is totally absolved of responsibility. If you haven’t read Dr. Lenore Walker’s classic book, The Battered Woman, do not miss it! And in my most recent edition of The Myth of Women’s Masochism, I have a section in the new preface about emotional/psychological/verbal abuse and how it is even more insidious than physical abuse because it doesn’t leave visible evidence and because it is too easily dismissed as “He was just kidding” and “You are way too sensitive,” so I include guidelines about how to recognize this kind of abuse.

  • Patrick, some important writing you’ve done in this article! Just a few comments:

    (1)Biederman was massively helped in his diagnosing and drugging of children by Johnson & Johnson working with Allen Frances. See

    (2)You mention women taking hormone “replacement therapy” as though it were a healthy thing. You seem not to be aware that taking that kind of hormone has been extremely dangerous for huge numbers of women. I hope you can perhaps edit out that bit of your article so as not to mislead women.

    (3)I wish you had addressed the fact that “ADHD” — see the brilliant work especially by Dr. David Cohen — is an utterly unscientific entity. So all these people who say they studied treatments for “ADHD” are talking about an entity that has no validity.

  • Just want to mention these things: (1)I have heard from a huge number of people (including but not limited to military veterans) who have been “informed” by therapists: “You have PTSD. And you always will.” When people have — as someone suggested in a comment — given themselves that label, it is usually because (A)They are misinformed and believe it is a synonym for “I have been traumatized,” and no one has explained to them that they are calling themselves “mentally ill” and all the dangers that can follow from that….or (B)There are benefits or “services” (some of which are actually harmful to them, but they don’t know that until they try) that they want and deserve but cannot get unless they agree to accept a psychiatric label. For people in the latter group, I usually say, “I wish I could change the system so it wouldn’t be necessary to accept a label to get what you want. But at the very least, I want you to understand the huge array of risks of harm to which you may or will be exposed once you get just about any psychiatric label. However, I understand that you want the benefits or services that accepting the label will get you. So it’s your decision, but if you decide to accept a psychiatric label, just know deep in your heart that you are not ‘mentally ill,’ not ‘crazy.'”

  • I have gotten rather lost in the extremely lengthy comments about who makes laws, and I have no expertise about laws outside the U.S. But a major reason I have been pushing for Congressional Hearing about psych diagnosis for decades is that that would help expose why FEDERAL legislation for oversight is needed.

    Please everyone go to this link and sign and share the petition calling for Congressional hearings about psych diagnosis.

    Then please everyone go to this link and sign and share the petition calling for a boycott of the DSM.

  • Please everyone go to this link and sign and share the petition calling for Congressional hearings about psych diagnosis.

    Then please everyone go to this link and sign and share the petition calling for a boycott of the DSM.

    CAN YOU HELP? I had long ago posted two petitions on I cannot find the links and want to post them here. One is called Call for Congressional Hearings about Psychiatric Diagnosis. The other is Boycott the DSM or Boycott Psychiatric Diagnosis. If anyone can find these and figure out why I cannot find them, please let me know! And if you can post the links here, I hope everyone will sign and share them!

  • Audrey, the VAST majority of people who hear you (as you CAREFULLY say) remark that you “were given diagnosis X” will hear it as “Audrey HAS X mental illness.” What I urge you to do is to say instead, “I was given Diagnosis X, which has absolutely NO scientific basis or validity, that is, it doesn’t actually exist, and then I want you to hear the details of the hell I went through, all of which was “justified” on the basis of that diagnosis. And let me tell you in ordinary and accurate words what was REALLY happening to me at that time.” It is a way for you not just to speak your truth but to make sure people hear it instead of horribly misconstruing it and thus not seeing YOU. It is also a way to make them stop and think when they hear other such labels. Warmly, Paula

  • Sadie and Lucy, my earlier article in MIA, “Is COVID-19 Making Everybody Crazy?” (of course, the answer is “Upset, yes, but mentally ill, no”) is a good pair with this one. One of the points I made was that calling people’s upset “mental health problems” is WRONG and DANGEROUS precisely because it conveys to many people that “mental health problems=psych disorders.” Instead, we should use old-fashioned, accurate terms for these feelings, like “scared,” “angry,” “disoriented,” “hopeless,” “grieving,” etc.

  • CODA to my essay:
    The American Psychiatric Association issued a press release on Wednesday, in which they crowed about the House of Representatives’ Veterans Committee removing from its Veteran Suicide Prevention legislation the permission for psychologists at the VA to prescribe psychiatric drugs. They tried to make this seem like a good move on the grounds that so many veterans kill themselves and need excellent mental health care, which, they believe, comes from psychiatrists but not from psychologists being able to prescribe drugs. Though I personally am in favor of having the smallest number of people in ANY discipline prescribe psychiatric drugs — including because so many such drugs increase suicide rates — it is important to note that psychiatrists have no evidence that their drug prescriptions are any more responsible than those of psychologists, nor that they do more careful follow-up of patients they put on drugs than would psychologists.

  • Boans, you can find the references you asked for in this article: Caplan, Paula J. (2005) Sex bias in psychiatric diagnosis and the courts. In Wendy Chan, Dorothy Chunn, & Robert Menzies (Eds.), Women, mental disorder, and the law. London: Cavendish, pp. 115-26. I don’t have the chapter in my computer, but your local library can no doubt order it via interlibrary loan if they don’t have the book itself.

  • Dear “Someone Else”:
    You can contact me directly and send me your email address through When I get some time, I am wanting to do a zoom call for people interested in this issue to see what kinds of action to take. Fiddling a bit with the DSM will do no good — the book must be thrown out, which begins with all of us making the truth about it known.
    Also, you might be interested in the annual “Battered Mothers Custody” conference, which you can learn about at

  • Dear Mr. Ruck,
    Your message is heartbreaking. Since I know nothing about you except what you wrote here, I was trying to think of what kinds of things people who said similar things were feeling was preventing them from having hope for a better life…or a better life, and two that come to mind right away are people who were in miserable or even abusive marriages but whose religion forbid divorce and people whose sexual orientation or gender identity led their religions to cast them out and call them sinners. Many of the latter found a film called “For the Bible Tells Me So” to be immensely helpful. There are people in most religious denominations who are helpful for people who want to get a divorce or who have sexual orientations or gender identities that are condemned by the religion’s leadership. It may be that religion is not what is preventing you from doing what would make your life better. If you are inclined to say more, please do, and I will see if I can think of anything that might be of use to you.

  • Peter Simons, I am a HUGE admirer of your work, and there is so much of great interest in this article. I would like to point out some things I wish had been included — any chance it could be added?. It goes like this: Nowhere in the article is it mentioned that, like all DSM diagnoses, “Autism” has no scientific validation, so it should simply never be used. Instead, people trying to help a child or adult who is struggling (or who has been identified as “a problem”) should carefully try to get to know as much as possible about the person, who considers the person problematic, does the person consider themselves to need help and if so, what kind of help, what HAS been helpful (if anything) and what HAS made things worse, etc. etc.
    Another thing is about something you wrote, which was, “for every 100 toddlers who screen positive for autism spectrum disorder (ASD), only about 18 of them will go on to receive a diagnosis. The other 82 toddlers will be referred out for further assessment, told that they “may” have ASD, and potentially be exposed to drugs such as antipsychotics (often used for behavioral control in children with autism), all without even meeting the criteria for an ASD diagnosis.” That helps reify “Autism Spectrum Disorder,” which also is not a scientifically supported category. That quotation does, however, go a long way toward showing how pointless the whole endeavor is — that is, most of the toddlers who appear to have “Autism Spectrum Disorder” on the screening instrument never even get the ASD diagnosis, but the whole endeavor is also dangerous, because it greases the skids, getting huge numbers of kids into the traditional mental health system, where they may miraculously get a helpful therapist and not get put on harmful drugs but most likely will suffer great harm.

  • I just now read some of the later comments and find it frightening that people are saying Fauci is lying or just wants to control people! I hope you will look at the GOOD science that proves that wearing masks and social distancing really do reduce the spread. Have a look, PLEASE, at the areas where covid increased when masks and social distancing were NOT used and the areas where covid decreased when they were used. I don’t want people reading comments after my article to end up believing that covid is all a hoax and a plot! People are dying at a scary rate from this. We cannot render them and their loved ones invisible, please!

  • Audrey, I am happy for you that you found your way so well without the mental health system. However, I am saddened that you continue to use psychiatric terms like “Bipolar Disorder” and “Complex PTSD” instead of using this essay as a chance to teach others that psychiatric diagnoses have NO scientific basis and cause massive harm of a vast array of types. I guess someone told you that you “have” “Complex PTSD,” but what you really “have” is your own way of having reacted to and tried to cope with the trauma you experienced. You do not need to use such a damaging system’s language to refer to yourself. I urge you to use ordinary words that will help you stop pathologizing yourself and others who have been traumatized. I wish you well.

  • Peter, like so much of your work, this is an important article. I agree with Oldhead, though, that to report the 0.5% statistic is a good start, but then to continue on to say what the rest of a totally in-valid entity called “schizophrenia” consists of undercuts the quotation marks used around the term in the headline. It makes it seem suddenly as though “schizophrenia” were a real entity BUT that only a tiny bit of it is accounted for by genetics. In fact, NO PERCENT can be accounted for by anything, since it has no scientific basis supporting the claim that it is a real entity…I hope people will read Robert Whitaker’s book, Mad In America, and Jeffrey Poland’s chapter called “Bias and schizophrenia” in the book Bias in Psychiatric Diagnosis. These make it clear that the category itself is a godawful mess. And we know it does massive harm.

