Who is normal?

They say you are crazy; How the most powerful psychiatrists in the world decide who is normal by Paula J. Caplan, Ph.D.

Reaching its peak: how my mind got rid of delusions in psychiatry by Al Siebert, Ph.D.

Practical psychology

Here are two books by Ph.D. psychologists, one American and one Canadian, that ask the question, “Who decides who is normal?”

Both authors vigorously challenge the generally accepted view that psychiatrists are in the best position to decide who is normal and who is not.

Are psychiatrists (and other therapists) themselves “normal”? Hardly. How can someone who chooses to listen to other people’s miseries day after day be considered normal, if by that we mean “average” or “typical”? Therapists are clearly not normal, we are a minority and we are unique. So are people from other professions. You too.

Normal is very difficult to define. What we generally mean by “abnormal” is insane, psychotic, mentally ill. Some authors [most notably psychiatrists Thomas Szasz (The Myth of Mental Illness) and Peter Breggin (Toxic Psychiatry)] Attacking the very concept of “mental” illness, saying that it is a metaphor erroneously made concrete, or that drug treatment only adds to the afflictions of those who suffer from it, that the so-called mental illness is more appropriately called “problems in life “and” treaties “. either by the courts or with exceptional care, empathy and understanding.

Thirty years ago, Dr. Siebert was admitted to the hospital as a “paranoid schizophrenic.” He claims that he was sane, that he was going through a “development crisis” at the time. His book, attractively written as instructed with his colleague Sam Kimball, PhD., Recounts his experience and the insights that led to his (semi-voluntary) incarceration.

Clearly, Dr. Siebert, at the time of starting a postdoctoral fellowship, annoyed his psychiatric colleagues with his unusual ideas and his wife with her mysterious silences. Dr. Siebert got caught up with his idea that basically we are all selfish, that even so-called altruistic behavior is based on self-interest. (This became the basis for his work and book on The Survivor Personality.)

Peaking Out vividly describes life on a psychiatric ward. Although benevolent, his guardians labeled Dr. Siebert as mentally deranged and could not see beyond the label. His claim to heal, by suspending the labeling and truly listening, to a woman who heard the voice of God, was ignored by the authorities.

It is not clear why Dr. Siebert decided to publish this book now (and reveal “a secret that was kept hidden for thirty years”). But her outrage at what she considers to be the abuse of power by some psychiatrists over her is matched, if not surpassed, by Dr. Paula Caplan’s anger at the audacity of psychiatrists to decide who is not normal, not through science and evidence, but through prejudice and politics.

Dr. Caplan, a Canadian with equally impressive authoring and teaching credits to Dr. Siebert, attacks the process by which psychiatrists endorse the contents of the Diagnostic and Statistical Manual of Mental Disorders, popularly known as the DSM.

This volume attempts to define mental illness with the same certainty and precision with which physical illness is described. It is an obvious attempt to achieve a degree of respect and scientific authority similar to that generally accorded to other physicians.

But the DSM IV, like its predecessors, is a sham. This is the only conclusion you can reach after reading Dr. Caplan’s very detailed account of partisan bargaining (“horse bargaining”) that takes place in determining what will and will not be included. will include in the volume.

A research expert, Dr. Caplan points out the paucity of data on which the DSM IV is based. He got involved a few years ago when the committee (all white males of a certain age) tried to turn PMS into a mental disorder. The fight was tough, feminists lost, but not until furious arguments from both sides were spread in psychological magazines and in the media.

Only arrogance (or despair) can explain how male psychiatrists (and some women) dare to pretend that human mental disorders can be boiled down to the type of disease-specific data applicable, for example, measles.

Dr. Caplan goes out of her way to be charitable about the motives of the DSM IV perpetrators. However, one has to suspect that power and money (DSM IV sells hundreds of thousands of copies and is a mandatory benchmark for many insurance reimbursements, not to mention hospital financing, etc., especially in the United States ) are the main motivations of the authors of DSM. .

Perhaps, as Dr. Siebert asserts with regard to their persecutors, the authors of the DSM have become convinced of their righteousness and of the need to impose good on those who suffer, even if those who suffer have not requested such help.

History, including the history of psychiatry and “mental health,” is replete with examples of well-meaning people imposing what they thought was right on bewildered victims. The perpetrators are deaf to any idea other than their own. Belief systems are very difficult to change.

Look at Sigmund Freud’s absurd notion that little girls want to have sex with their parents. I was amazed by Dr. Caplan’s claim that many therapists still practice orthodox Freudianism: they hide behind a couch, refuse to believe their patients’ accounts of incest, etc. Perhaps this horror persists only in Toronto?

Two examples will suffice to demonstrate the arbitrary nature of DSM IV: Over the years, homosexuality has gone from being classified as a mental disorder to being covertly included, to not being included in the current DSM. Can a disease stop being a disease? Either homosexuality was never a mental illness or the psychiatrists submitted to public pressure. However, obviously, the inclusion or exclusion of homosexuality was not based on science.

The other example is the rejection that Dr. Caplan and her colleagues encountered when they tried to make the stereotypical descriptors of “women” in the DSM match a description of typical male behavior as mental illness.

Certainly the greatest irony about the dangerous DSM IV is that while it claims to list all mental disorders in exhaustive detail, it does not offer solutions or treatment guidelines. Could it be because we actually know very little about the mind and even less about how to cure its disorders?

Most of what we do as therapists is art, intuition, relationships. Medicalizing life’s problems, as DSM disciples often do, is a disservice to clients and therapists. Clients, because they need care, not categories. And therapists, because such illusory certainty leads us, like Dr. Siebert’s colleagues or Dr. Caplan’s detractors, to unite in a collective illusion of being scientists.

Read Dr. Caplan’s book and mourn for the thousands of people (mostly women, of course) whose lives have been damaged by being labeled with the stigma of mental illness, when in reality their only problem was that, as Dr. Siebert, dared to be different. Or human.

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