The Great “Crazy” Cover-up: Harm Results from Rewriting the History of DSM
I have been immersed in the field of psychiatric diagnosis – and resistance to it – for more than a quarter of a century. In the late 1980s, I was a consultant to two committees appointed by DSM-IV Task Force head Allen Frances to decide what DSM-IV should contain. I resigned from those committees after two years because I was appalled by the way I saw that good scientific research was often being ignored, distorted, or lied about and the way that junk science was being used as though it were of high quality . . . if that suited the aims of those in charge. I also resigned because I was increasingly learning that giving someone a psychiatric label was extremely unlikely to reduce their suffering but carried serious risks of harm, and when I had reported these concerns and examples of harm to those at the top, they had ignored or even publicly misrepresented the facts. I wrote about what I learned from my insider’s position in my book, They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal (Caplan, 1995).
From about 2009 until DSM-5 was published in 2013, there was massive coverage in popular and professional media about outcries against DSM-5. The outcries were largely based on the assumption that it would represent a break with DSM-IV (published in 1994 and minimally altered for a 2000 edition), which was seriously misrepresented as having been solidly scientific, helpful, and – for all but a tiny number of its hundreds of categories – not harmful. The rewriting of history has continued in publications since DSM-5 appeared, so that there has been a massive and damaging rewriting of history, and it lends a legitimacy to DSM and other diagnoses in general, when, in fact, the recurring problem is that psychiatric disorders have never been validated, in fact not even shown to be reliable.