  • Peter, this is SUCH an important article and should make everyone stop and think before accepting claims to “prove” connections between emotions or thoughts and the brain! In our book, my co-author (an HONEST neuroscientist!) and I have a whole chapter about this! The book is short and very accessibly written, by the way.,aps,115&sr=8-1-fkmrnull&linkCode=li1&tag=whejohandja0d-20&linkId=f7e069369609c5b0095adc0c20cf1c49&language=en_US

  • This is about a post way up the line. I wanted to respond to Steve McCrea’s comment that terms like “narcissistic” are different from “Narcissistic Personality Disorder.” I TOTALLY agree! Nearly every head of every DSM Task Force and nearly every president of its publisher, the American Psychiatric Association, which is officially registered as a lobby group, has either said nothing publicly about the DSM or has proclaimed that psych diagnosis is scientific! Nothing could be further from the truth. Steve is right that terms like “narcissistic” have long been used by the novelists, the poets, and ordinary people to describe people who are totally self-absorbed, etc. But to use a term like “NPD” that comes from the DSM is to become complicit with the DSM authors and marketers and profiteers who benefit from the false claim that such labels represent scientifically validated entities…and from further false claims that, because they “are” scientific, therefore whatever “treatments” they recommend inevitably follow from the diagnostic label.

  • I had stopped reading the comments to this post when it looked like they were slowing down, so I was surprised to check in just now and see how many more were posted. I haven’t yet read them all and am also surprised to see how many veer WAY away from the subject of my article but will try at least to read the relevant ones. However, I need to point out a libelous statement I noticed by someone who won’t use their real name but signs on as “Berserk.” That person alleged, among other offensive and totally uninformed comments, that I was paid to be a consultant on DSM-IV. That is completely untrue, and the idea that I did it for money is libelous. If “Berserk” or anyone else is genuinely interested in why I agreed to be a consultant and stayed for two years (I hoped to have a role in encouraging their Task Force to be honest about the relevant research and to take steps to prevent harm from psychiatric diagnosis, and I resigned when it became clear that both were hopeless), as well as learning about how the DSM process looks from the inside, it’s all described in

  • Will, thank you for this extremely important article!

    I have been terrified by discussion by media people and politicians who think it’s a good solution to replace police with “mental health professionals,” given the oppressive and even violent ways that the latter have treated people who are suffering. And Will, I agree that NONPATHOLOGIZING, NONCOERCIVE approaches are needed, but how do you think, in a practical way, anything can be done to make sure that groups calling themselves “mental health advocates” and such but that are Big Pharma-funded and focus on labeling don’t increase their access to and power over those who are suffering? What steps can be taken to make sure that the compassionate groups and individuals are the ones who are called when someone is frightened and/or menacing?

  • Thank you for this important article, which I hope people will read with Dr. Lauren Tenney’s recent, devastating article about electroshock that was also published in MadInAmerica!
    I do wish that EVERYONE would stop calling it ECT, as the late Leonard Roy Frank — himself a victim of electroshock — used to plead with people to do, because, as he pointed out, the “T” stands for “therapy,” which is dead wrong for something that wipes out people’s memories, as they did to him. Also, to say “ECT” means not coming right out and saying “electroshock.” Even the “C” in “ECT” is a bit of whitewashing, since it stands for “convulsive,” which sounds more clinical and less horrible than “shock” or “seizures.” We can all help educate people about what this involves, and one of the ways to do this is always to call it “electroshock.” Make people hear those words and know what it is.

  • Steve McCrea, I cannot see a way to REPLY to your comment, which was this:
    Of course, that begs the question of how any person could be determined to “have a mental illness” when these “illnesses” are clearly subjective judgments about a person’s behavior or character, without any objective way to determine who does and doesn’t “have” these spurious “disorders.”

    But I want to note that the term “beg the question” (which is a term of rhetoric) doesn’t mean “raises the question” (despite its mistaken use frequently) but actually means “avoids the point.” So I know what you mean is that this RAISES the question, and then I totally agree with your comment. 🙂

  • So many lawyers who work within the Protection and Advocacy domains are goodhearted people. However, I have gotten NOWHERE when I have said to individual lawyers and to the heads of major organizations who try to protect the rights of people who are diagnosed with mental illness that “EVERYTHING bad begins with psych diagnosis, so instead of saying that your client ‘with mental illness’ deserves to have rights, you could save vastly more people if you filed a lawsuit about the false advertising of psych labels as scientific and failure of the APA and its DSM honchos to warn of the huge array of kinds of harm that all start with the diagnosis.”

  • So glad you wrote this, Jim Gottstein, and so glad that Evan has you trying so hard to help him. Is there no legal clinic (Harvard Law, for instance) that will take his case?
    One other point — you said that you feel lucky that mistreatment by the system did not end up making you “mentally ill,” but I don’t know what that means, since that term is meaningless and so misused by the very system we despise. I assume you mean that mistreatment by the system can intensify and multiply the manifestations of a person’s suffering, yes? 🙂

  • Very good list in this article, but I wish you had added that psychiatric diagnosis is utterly unscientific, rarely helpful (except for requirements for “services” the person might want and need), and appallingly harmful.

  • I am so sorry about what you went through. You deserved to have people make you comfortable telling about your suffering a long, long time ago. It is tragic that that failed to happen. It is also tragic that people have given you psychiatric labels, and I hope you have not accepted them as either scientific (NO psych diagnostic label is scientific) or helpful or safe for you to have attached to your name. In fact, I know there are people who will read your brave article and be dismissive on the grounds that you “have” these various “disorders.” You don’t really “have” these made-up, unscientific entities. You have suffered in a number of ways and have coped in a number of ways, and finding out what is helpful in alleviating your suffering is what really matters. Diagnoses tend to get in the way of that. And they expose everyone who is diagnosed to a vast array of kinds of harm. Wishing you all the best. You might want to have a look at which you might find of some help.

  • Thank you for this scrupulous study of the effects of neuroleptic or “antipsychotic” drugs on death rates. This is so important to have all this work carefully described and critiqued.
    Happily, I note that you refer to people diagnosed with schizophrenia and bipolar disorder rather than to “schizophrenics” and “people with bipolar disorder.”
    Since I know you and I and many others agree that there are all sorts of horrible and dangerous reasons that people are given psychiatric diagnoses, I want to reread your article, considering what other thoughts would have come to mind if instead of calling people “seriously mentally ill” some other kinds of terms had been used.

  • Magdalene, since it appears that you are an attorney and are asking why the law and legal systems have failed to scrutinize and curb the damage caused by the DSM, please contact me at, because as a psychologist who has done a great deal of work in the legal system, I have been working and writing extensively on that very thing for decades. I assume you are not in the U.S. (you use the spelling “scrutinise”), and wherever you are located, I hope to hear from you.

  • Miranda, this is a terrific article! I would like to add a few things.
    (1)Even saying lots of people are experiencing “anxiety” and “depression” (whether psychiatrically labeled or not) can impede the path to feeling better. This is because both words are so vague and give little guidance toward how to cope. If anyone tells me they feel either of those, I ask what words they would use if they were NOT going to use those. The answers are far more helpful. What’s called “anxiety” is usually “fear,” and calling it that helps the person identify the fear’s source and set about figuring out how realistic the fear is and how to protect oneself. What’s called “depression” is used in a staggering array of ways, as David Cohen’s and David Jacob’s classic article about tests of “anti-depressants” shows, and it helps if one can recognize that they are feeling loneliness and isolation or helplessness or hopelessness or nostalgia or fearfulness.
    (2)I urge EVERYONE to put quotation marks around every term ever used to pathologizes people. It’s a very important form of educating others and reminding ourselves that they have no scientific basis and therefore are usually useless and often VERY harmful.
    (3)Since suicidal thoughts were mentioned, I want to say that I addressed this in my MIA webinar last week (which people can sign up to watch, including Bob Whitaker’s brilliant opening webinar and the ones that will follow), and good heavens, what could be more natural than thinking about suicide when death feels close to us (in our death-phobic and death-denying society) than in a long time?
    (4)Miranda included this from some media coverage:“difficulty sleeping, changes in eating patterns, rapid changes in mood, inability to carry out required or necessary tasks, [and] self-medication using alcohol.” These were being used to signal “mental illness.” So somebody tell me, do we really want to believe that in the face of this pandemic and all the unknowns about it and the fact that death is its ultimate outcome, we should have NO new difficulties in eating, sleeping, emotions, carrying out tasks, and trying to find ways to help us calm down? So what IS the “normal” way we should all be coping?
    Finally, I don’t think the word “grief” was mentioned here, but grief is something so many of us are feeling — grief that we cannot hug loved ones or help them in person, grief that we cannot go to the grocery store for potato chips even WITH a mask and gloves and not feel tense and watchful, grief about so much that is unavailable to us now, and perhaps grief that we are not handling this with as much serenity and resourcefulness as we would have hoped.

  • Anthony Murray, I know that good lawyers for this kind of situation are few and far between. I urge you to read Jim Gottstein’s new, brilliant book, The Zyprexa Papers, because one thing he does is to lay out exactly how he tried to prevent a client from being forcibly drugged. And a lot of this applies also to being committed against one’s will. It might be helpful to you in trying to work with a lawyer who might do better by seeing what Jim Gottstein did. He is a great role model! Good luck to you.

  • Hi, Kindred Spirit,
    I agree with you. In the article I wrote here, I didn’t spend much time on the kinds of things you are describing, because I have written so extensively about that elsewhere so many times, and this article was intended specifically to be a critique of a couple of pieces of research that function to cover up exactly the kinds of things you mention. So at one point I listed some of the real causes of veterans’ trauma, and I think you missed my mention of moral anguish in the above article (as just one of many causes of their trauma), but that is the term that came to me when I was writing my book,aps,220&sr=8-1-fkmrnull&linkCode=li1&tag=whejohandja0d-20&linkId=1dbd7dedc192a717801d8a2ccc9ed082&language=en_US about veterans, before I had heard Jonathan Shay’s term “moral injury.” I like that he highlights the importance of the kinds of things you describe in your comment, but I continue to use my term “moral anguish,” because anguish is a less neat-and-clean term than injury, and anguish is what veterans themselves told me about.
    I am glad you mentioned Veterans for Peace. I am a longtime Associate member of Veterans for Peace and winner of a Friend to Veterans Award from them, at least in part because I have for more than a decade been calling out the entities and individuals who keep trying to conceal the real causes of servicemembers’ and veterans’ trauma, including being in a war and being sexually assaulted in the military.
    Thank you for writing.

  • Hello, Someone Else,
    If you will listen to the podcast again and look at the website at you will see that we do NOT have veterans as listeners. Please note that the project is called Listen to a Veteran! We have nonveterans who are not therapists listen to veterans.
    As for having listeners for people who were abused as children or adults, I hope you will set up listening sessions for them. My approach as described on the above website is easily used for listening to anyone who is suffering. I don’t arrange for listening sessions for anyone other than veterans or servicemembers or their loved ones, because I have no staff, no assistance of any kind, and no funding. But I encourage you to do as you suggest.
    And yes, I certainly agree that all sorts of nonpathologizing approaches are the right things to use for people who are suffering in any way. The more than two dozen examples of such approaches can be seen at from a conference I organized that is for veterans, but the approaches are useful for everyone. And I beg people, as noted in the podcast, to stop using terms like “art THERAPY” and “music THERAPY” and just call them art and music, etc.
    Thank you for your comment.

  • So glad to see the topic of this article. Dr. Phyllis Chesler indeed deserves massive praise and respect, and her book — which is not mentioned in Lucas’s article — WOMEN AND MADNESS — is THE pioneering classic of feminist critique of the mental health system and remains all too true today. So do her MANY other courageous books (do google her and see the vast array of important subjects).
    And Chesler was one of the dynamic founders of the Association for Women in Psychology, which was an intensely activist organization whose activist roots are currently being revived — see and especially the information about its Activism Caucus.
    The recently deceased Dr. Bonnie Burstow has also been a tireless and inventive critic of the traditional mental health system and deserves mention.

  • So glad to see this article. It’s something that’s been close to my heart for more than a decade. In my book,When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans, which was published in 2011 and won three top national awards for nonfiction.,aps,220&sr=8-1-fkmrnull&linkCode=li1&tag=whejohandja0d-20&linkId=1dbd7dedc192a717801d8a2ccc9ed082&language=en_US
    there is an entire chapter about “What the VA Is Doing and Why It’s Not Enough,” and Chapter 6 (much different in the revised version and more up-to-date) is all about the importance of JUST LISTENING to veterans and how anyone can do it. Readers might also want to check out, especially the very brief video at the top of the page, where I describe what the listening sessions are, why/how I conceived of them, and a bit about outcomes. We have a lot of data on outcomes in addition to that. It would be great if the VA were to bring Listen to a Veteran! which is extremely simple and nonpathologizing and helpful to the VA. And it costs nothing. But so far, no VA people have been willing to bring this to their facility.
    Our film about this, “Is Anybody Listening?” was screened on Capitol Hill in D.C. and on Parliament Hill in Ottawa, had 140 showings on PBS stations across the U.S., had many endorsements from highly respected veterans’ entities and veterans, and has won numerous awards.
    Veterans interested in having a nonveteran (NOT a therapist, just a person!) listener or in learning more, please don’t hesitate to get in touch via

  • Hughmass, it is heartbreaking to hear what the VA and the state hospital put you through. Occasionally I hear of someone who got real help from the VA, but is far more often that I hear nightmarish stories like yours. You deserved so much better! I invite you and other veterans to go to and see if you are interested in having a totally private, nonjudgmental, free listening session from our Listen to a Veteran! Program.

  • Thank you, Patrick Hahn, for this thoughtful and important article! If people are interested in empirical research that is a documentation of the vast extent of mother-blame, I refer them to:
    Caplan, Paula J., & Hall-McCorquodale, Ian. Mother-blaming in major clinical journals. American Journal of Orthopsychiatry, 55, 1985, 345 353.
    Caplan, Paula J. & Hall-McCorquodale, Ian. The scapegoating of mothers: A call for change. American Journal of Orthopsychiatry, 55, 1985, 610 613.
    I followed this research with a wider-ranging book about mother blame,,aps,112&sr=8-1-spell&linkCode=li1&tag=whejohandja0d-20&linkId=ebbdc31e3728055aed59ab0b60631dc4&language=en_US in which, among much else, I address the myth of the schizophrenogenic mother.
    Later, I wrote:
    Caplan, Paula J. (2007). Mocking Mom: Joke or hate speech?, Vol. 1, No. 4. June 23.
    And as for the whole, absurd and dangerous concept of “schizophrenia” itself, you’ll find this insider’s story about how all psychiatric diagnostic categories are invented and then falsely claimed to be scientific in

  • Thank you, Don, for this wonderful essay about Bonnie.

    I had heard about Bonnie Burstow — and Don Weitz — many decades ago and found the revolutionary work that each of them did individually and together to be stunning, courageous, and inventive. Over the years, Bonnie and I were in touch about the work, and I was always struck by how hard she worked, how varied were the kinds of ideas she had, how knowledgeable she was, how she put together the pieces of information in revelatory ways, how she combined intelligence with compassion, how her determination to make a better world never flagged. With regard to this last matter, we rarely communicated with each other, for no reason other than that both of us were busy, but awhile back, I called her after learning that she was struggling with terrifying vision problems. I made some suggestions, but she explained there were reasons she could not try them. I was thinking how scary and difficult it must be to try to continue working, as she had said she was doing, while losing one’s sight. And then after awhile, I learned that she had written a novel! A woman with a passion to reduce human suffering and who worked to do that in so many ways — writing nonfiction articles and books, writing a novel, and creating an anti psychiatry scholarship — there has never been anyone like Bonnie Burstow. The world is impoverished by her death but forever enriched by her spirit and her work, which will live on.

  • Terrific article, Miranda Spencer!

    The following quotations from your article so clearly suggest that she has suffered a lot from being in a “mental health facility” and from being on psychiatric drugs and/or having dosages changed, not from having a “mental illness”:

    “The conservatorship continues, her manager told the Post, because earlier this year she had been struggling to adjust to changes in her medication regimen and became ‘rattled and destabilized.’

    “Having defended the conservatorship, the Post article then turned its attention to the #FreeBritney movement. In this arena, noted TMZ in one of its articles, Spears did have a voice. “There are indications that Spears herself craves more freedom. At the hearing, she reportedly told a judge that ‘her father . . . committed her to a mental facility a month ago against her will and also forced her to take drugs.”

  • Just repeating here what Irit Shimrat wrote in her comment above, because it is just what I was going to write!! She wrote:

    They write, “The DSM is not simply a scientific manual, but a social laboratory where political, sociological, ethical and psychological issues are discussed and confronted.”

    imho, this article could have been replaced (and readers’ time thus not wasted), by the sentence “The DSM is not a scientific manual.”

  • Bob and Derek, great work in pulling together these various sources of data.
    (1) As you know, in my 2011 book, When Johnny and Jane Come Marching Home: How All of Us Can Help Veterans,,aps,220&sr=8-1-fkmrnull&linkCode=li1&tag=whejohandja0d-20&linkId=1dbd7dedc192a717801d8a2ccc9ed082&language=en_US I spent three entire chapters writing about this very thing…and much more. Chapter 3 includes detailed analysis of the problems with not only “PTSD” but other psychiatric labels being harmfully applied to servicemembers and veterans whose deeply human reactions to war trauma, military rape trauma, and so on were thereby pathologized and about the harmful use of psych drugs as a result of that pathologizing; Chapters 4 and 5, respectively, are about what the military has been doing and “why it’s not enough” and what the VA has been doing and “why it’s not enough.” In Chapters 4 and 5, I track the DOD’s and VA’s press releases, showing a pattern of their expressions of dismay about suicide rates, bewilderment about their causes (usually avoiding any mention of numbers of deployments, the moral anguish coming from lies they had been told about how the military was being used and what was really happening, trauma from participating in or witnessing acts of war, and military sexual assault), and claims that they were introducing new initiatives to try to prevent suicides…followed by similar press releases with “new approaches” and continuing avoidance of real causes the next time. A long time ago, I met with the two top people in the Army who were then in charge of what they called suicide prevention, and they said their two main initiatives were to emphasize that “Army strong” includes acknowledging when one needs help and trying to get people more “mental health care” sooner. They were clearly totally uninterested in the serious problems I pointed out (politely) about each.
    (2) Many years ago, Col. (Ret.) David Sutherland and I wrote an article about the four main reasons veterans kill themselves, and two of the reasons were those you mention: the diagnosing of them as mentally ill and the use of psych drugs. (Sutherland, Col. (Ret.) David, and Caplan, Paula J. (2013). Unseen wounds. Philadelphia Inquirer. )
    (3)The long-famous “22 veterans commit suicide every day” statistic was based on VA data from only 21 states, not including California and Texas, whose veteran populations are huge. It would be good to find out — if it is in fact possible to do so — whether the VA’s current claim of “20 a day” is based on all states reporting, as well as how they defined “suicide,” since sometimes causes of death are mistakenly applied as cover-ups.
    (4)A great addition to your article would be description of what truly does help, and so I refer you and your readers to the Listen to a Veteran! Project, which has definitely been shown to reduce veterans’ isolation, which is of course a major cause of suicide. This is a completely free service, in which a veteran from any era (combat or noncombat, woman or man) is paired with a nonveteran who is NOT a therapist and who truly JUST listens with their whole heart to whatever the veterans wants to say. Data from a Harvard Kennedy School study and subsequent data have shown these simple, private, unrecorded sessions to be stunningly helpful for the veterans and life-changing for the nonveteran listeners. I also refer you to the 28 nonpathologizing, non drug, low-risk or no-risk approaches to helping veterans and their loved ones that are presented in extremely brief (10 minutes or less) videos filmed at the conference I organized in 2011 at Harvard Kennedy School’s Ash Center for Democratic Governance. It was called “A Better Welcome Home,” and the videos can be seen at Several Pentagon higher-ups have requested this information, and we urge not only veterans and their families but also anyone who is suffering to go to that site, find a few approaches that resonate for you, watch the videos, and try those approaches.
    (5) Yesterday I posted the following to mark Veterans Day on my Facebook pages and on Twitter:
    Easy, wonderful things anyone can do to mark Veterans Day (before, during, and/or after):
    (1)LISTEN TO A VETERAN! Truly, just listen…with your whole heart.
    (2)Go to and watch any or all of the 9 very short (10 to 45 seconds each) “Listen to a Veteran!” Public Service Announcements that won a Telly Award — and see whom you recognize and if you have a favorite one.
    (3)Order and watch — or give as a gift to a veteran or veteran’s loved ones or a caring nonveteran — the 50-minute, awardwinning film, “Is Anybody Listening?” is the film’s website, and you can order the film at

  • How troubling to see that MIA is again — and this time in a major way! — publishing a piece in which “PTSD” is used without the least mention of the unscientific nature of the category, the way it pathologizes people who are having deeply human reactions to trauma, and the devastating harm the label has caused. Do some people say they want the label applied to them? Yes. That is nearly always because (1)It’s the only time anyone has ever tried to convey, ‘I believe you’re suffering,’ but that could be done by using those nonpathologizing words instead; (2)The labeled person BELIEVES that getting a label represents something scientific that will pave the way to relief from their suffering; and/or (3)They cannot get certain benefits unless they accept a label. Re: (3), I tell people that since the system providing benefits is intractable, if accepting the label gets them what they need, they should nevertheless know in their hearts that they are not mentally ill for being upset by trauma. I address these problems in a couple of my books. Most importantly, I have heard the devastating stories of people who have suffered because of getting this label.

  • Dawn, is that you replying as “ArmyWife”? I appreciate the clarification. If someone can tell me how to correct that mistaken phrase in my comment, I am happy to do so! I did of course read the article but did not see a mention of VCPA (Veteran’s Center for the Performing Arts). I know Stephan has done work combining Shakespeare and his own military experiences in his brilliant, one-man show, CRY HAVOC! which I have seen praised to the skies and urged everyone I know to go see. When I learned about DE-CRUIT and saw the performances of some of the veteran/students participating in Stephan’s Shakespeare class, it was the night that it was done in conjunction with Bedlam Theatre, and Stephan and Bedlam’s founder Eric Tucker (also a veteran, who I believe directed CRY HAVOC! at least at some point) and I talked that night about disseminating the work and the principles of it as widely as possible. It now strikes me that Bedlam is not mentioned anywhere in the MIA article, so are DE-CRUIT and Bedlam no longer connected? I am very much aware of and a great admirer of Alisha Ali’s work in general and with DE-CRUIT, and she and I are longtime colleagues and friends. In fact, after Stephan came with Alisha to the NYC premiere of my film about the tragic and unhealthy divide between veterans and nonveterans, “Is Anybody Listening?”,, I was delighted to meet Stephan, and Alisha and a number of my other friends and colleagues talked at length afterward, which was when I began to learn about her work with Stephan on DE-CRUIT. I continue to wish that there could be this glorious use of theatre for veterans — and indeed for other traumatized or otherwise suffering people — everywhere! And Dawn, if you are the one who wrote that above comment, I had the pleasure of meeting you at an LA performance of CRY HAVOC! and know how crucial a part of the work you are.

  • Drew and MIA, I am thrilled that you have featured the phenomenally wonderful DE-CRUIT program here! In DE-CRUIT, the brilliant Stephan Wolfert has conceived, created, and implemented with so much art and heart a way of helping veterans without pathologizing them, without using risky approaches like psych drugs or forced “treatment,” and with a way of using theatre and other literature to reconnect with aspects of themselves, with the arts, and with the humanity of themselves and others, as well as — importantly — with Stephan and with their DE-CRUIT classmates. The work that Stephan and Dr. Alisha Ali have done in documenting the powerful effectiveness of DE-CRUIT and _why_ it works is also tremendously important.
    I had the privilege of attending an event at which DE-CRUIT participants performed Shakespearean monologues and poetry they had written themselves, and what was stunning was that, both those veterans who are or want to be actors and those who are/do not, the depth into which they dove in exploring or creating the material and presenting it and the honesty and integrity with which they did it were all too rare onstage and in life. This is a tribute both to Stephan and to the veterans. The night I attended that event, I said I wished that every veteran could have the chance to participate in DE-CRUIT and urged that they — and Eric Tucker’s BEDLAM Theatre Co. in which DE-CRUIT was born — create a video to help spread the word.
    I have two other comments. One is that I hope that the nonpathologizing, even DE-pathologizing nature of DE-CRUIT comes through strongly enough in Drew’s article that the use a number of times of the dangerously pathologizing term “PTSD” is understood by readers to mean “people who have been traumatized by military experiences and/or by homecoming experiences and have wrongly been given the pathologizing ‘PTSD’ label when instead their reactions are deeply human ones that should never be pathologized.” Although many MIA readers would automatically make that translation in their heads each time they see a term for a psychiatric “disorder,” for some, there is the danger that any mention of one of these labels without a reminder that such labels are unscientific and expose the labeled person to a wide array of kinds of harm runs the risk of perpetuating the harm of such diagnoses.
    My other comment is based on my experience when I blogged for Psychology Today. There, I wrote about a great variety of such subjects. I found that any time I wrote about veterans, the number of readers ranged from 30% to under 3% of the number who read about any other topic. As I wrote in my book,,aps,220&sr=8-1-fkmrnull&linkCode=li1&tag=whejohandja0d-20&linkId=1dbd7dedc192a717801d8a2ccc9ed082&language=en_US, nonveterans — who represent 93% of the U.S. population — don’t like even to _think_ about veterans, as those percentages show. As an experiment, after I saw those figures, the next time I wrote an essay about veterans for Psychology Today, I made sure the headline did not reveal that veterans were the subject. Within about three days, that essay received as many hits as my other articles that were not about veterans. I see a similar pattern here. I think it is wonderful that MIA plans to publish articles about veterans and trust that they will be about depathologizing them, but it is poignant that so few comments have been posted in response to Drew’s article, and I hope that that is not a reflection of low readership. Nonveterans who have been pathologized and otherwise harmed in the traditional system would do well to make common cause with veterans, because the system has done them harm in so many of the same ways to people in both groups, and people who have not been labeled and “treated” are often frightened by appalling stereotypes of both “mental patients” in general and of veterans as Other and as dangerous.

  • I am so sorry to read this tragic and all too common kind of story. I have been listening to veterans for more than a dozen years, and for people who want to read more about this, please see,aps,220&sr=8-1-fkmrnull&linkCode=li1&tag=whejohandja0d-20&linkId=1dbd7dedc192a717801d8a2ccc9ed082&language=en_US and especially Chapter 3 about what is wrong with calling traumatized veterans mentally ill and putting them on psychiatric drugs, and Chapters 4 and 5 about what the military and the VA are doing and why it is at worst wrong and at least not enough.

  • You are right, Rosalee, that they didn’t put DDPD (the Delusional Dominating Personality Disorder that Dr. Margrit Eichler and I created) in the DSM. It’s too much like the DS people themselves. So glad you are liking “They Say YOu’re Crazy.”

  • LavenderSage, I wish I could answer your question, but I believe this varies from one school district to another, not just from state to state. I assume that whatever the school district’s rules, there is no harm in a parent asking that a child not be labeled with a diagnosis, and that could be a good teaching moment for school personnel, but I suspect the reply will be that if they don’t get diagnosed, they cannot get the help they need. Another way to approach it would be to ask if there is ANY way for the child to get the needed help without getting a diagnosis. I wish that parents might band together and start advocating for changes, but parents who are trying to get help for their children are often too exhausted to get politically involved. That is why others need at least to help with this kind of action.

  • Eric Coates, there is absolutely no reason for, as you say, the MIA editors “to spend thousands upon thousands of hours teaching the webzine’s various writers how to talk about psychiatric issues with any clarity while at the same time lacking the kind of consensually agreed-upon language that I have been advocating.” I have been happily stunned by the huge number of comments posted in response to my essay, about 99.9% of them positive. It seems that the wide variety of people posting comments had no trouble grasping the principles of my concerns or the extremely simple solutions I suggested. It only takes a few minutes to read my whole essay. I would be totally comfortable if the MIA editors wanted to ask all writers to read the essay…or if they just lifted the various solutions that I proposed — two of which were suggested to me by Amy Smith — and posted them in an “Instructions for Written Submissions” section that would be there permanently.

  • With regard to what you said about Allen Frances saying psych diagnosis “is bullshit,” (1)If you look in Gary Greenberg’s important and fascinating book, The Book of Woe, you will see that Frances was enraged that Gary made it public that he had said that, and (2)Frances has repeatedly ALSO said that HIS (only his) Task Force’s work on the DSM was “scrupulously scientific,” something I, having been on two of his committees before I resigned in horror at how they operated, can attest could not be farther from the truth. Hmm, what to make of Frances saying two totally opposite things about psych diagnosis…and having the nerve to title his absurd book about it, “Saving Normal,” when he more than anyone in history was responsible for a greater increase per year in DSM categories (even more than in DSM-5) and has continued in many ways to reify categories of “mental illness”?

  • s_randolph, I do hope that what I wrote will be helpful to any human beings. But you misrepresent me by implying that the only reason I totally dissociate myself from Scientology and its so-called Citizens Commission on Human is that “once upon a time a different Scientologist lied” to me. They are dangerous and alarming for a vast number of reasons, some of which I experienced directly and many others of which are well-documented in publicly available places.

  • Julie Greene, I do object to the word “disorder” in “eating disorder,” because it pathologizes it. I know you do not consider eating problems to be brain diseases, but to say “it” (there are actually various kinds of eating problems) is a nutritional disorder is a statement that does not include consideration of the ways that intolerable pressures on girls and women about their appearance being hugely important in determining their worth, and those pressures definitely do contribute in major ways to many girls’ and women’s frightened, often extreme ways of dealing with food. These factors can certainly lead to serious nutritional problems…I agree.

  • I have repeatedly expressed my concerns to MIA when they continue to publish pieces in which psychiatric diagnostic terms are used without a single mention of the fact that they are NOT scientific, that it is NOT helpful to use these terms (including ADHD) when trying to alleviate suffering or help people change their behavior IF THEY WANT TO, and that getting ANY psych label exposes one to a vast array of kinds of harm, and that there are MANY other approaches that do NOT involve pathologizing or drugging and that have few or no risks and are shown to be effective. I would like to know which person or people at MIA are currently in charge of overseeing such things, and I beg MIA yet again to stop helping with the reification of these labels!

  • Julie, so glad you are conveying this important message and glad your parents were so clear-sighted. I had an email address for you but cannot find it now and would like to send you a private message. Can you please email me, or if you don’t have my email address, then — though I usually avoid Facebook messenger consistently — please send me your email address through a Facebook message. Thank you.

  • Thank you for writing this. I assume you have not seen my “Diagnosisgate” article about how Allen Frances the very year after his DSM-IV was published (so that he was the world’s most powerful psychiatrist) secretly joined with two other psychiatrists to earn about half a million dollars from Janssen Pharmaceuticals, a division of the evil Johnson & Johnson (the company that knowingly sold baby powder filled with talc and asbestos, which caused deaths due to ovarian cancer and heaven knows what else), to produce a “practice guideline” that would help Janssen promote the extremely dangerous drug Risperdal. You can see the article at

  • Since Bipolar Disorder, like virtually everything in the three or four most recent editions of the DSM, lacks scientific grounding, lacks even interrater reliability and stability and therefore cannot have validity, a more appropriate question to headline this article might have been “Can ANYONE ‘Have’ ‘Bipolar Disorder’?” Although the author makes some crucial and interesting and helpful points, in troubling ways she reifies the notion that Bipolar Disorder for anyone is a valid or helpful and not harmful category.

  • Julie Greene, I am sorry to say I have absolutely no control over which of my books is ever put on kindle or not. In fact, there is now a different publisher distributing They Say You’re Crazy than the one who originally published it. (These publishing houses keep buying each other out.) But perhaps if people write to the current distributor — which I believe is Perseus — and request that it be put on kindle, they might listen.

  • Lawrence, I would love to know how you found out that Allen Frances had hoped to play a crucial role in DSM-5! I have always wondered whether he left that whole enterprise willingly or was turfed out…and if the latter, for what reason. Please either post more info about that here, or write to me directly.
    Also, no, no one on the DSM-IV Task Force ever admitted why they did what they did. In my book, They Say You’re Crazy, I included an entire section about their possible motives, and there is a whole chapter about the dozens of gatekeeping technique they used that I experienced directly (I am sure there are more, but these are the ones I could report having experienced myself).

  • Thank you, streetphotobeing, for the kind words about my work. You may know that I organized the filing of 9 complaints to the APA’s Ethics Department about harm from psych diagnoses, but they dismissed them with no attention to their merits and on totally spurious, manufactured grounds. I wrote about this in madinamerica. I also wrote in madinamerica about the 5 complaints I then helped file with the Office of Civil Rights of the U.S. Dept of Health and Human Services and got the same results. But all this provided an essential paper trail PROVING that PSYCHIATRIC DIAGNOSIS IS ENTIRELY UNREGULATED, AND THE TWO ENTITIES THAT OUGHT TO BE PROVIDING OVERSIGHT HAVE NO INTEREST IN DOING SO.

  • I totally agree with almost everything in this essay, and people wanting documentation of the points in the essay will find the inside story of how this came to be in They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal As far as I know, I am the only person who actually served on a DSM Task Force (two of its committees under Allen Frances’ DSM-IV reign), resigned on moral, ethical, and professional grounds, then wrote about what I learned about how the DSM is put together, how science is ignored, distorted, or lied about, and how the harm it causes is concealed by the folks who publish the manual. One correction: It’s mentioned in the essay that Allen Frances has acknowledged that his edition of the DSM led to some epidemics of diagnosis, but it is crucial for people to understand that: (1) he named only three diagnostic categories that he said were the subject of epidemics; (2) he elsewhere has said repeatedly (I have the documentation if anyone wants it) that the process he oversaw of creating his DSM-IV was “scrupulously scientific,” when that is patently absurd (as I documented in the above named book); (3)in a book he wrote, he first says he is about to issue a mea culpa, then mentions the epidemics of the three categories, then says that he and his DSM colleagues could not possibly have foreseen these epidemics, and then goes on to blame for the epidemics just about everyone and every entity except himself and his colleagues; and (4) he continues to this day to talk out of both sides of his mouth about psych diagnosis, having said at one point that psych diagnosis “is bullshit,” as quoted by Gary Greenberg in an article in Wired, which Greenberg says in his Book of Woe led Frances to berate him for having quoted Frances accurately about that … and then he currently goes on to say that people who have “serious mental illnesses” are being under diagnosed and underrated. So please beware of simply citing without context his acknowledgement of a tiny number of diagnosis epidemics.

  • I have long been expressing my profound concern and even alarm that MadInAmerica continues to publish articles, essays, etc., that help to reify psychiatric diagnostic categories and labels, when it has been proven compellingly that (1)psychiatric diagnoses are NOT scientifically grounded — indeed, they are not even reliable, so they are even farther from being valid! (2)giving someone a psychiatric diagnosis does NOT increase the likelihood that their suffering will be reduced, and (3)giving someone a psychiatric diagnosis (even those that would seem to be the least severe) exposes them to a vast array of risks of harm. People interested in learning more about this can have a look at, at and at as well as many essays in the Psychology Today blog I wrote for some years.

  • It is SO troubling that people writing for Mad In America would use totally unscientific and VERY harmful terms of psychiatric diagnoses and using those categories as the core of research! Even one of the greatest purveyors of the term “ADHD” has publicly, repeatedly acknowledged (in his rare moments of candor) the harm that the epidemic of use of that diagnosis has caused. I hope that people will stop doing this sort of thing, especially in Mad In America but also elsewhere. You yourselves cause terrible harm by reifying these diagnostic labels, which have been proven time and again to cause terrible harm.
    and see my chapter in (available much more cheaply on Kindle)

  • I hope Mark and all the commenters here will read the brilliant work by Jeffrey Poland in his article about so-called schizophrenia (which is based on a THOROUGH review of the research literature and will give all of you a grounding to fortify your arguments) in the book called Bias in Psychiatric Diagnosis. What he wrote in that chapter would have given you a powerful way to support what you wrote, and in it, he covered vastly more and in stunning depth some years ago. It is something everyone interested in this topic should read. The publisher priced the book higher than we wanted, but ask your library to order it!

  • Dr. Hickey, I appreciate your clarification about this matter. But I think it is important to point out that, quite apart from anything related to “unduly severe,” I hope people will read the following criterion from Major Depressive Episode in DSM-IV, noting as you say, the word “or,” so that any ONE item in the list of “marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation” causes the person to meet section “E.” And given that it has been shown (e.g., by Meadow Linder in that even very caring therapists often assign a psychiatric label even if the person does not meet ALL of the criteria, and given that (as Cacciatore and Lacasse have shown) professionals often immediately prescribe psychiatric drugs for the bereaved and of course have to find and assign a psychiatric label to justify the prescribing, it is clear that, in effect, there was no effective bereavement exclusion in DSM-IV.
    E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

  • THIS IS URGENT, because there is a major error in Dr. Hickey’s article here, although he has always before been absolutely accurate and compelling about everything. This is urgent, because the huge numbers of people who were diagnosed with Major Depressive Episode from DSM-IV even during the very earliest stages — even in the first few days of bereavement — will know that it is not true that there was the “bereavement exclusion” that DSM-IV king Allen Frances CLAIMED was in DSM-IV was actually in there. In other words, there was no effective bereavement exclusion. There is something about not diagnosing Major Depression if the person has been bereaved in the past two months. HOWEVER, if you look in the DSM-IV on about the fourth page into the description of Major Depressive Episode, you will see that it says not to diagnose this if the person was bereaved UNLESS the person had ONE of these things — “unless they are associated with marked functional impairment or include morbid preoccupation with worthlessness, suicidal
    ideation, psychotic symptoms, or psychomotor retardation” (p.352 of DSM-IVTR). ALL OF THESE ARE absolutely typical of bereavement — NORMAL (I have problems with the words “normal” and “abnormal,” but you know what I mean) bereavement. In other words, Frances’ DSM-IV included the clear specification that normal bereavement even on the day of the loved one’s death SHOULD BE classified as Major Depression (it was Major Depressive Episode). And Joanne Cacciatore and Jeff Lacasse wrote a paper in which they neglected to mention all of the above but importantly documented how speedily bereaved people were put on psychotropic drugs, so clearly by implication, those were people who were not classified as having deeply human, even typical reactions to bereavement but were mentally ill and thus needing drugs. I’ve written about this in these two places and, I think, in something I wrote for MadInAmerica, too:
    –Caplan, Paula J. (2014). When you try to speak truth to power, what happens if the powerful turn off their hearing aids? In D. Holmes, J.D. Jacob, & A. Perron (Eds.), Power and the psychiatric apparatus: Repression, transformation, and assistance. Surrey: Ashgate, pp. 165-181.
    –Caplan, Paula J. (2013). Psychiatric diagnosis as a last bastion of unregulated, rampant harm to the populace. In M. Dellwing & M. Harbusch (Eds.), Krankheitskonstruktionen und Krankheitstreiberei: Die Renaissance der soziologischen Psychiatriekritik. Wiesbaden: Springer, pp. 351-388.

  • This is a much bigger scandal than this journalist describes, and I have two concerns about this article, although I am of course glad that yet another article about the Risperdal scandal has been written. One concern is why the “marketing group” to which the writer refers is not identified, why this writer — like every other major media person who has written about the scandal — fails to mention the readily available information about the three psychiatrists who were paid vast sums of money to create a false “Practice Guideline” for using Risperdal that laid the very foundation for all that followed AND who also were paid vast sums after that to produce what their leader, Allen Frances of DSM-IV fame (infamy) called their “marketing plan.” Why do the major media people protect these people over all these years, when they readily name the names of others who were involved. The full story is told in this video and in these articles, one of which is in MadinAmerica: and
    My other concern is about how the writer of this article, like investigative Stephen Brill in his 15-part series (!) about the Risperdal scandal, focus so intensively on gynecomastia. Certainly the photos that accompany the current article are intended to be shocking, but I would not have expected MadInAmerica to decide to include any such photos, never mind several! I do feel badly for the young males who were already suffering in some way — or causing trouble for others — because why else would they have come to the notice of whoever put them on Rispderal? And on top of whatever else was going on, to be adolescent boys or men and develop breasts must have been terrible. But it is terrible because of the combination of misogyny — “Eww, who wants to have a body part that is associated with women?!!” — and the rigidity, manifested in so many ways, that people have about sex and gender. As some of the other people who commented on this article have wisely observed, where is the alarm about the other Risperdal-caused harm, including shrinkage of the brain, diabetes, hyperglycemia, and even death? Why is this entire article and a 15-part series focused on gynecomastia?

  • It is very important to expose the appalling practice of the prescribing of so-called antipsychotic drugs for people who are suffering from war trauma. But I am surprised that Madinamerica would allow the unchallenged use of terms for psychiatric disorders like “PTSD,” since there is no scientific validation for them, a point that has been documented over and over and over. I hope that Madinamerica and Ms. Pagan-Ortiz will not do this in the future.

  • Begging Madinamerica and everyone who writes for them and posts comments will refrain from using “ECT” or “electroconvulsive therapy.” Please, please call it electroshock instead. Many years ago, I heard the brilliant survivor of electroshock, Leonard Roy Frank, who suffered in devastating ways from electroshock, plead with people never to use the “T” or “therapy” in connection with electroshock. As Audre Lorde wrote, “We cannot use the master’s tools to dismantle the master’s house.” Using “T” or “therapy” is using the marketing term for electroshock and helping perpetuate the coverup of its dangers.

  • In this otherwise interesting and important article, what is not mentioned is that Allen Frances was the driving force behind probably the most stunning conflict of interest and story of corruption in the modern mental health system…and it involved his creating a marketing plan for a dangerous antipsychotic drug. That information is in “Diagnosisgate: Conflict of interest at the top of the psychiatric apparatus.” APORIA:The Nursing Journal 7(1), 30-41. The article is at…/articles/2015_01/commentary.pdf To clarify some other bits of the history: Frances started trashing DSM-5, on whose Task Force he did not serve, while simultaneously making false claims that his own DSM-IV was “scrupulously scientific.” It most certainly was not, as I know from serving on two of his DSM-IV committees for two years before resigning after seeing how resistant he and his colleagues were to accurately reporting the findings of high-quality research, how they regularly based decisions on appallingly poor research, and how they ignored and even denied the harm done by psychiatric diagnoses. Furthermore, the grounds on which he trashed DSM-5 — that it is unscientific, that many of the Task Force’s deliberations were carried out secretly, that they were expanding the boundaries of abnormality — were the very grounds on which his DSM editions had been accurately criticized, but he never mentioned that. What has been fascinating, though bizarre, has been to see how he tries to position himself as the White Knight who warns people about the harm that diagnoses and drugs can do (and astonishingly, he has some people believing that he is a true critic, that he has somehow totally switched sides) while claiming that many people who need drugs are not getting them. And what class of drugs is he pushing in this way? Anti-psychotics. Think there might be a connection between that and what Johnson & Johnson paid him to help them market their anti-psychotic drug Risperdal?

  • How wonderful of Lauren Tenney to recognize that this story needed to be told and then to do all of the digging, FOIA request filings, and analysis of the information obtained! She so often is way ahead of the pack at spotting dangers and reporting them with penetrating analysis.

    And I love the comments posted above!

    I have to say that twice, people I respect tremendously have told me that electroshock was helpful to a close family member when nothing else had helped. My reactions to those reports are (1) I am first and foremost glad that they felt better, (2) I hope that they were fully informed ahead of time about the real and devastating kinds of harm that so often result from electroshock (but I know that it is highly unlikely that they were), (3) if it was in fact the electroshock that helped them, rather than something else, that of course does not disprove the harm that electroshock has been shown to cause in so many people, and I have heard far more first-person stories from people I greatly respect about its devastating consequences.

    With regard to footnote 3 of the article, if people are interested in the work I’ve done and am doing with veterans, better websites than the one given there are and

  • You are so right, and I appreciate your posting all of this.

    Bipolar Disorder is no more scientifically valid than anything else in the DSM. All of these labels are based on criteria that are so subjective that in essence, your therapist gets to decide if you have too much of one thing or not enough of another. Do some people suffer terribly from severe mood changes? Of course! Do they deserve help? Of course! But applying an unscientific label and then prescribing treatments that cannot be proven to help with something that has not been shown to exist is in effect experimental treatment without the patient’s knowledge or consent. Do some people say they were helped by treatments that were held out as based on their diagnosis? Yes. Do we need to believe what they say? Of course. But how many of them were ever told, “I don’t want to label as a mental illness what is happening to you, I see that you are suffering, and I will try to help. Now here is a huge array of things that have been found to be helpful by at least some people who have experienced something like what you are experiencing, and all of them are low-risk are no-risk”? We have 28 of these — and there are MANY more — at The people on these 28 very brief videos are referring to veterans, but these are all helpful for anyone.

  • Having served on two DSM-IV committees — to which I was appointed by Allen Frances and from which I resigned in horror after witnessing the way they ignored, distorted, or lied about good research if it failed to fit with what they wanted to do and the way they ignored and some even publicly denied that psych diagnosis causes harm, though I had given them many examples — I feel a kind of existential nausea every time I see that Allen has again trashed DSM-5 and contrasted it with what he has called the “scrupulously scientific” process he followed for DSM-IV. My article about this whole matter in the journal APORIA: The Nursing Journal at sheds much more light than this briefer article that the MIA people kindly published here. I think the devil is in the details, and I hope that people will read that APORIA article, because it is packed with information that is truly illuminating with regard to Allen Frances. If he were an ordinary citizen with no influence and no power to cause harm, it would not matter what he does, of course. When he first started trashing the DSM-5 people, I wrote to tell him I thought it was great that he was doing that…until I noticed the pattern, i.e., that he would criticize them for the very things many of us had asked him to stop doing with DSM-IV, including taking no notice of what the good scientific research showed, pretending his process was scientific, failing to document and warn of the harm of so many kinds that all begin with getting classified as mentally ill, failing to make any attempts to redress the harm, and operating so much in secrecy.

  • Thank you, Steve Spiegel, for your lovely comments. Because the facts are so clear and so well-documented in Dr. Rothman’s sterling report, and because that report has been in the public domain for some years, really anyone who spent some time reading the report and knowing some about the positions of the main characters could have written this article. I wonder if you or anyone else might want to suggest how it happens that these three men have escaped major media coverage…and what can be done about it. Note that I have not received a single inquiry from any major media person since this MIA article was published the other day, in spite of the huge MIA readership and the fact that I sent it to my own extensive media list, which is primarily composed of reporters and producers who initially reached out to me for interviews about the mental health system.

  • Thank you for the lovely comments about the article. What a nightmare your story is. I hope you have gotten help for the osteoporosis. My mother is 92 and a few years ago had osteoporosis and then found some (partly Rx and partly supplements and partly spending 20 minutes on the treadmill EVERY DAY) things that helped, to the point that she now has the less alarming condition of osteopenia but not osteoporosis. It is a tribute to her and to her doctors!

  • I sent a Facebook message (the only way I knew to reach him) to Steve Brill after the first or second chapter of his excellent series, saying I assumed he was aware of the Rothman Report and the participation of the three psychiatrists that I described in my initial “Diagnosisgate” paper but in case he had not I was sending him the link to it — Caplan, Paula J. (2015). Diagnosisgate: Conflict of interest at the top of the psychiatric apparatus. APORIA:The Nursing Journal 7(1), 30-41.
    I received no reply. I had hoped he would read the article and the Rothman Report and include it somewhere in the rest of his very lengthy series, but he did not.
    And when Nicholas Kristoff wrote a glowing column in the NYTimes about the Brill series, I sent him a similar message and received no reply, and he apparently has also not written about it.
    Isn’t this strange and disturbing?

  • Yes, Dr. Hickey, you are absolutely right. When people who have power and have caused enormous harm seem to have seen the light but are not coming straight out and acknowledging the harm and are not using their own time and money to redress the harm but instead spend their time and energy calling out others for causing harm, it is frightening that people will put their trust in them. That is why in the article cited in footnote #1 of this current piece, I reported his own words — comparing what he says at one time and place with what he says in another — so that people can see the facts and make up their own minds. Your work in getting the truth out about what is done to people who are suffering and come seeking help is stellar and so important. Thank you.

  • Lauren Tenney, your analysis is brilliant, as usual!
    A word of caution, however, about the framework Bob Whitaker and Lisa Cosgrove advocate in their book — which they in fact do not follow consistently even within that book — is that they baldly state, “There are no bad apples, only bad barrels.” And Bob has said that the only way to make real change is to use that framework. However, if that were true, it would mean that the enormous power that many individual people in mental health and other fields hold, as well as their free will and their responsibility to behave ethically, are pretty much considered irrelevant. Sort of like “The dog ate my homework” excuse, people who abuse their power would by the Whitaker and Cosgrove theory be able to avoid being held responsible for unethical behavior by saying, “I couldn’t help it! That awful system MADE me do it!” Surely whistleblowers within those systems are to be commended and rewarded for bravely speaking the truth, and that is precisely because often it is only when _individuals_ within a corrupt system speak the truth publicly that these systems change. In fact, there is a good argument to be made that that has often been the primary way to make them change.
    Bob Whitaker has made it clear that he considers Dr. Biederman reprehensible for having been such an ardent promoter of the appalling notion that Childhood Bipolar Disorder both exists and should be cause for feeding children and even toddlers dangerous psychiatric drugs. He is right to see Biederman that way, but both Biederman’s role in causing harm and the roles that a vast number of other individuals have played in causing harm in the psychiatric and psychological systems belie the “no bad apples” assertion, rendering it clearly hollow. Thus, in their book, Bob and Lisa repeatedly name individuals whose conduct was deceitful, harmful, and otherwise unethical, but they protect others who have caused great harm and even quote them unquestioningly as though their claims should be considered true and reliable. So I want to caution people not to worry that it is somehow inappropriate or unwarranted to hold individuals responsible for harm that they cause by knowingly participating in corrupt systems and profiting from their participation. Such individuals by exercising their free will in harmful ways have deprived many readers of Mad In America, among others, of their freedom, human rights, dignity, and self-respect. And the full truth must always be spoken — about corrupt systems and about the individuals who keep those systems humming.

  • How troubling that in this entire article that comes across as terribly scientific and technical, the author reifies “psychiatric disorders.” Indeed, referring to them as though they are real, reliable, and valid entities — in the context of the citation of theory and statistics about heritability — is stunningly misleading. Why worry so much about alleged heritability of entities that have been used to cause so much harm, including to so many of the people who read MadinAmerica?

  • I hope that Bob and/or Rob will write an article about the apparent and quite dramatic change in the policy of Madinamerica, since it now is giving space to the kinds of unfounded and dangerous claims that Bob has spent years — at great personal cost, I suspect, and certainly with great courage — exposing. And it would be good to know why this particular study is presented as news, when there are enormous numbers of such studies coming out all the time. If MIA wanted to publish full-fledged, thorough, informed critiques of many of these, that would be great. Having taught critical thinking and research methodology for decades, I have a neat “How To Do a Critique” page composed of the step-by-step way one goes about evaluating a study. Bob and/or Rob, would you like to publish that page and invite people to write in-depth critiques so that readers of MIA will be well-armed to refute Pharma’s irresponsible claims, you could do a great service. I would be glad to help with this in other ways and write some such critiques myself. Just let me know.

  • When a colleague sent me this article, and it looked like it was published in Madinamerica, I swear to you that my immediate thought was that this had been published in The Onion as a joke — because everyone knows that Madinamerica would never publish something that goes so totally against what Robert Whitaker has long and bravely stood for. How many readers of Madinamerica — especially those with no background in scientific methodology (and I do have that background but find that the criticisms in this form make my eyes glaze over) — will understand the important implications of the minimal bit of Vipond’s “critique” of this study, which comes across as though these are just some limitations of the study? Rob Vipond, I am at a loss to know why you failed to state clearly that the whole article is based on a never-proven, indeed a disproven and harmful claim about serotonin. Finally, does the headline Madinamerica chose allow room for the minimal critique to be seen as substantial? It looks like a headline that Pharma would have written. Can we now expect that Madinamerica’s policy will be to publicize more pieces of “research” that are based on the kinds of disproven assumptions that have destroyed the lives of so many readers of Madinamerica?

  • Nancy, thank you for this thoughtful, powerful, nuanced essay. Wonderful work.
    As for suing the APA for racketeering, I have been trying for decades to find even one lawyer who would file suit against the APA for all the harm they caused through the DSM, which they knew (or ought to have known) was unscientific, did not lead to reduction of human suffering, and carried enormous risks of harm. No one (except one Scientologist, so I cannot work with him) has been willing to take on the huge financial burden that such a lawsuit would involve, especially given the vast fortunes the APA has at its disposal and the fact that Pharma would surely kick in huge amounts of money as well to hire the top attorneys to oppose such a lawsuit. Furthermore, the barriers to winning any lawsuit against the APA are very high and numerous…no time to go into them all here. But when I wrote They Say You’re Crazy in 1995, I very carefully documented a vast amount of unscrupulous activity on the part of the DSM people, and I did it partly to save a lot of time and trouble for attorneys who might take them on. But I would be glad to work with any lawyer who is considering any kind of lawsuit against the APA, because I am happy to share with them tons of information that is very damning.

  • This is in reply to a couple of things said by two different people here above.

    One is that it is correct that one reason lawsuits are hard to win in this field is that the pernicious approaches — all of which start with assigning a DSM label, which means it is not scientific and carries risks of harm — are indeed considered the “standard of care,” and the Daubert decision by the Court helps maintain that problem.

    The other is to mention that the very brave attorney Jim Gottstein of PsychRights has done groundbreaking work about doctors who knowingly prescribe drugs that have been proven to be harmful and rarely helpful.

  • Just in case the question about what is normal is not intended as a rhetorical question, an entire chapter in my book, They Say You’re Crazy, is dedicated to that question, and I go through many different ways of deciding what is normal and address the serious problems with each.

    May I request that people commenting in here refrain from name-calling against anyone and just focus on facts and debate. As people who write essays here and post comments here know better than most people, there is much nastiness and hurtfulness in the world, and I know that some people come to MadInAmerica looking for information, validation, or thought-provoking material…but not nastiness.

    And if you have not read everything that any given author has written, how about instead of calling names and assuming the worst, just asking the author if they have addressed Question X or Y?

  • Dr. Lawhern,

    People are constantly asking me why I don’t organize a class action suit about psychiatric diagnosis. It seems such an obvious question, and I can see why you raise it, and I appreciate your interest. First, for two decades (first in my 1995 book, They Say You’re Crazy), I have been searching for lawyers (who are NOT affiliated in any way with Scientology or its CCHR or any of its front groups) who will take on even a single case about this. I have not found one. With regard to class action suits, it can take years of attorneys’ work to try to figure out the best way to define the “class” — and often it goes to an appeals court, even the U.S. Supreme Court, which then declares the lawsuit cannot go forward because it is not a legitimate class. Since this happened with so obvious a class as the women employees of WalMart, when there was massive evidence that they had been discriminated against systematically and appallingly, just imagine what would happen with trying to define, e.g., the class consisting of “people who have all been harmed by psychiatric diagnosis.” The kinds of harm and the routes through which they were done are so varied. Furthermore, I have spent endless hours talking with and writing to lawyers who at first expressed an interest and who then dropped out, often because they know that a lawsuit against the APA for harm done by its DSMs would be opposed with the vast sums of money the APA has and no doubt joined by the vast sums Big Pharma and other entities such as perhaps insurance companies would provide in order to keep the diagnosis juggernaut rolling along, and I don’t know any law firm or even individual lawyer who can afford or is willing to risk everything they have to fight a case like this. I have ideas for much less demanding cases that could be wedge cases and very effective, though.

  • Such brave, important work you have done on this, David Oaks!!! Remember when we were at a conference ages ago, and the late, dear Leonard Roy Frank urged the audience when he gave a talk — since he had been subjected to electroshock, and the effects on him and many others had been so devastating — never to call it “ECT” because the “T” stands for “therapy”? So I always call it “electroshock” instead.

  • If you look in my book, They Say You’re Crazy, and in the chapter on sexual orientation by William Metcalfe and me inmo the book Bias in Psychiatric Diagnosis, you will see that it is a huge myth created by DSM-III head Robert Spitzer that he REMOVED homosexuality from DSM-III. Here are the facts: They CHANGED it to “ego dystonic homosexuality” but announced very publicly that they had decided that homosexuality was no longer a mental illness (because they voted that it was not — a vote — that is how “scientific” it all was). What is “ego dystonic homosexuality”? It is being homosexual but not being totally comfortable with that, not feeling like it is fully consistent with who you are. In the very homophobic society at the time DSM-III was published, it was extremely rare for anyone who was homosexual NOT to have “ego dystonic homosexuality.” So Spitzer and his cronies had it both ways — they continued to pathologize being lesbian or gay, AND they got all the acclaim from lesbians and gays who mistakenly believed the lie that homosexuality itself had been removed from DSM-III. Right now, it is not in the current DSM, but there are still ways to diagnose homosexuality as a mental illness, such as by classifying a homosexual with a DSM category like Sexual Perversion. Be aware, too, that, as Jeremy Caplan and I document in the chapter on sexual orientation in our book, Thinking Critically about Research on Sex and Gender, after claiming to have removed homosexuality from the manual, Spitzer announced that he did “research” in which he “proved” that people could be converted from homosexuality to heterosexuality! But even later than that, after many of us pointed out how horrifically poor was his research — it was like a made-up research design in which as many methodological errors as possible had been included! — he acknowledged that his study had been appallingly bad.

  • One more crucial point that has not been mentioned in this article or the comments yet: The whole enterprise of psychiatric diagnosis is — at least in the U.S. — _totally_ unregulated. That means that it is even less regulated than the financial giants who have so damaged the economy. I hope that everyone who reads this will consider signing the Call for Congressional Hearings about Psychiatric Diagnosis, which was posted more than a year ago at This is a follow-up for such a petition that I created many years ago, but it has been difficult to get members of Congress to pay attention to this need. I hope that people will contact their Senators and Representatives to urge them to support this call. It is just another of the many ways it will be necessary to come up with in order to dismantle a damaging system or at the very least provide sorely-needed safeguards, because now, there are none.

  • Thank you for raising this. I have seen a letter to the effect that Medicare and Medicaid are switching from the DSM to the ICD. I would love to know why, and if anyone knows the back story, I hope they will post it here or write to me directly. I am wondering whether the military and VA mental health systems are also considering making the switch. And I have not yet heard what private insurance companies will do. I would also be interested in learning about that if anyone has any information. But let us not let our guard down and assume that these changes will result in less damage. In fact, for those of us in the U.S., at least we were able to find out how to file ethics complaints with the APA about harm from the DSM in order at least to _make the effort_ to hold them accountable. But so far, we have not even been able to get clear information about _whether_ there is a way to file a complaint with the World Health Organization if one has been harmed by psych diagnosis that came from the ICD. And is the filing of complaints the only thing that needs to be done? Of course not. But it seems important to file such complaints in order to see whether the purveyors of these diagnostic classification manuals can ever be held accountable when their work leads to harm.

  • Just a few updates:

    –It is so encouraging to read Amy Smith’s post about alternatives to diagnosing, and I hope she will post more details here when she has a chance.

    –I guess that it was as a result of my having written the book about what I learned when I served on two of Allen Frances’s DSM-IV committees — the disregard for both what the science really shows and for the suffering caused by diagnosis — that has, over many years, led many whose lives were destroyed by diagnosis, whether from the DSM or the ICD, to contact me. And thinking back over much of what various people posted and emailed yesterday, I find myself hoping that more people who sincerely seem to consider the ICD a less dangerous alternative would hear more of the stories of harm. Once heard, those tragic stories live in one’s heart forever.

    –In light of the discussions yesterday, I decided to make an effort in a different way to find out whether the ICD enterprise has a procedure for filing complaints when people have been harmed by its use (as we filed complaints ethics complaints last year with the APA because of harm from the use of the DSM … something about which I wrote in two articles at as well as on my Psychology Today blog). I also made an effort to find out what the World Health Organization does with the income from sales of the ICD. Their medical officer wrote back promptly but only referred me to other websites that did not in fact include any of that information. So I have written to him again and will post here whatever he replies if I hear back from him again. It is proving to be tough to find out about the internal workings of the ICD and thus for therapists who want to use the ICD to be fully informed about what they are doing and whether their patients, should they suffer harm because of getting ICD labels, would even have the most minimal recourse of filing a complaint about it. (I realize, of course, that the WHO might be as utterly cold and unresponsive if such complaints were filed as the APA has been about complaints about harm from the DSM, but it seems important to learn as much as we can.) If anyone who reads this knows anyone who has been an inside in the ICD enterprise and can put them in touch with me, I would appreciate that. I think it is healthy for people concerned about adding to the suffering of people who seek help in the mental health system to be able to toss ideas and suggestions back and forth and to have different perspectives. But I feel strongly that it is important for us to do this from a base of as much knowledge as possible. So I hope to learn from others what they know, and I will be grateful for that.

    –I hope that our awareness of the massive power of the systems that are supposed to help people in need but end up too often harming them will not lead us to aim only to try to disarm or dismantle one small part while we look away from the harm caused by the rest. Yes, it is daunting to aim to do it all, but if we do not make the effort, who will?

  • I should have added that the DSM editions both current and future are unscientific and harmful, but at least the DSM’s publisher, the American Psychiatric Association publicly announces that it has an Ethics Committee and that complaints can be filed. The fact that they summarily dismissed all nine complaints about harm from DSM labels that we filed last summer is truly terrible, but listen to this about the ICD: When we wrote to ask the ICD people what procedures they have for filing an ethics complaint, they wrote back but would not even give us an answer. The only reason I can think of for considering the ICD less horrible than the DSM is that the APA is a lobby group and, as far as we can determine, has never used a dime of its vast profits from the DSM to prevent or redress the harm its manual causes, whereas the ICD is published by the World Health Organization, so MAYBE — though we have not been able to find this out either — MAYBE the WHO uses the profits from the ICD for some better cause than supporting a lobby group. If anyone can find out, please let me know. Thank you.

  • I am sure Jack Carney’s intentions are good, but sadly, to urge a boycott of the DSM while urging people instead to use the ICD if they are going to use psychiatric labels reflects an overlooking of the fact that the authors of the DSM and the ICD have said repeatedly and publicly that they work hard to make sure that the contents of the DSM are as close to the contents of the mental disorders portion of the ICD as possible. It is actually dangerous to give people the impression — as Jack’s petition and this article do — that the appalling risks of serious harm caused by the use of DSM diagnoses (which have also characterized the unscientific editions of the DSM produced by both Robert Spitzer and Allen Frances) will be avoided by use of the ICD.
    As for the price of DSM-5, why is charging $199 in 2013 suddenly shocking, when there was no such outcry for Allen Frances’ current edition, DSM-IV-TR, which a call to Barnes and Noble just revealed a price of $142 plus tax? After all, DSM-IV went on the market nearly two decades ago, and the “TR” version has only a tiny number of changes and went on the market in 2000.
    Those who know my work know that I have been a critic of the DSM since serving on two of Allen Frances’ committees to plan DSM-IV from 1988 till I resigned in 1990 because I was so horrified to see how they used junk science, ignored good science, and falsely and publicly claimed that their work was scrupulously scientific (as Frances continues to do, allegedly in contrast to the DSM-5 people, who are also appallingly unscientific) and not harmful. So I, too, wish people would boycott the DSM but also that they would not assume anything about the ICD psychiatric section is either scientifically grounded, helpful in reducing human suffering, or less risky for patients than the DSM.
    I created the first anti-DSM petition in the late 1980s, which drew signatures from individuals and huge organizations (including NOW, the Canadian Psychological Association, and others) representing more than six million people, and I created a year ago last December the first “Boycott the DSM” petition at because I was so alarmed by how many people would continue to suffer from the DSM-IV-TR (as indeed they do right this minute) while Spitzer and Frances and others have focused all of their attention on trashing the DSM-5 editors for doing the same kinds of ignoring of science and harm and making of false claims of which Spitzer and Frances themselves were guilty). Hence, I did not limit my petition to boycotting the next edition of the DSM only. I wish that Jack had accepted my offer to work together on his new project, and it is unfortunate when the few people who want to take action in this movement cannot see their way clear to working together, but I hope his petition will be wildly successful. Not having volunteers or funding to pay people to help get the word out about my “Boycott the DSM” petition, I hope that he will get many more boycott pledges than I have done. But I hope that he will revise his petition to remove the misleading urging to use the ICD instead, because that is just urging people to flip their patients out of the frying pan and into the fire. Remember: unscientific and harmful labels were plentiful when Spitzer created DSM-III and then DSM-III-R, and then Frances freely acknowledges that he got rid of almost none of that when he created DSM-IV and DSM-IV-TR, and it is a good bet that most of that garbage will also appear in the DSM-5…and thus in the next ICD.

  • Thank you, Duane Sherry, for your kind words.

    And thank you, anonymous and powerful, moving writer for the letter you sent to Linda Hughes at the APA. I hope what you did will inspire others to do the same. Her email address is [email protected] She seems to be not a psychiatrist but the administrative head of the APA’s so-called Ethics Department. I hope people will also send their letters to the APA’s General Counsel, Colleen Coyle, at [email protected]

  • I have tried to work with Allen Frances, since the time in the 1980s when he put me on two DSM committees. If you read my books about psych diagnosis, or if you read the essays I have written about it on my Psychology Today blog, you will not be surprised that he wants nothing to do with me. In setting himself up as a hero who is trashing the DSM-5, he continues to make the unfounded claim that his own editions of the DSM were produced by a scrupulously scientific, multi-stage process. The multi-stage part is true. The rest is not. He, more than probably any other single individual in history, has been responsible for more people being pathologized, but in his recent public statements he manages to blame everyone but himself. Gee, he claims, he just had no idea what would be done with the diagnoses in his manual. Furthermore, he has publicly warned about what he calls the anti-psychiatry people (few or none of whom are actually totally opposed to all psychiatrists, just to the problems in psychiatry AND in psychology and all other mental health professions) and defends psychiatry rather than ever taking a single step to redress any of the harm his manuals have done. Many of the people he warns against are the very ones who have been hurt by not only the production of his manual but his failure and the failures of many in the APA (this is part of what the complaints are about) to educate professionals and the public widely about the facts that the DSM is unscientific, does not improve outcome, and carries huge risks of harm. I have been pointing this out since resigning in 1990 from those two committees to which Allen appointed me. Now do you understand why he is not interested in working with me? The complaints filed would have named him as a respondent, had he still been a member of the APA, but he no longer is, and APA says it is a secret when and why that changed. I heard something I thought was a joke but is apparently true: He has a book coming out just when the DSM-5 is due, and his book is to be called … Saving Normal.

  • Dear Marsie,
    Many thanks for this beautiful message.
    I am not sure what you are asking. Decades before 1980 there were two earlier DSM editions. DSM-III was published in 1980.
    In the nine complaints we filed (each of which runs to about 60 pages), we did indeed document that the respondents knew or ought to have known that a vast amount of harm had been caused by DSM diagnoses over the decades. And that is included in the template we have prepared that allows others to spend a minimal amount of time to submit their own complaint — but anyone is also free to add anything else to their own complaint (and to leave out any parts of the template that they do not wish to include).

  • I am glad that this work has touched a chord for people who have written comments here, and I hope that more people will file complaints and/or help locate an attorney who will file one or more actual lawsuits.

    As for the beautiful things some people wrote about me, I am deeply touched and grateful, but the people who were harmed by diagnosis and have had the courage to file complaints are the remarkable ones.