Making Us Crazy [Hardcover]

Herb Kutchins (Author), Stuart Kirk (Contributor)

Book Description

Publication Date: October 15, 1997

What makes a person crazy? Nowadays it's the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). For many mental health professionals, the DSM is an indispensable diagnostic tool, and as the standard reference book for psychiatrists and other psychotherapists everywhere, it has had an inestimable influence on the way we view other human beings. Deciding what we consider sane and normal, and reflecting the prejudices and values of each generation, it's not surprising that the DSM has become a battleground. But things have taken a strange turn. The fight is no longer about who escapes DSM labeling, but rather, how a person can qualify for a diagnosis. Now, mental health professionals must label their clients as pathological in order for them to be reimbursed by their insurance companies. This disturbing trend toward making us crazy when we are simply grappling with everyday concerns has even worse public implications. In Making Us Crazy, Professors Kutchins and Kirk reveal how the DSM is used to assassinate character and slander the opposition, often for political or monetary gain. None of this misuse bodes well for the future of mental health. Even children are being overdiagnosed and given drugs they don't need. Making Us Crazy is the long-needed antidote to the claims made about the DSM. Kutchins and Kirk argue that the DSM is not the scientifically based reference work it purports to be, but rather a collection of current phobias and popular mores.

Editorial Reviews

Amazon.com Review

Used by doctors and therapists all around the country, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders is the closest thing America has to a bible of mental illness. Currently in its fourth edition, the DSM (as it's commonly called) classifies more than 200 disorders and their symptoms, from Post-Traumatic Stress Disorder to Generalized Anxiety Disorder and everything in between. In so doing, say Herb Kutchins and Stuart Kirk, the DSM applies the language of mental illness to everyday behavior, transforming ordinary reactions to life's vicissitudes into billable pathology.

In Making Us Crazy, Kutchins and Kirk have used 15 years of studying the DSM to produce a lengthy diatribe against its ever-growing list of psychiatric disorders and their overly inclusive symptoms, including bad handwriting, impulsive shopping sprees, and reckless driving. The DSM, they contend, is most influenced by the needs of the insurance industry; every illness comes with its own diagnostic code, widely used for insurance claim forms. Moreover, its choices of which disorders to include and exclude are widely influenced by social prejudices as well as special interests. Given the DSM's list of diagnostic criteria, it is possible to classify almost anyone with objectionable views or behavior that deviates from social norms as "crazy." But in doing so, any mental-health professional would be acting irresponsibly by ignoring the behavior's context--the one factor a reference such as the DSM cannot quantify.

From Library Journal

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) was first published in 1952 but has become increasingly important?and controversial?in the past few decades, as managed health care plans have pressured psychiatrists for more "scientific" diagnoses. Kutchins (social work, California State Univ., Sacramento) and Kirk (social welfare, UCLA) counter arguments that DSM is a nonpolitical compendium by examining the processes of advocacy and protest that led to the exclusion of homosexuality, the inclusion of posttraumatic stress disorder, controversies over the use of the Borderline Personality diagnosis, and the history of racial discrimination in the assignment of diagnostic categories. Their admirable book belongs in academic libraries. Smaller public libraries are better served by less specialized titles that make many of the same points, such as E. Fuller Torrey's Out of the Shadows: Confronting America's Mental Illness Crisis (LJ 2/1/97).?Mary Ann Hughes, Neill P.L., Pullman, Wash.
Copyright 1997 Reed Business Information, Inc.

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Product Details

• Hardcover: 320 pages
• Publisher: Free Press (October 15, 1997)
• Language: English
• ISBN-10: 0684822806
• ISBN-13: 978-0684822808
• Product Dimensions: 9.3 x 6.2 x 1.2 inches
• Shipping Weight: 1.4 pounds
• Average Customer Review: 3.7 out of 5 stars  See all reviews (7 customer reviews)
• Amazon Best Sellers Rank: #960,647 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

41 of 44 people found the following review helpful:

5.0 out of 5 stars Important Book, if not always an easy read, September 27, 2000

By 

Nancy E. Macdonald (Sumter, SC USA) - See all my reviews
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This review is from: Making Us Crazy (Hardcover)

For those of us who eagerly consume critiques of the mental health industry, this book is not necessarily what we have come to expect. I often expect what amounts to a quick adrenalin rush, with horror stories of abuse by the system driving me to the barricades. Kutchins and Kirk do not provide a quick rush, nor even a quick read. But when you find yourself on the barricades, they do give you the ammunition.

This is a very detailed social/political history of the DSM, in and out of committee meetings and individual correspondence, providing the evidence of the point made so well by others such as Kaplan: that the DSM is in fact a political document, evolving to suit conflicting political and financial interests. More than a story of good guys and bad guys, much of this history includes the sad moral of unintended consequences, as in the fight to get PTSD into the DSM.

I teach undergraduate psychology, and I applaud the authors' coherent explanations of technical issues such as reliablity and validity of assessment. My teaching experience informs me that this is a tedious exercise for most students, and, I assume, for the educated lay readership to whom Kutchins and Kirk appeal. But it is critical to the central theme of the story: the misuse of the aura of science to mask a fundamentally political process.

Are there victims and villains of this process? Of course, and they are the usual villains: a system of managed care, and a variety of bureaucracies and agencies pursuing government funding, grants and influence based on ultimately manipulated numbers. And the usual victims: the over-labelled, over-prescribed and stigmatized recipients of "care".

The story wanders through so many mazes that a reader may lose the thread: PTSD, homosexuality, female masochism, borderline personality disorder. Each story differs in who started the process of getting a diagnosis in or out of the DSM, the motivation for doing so, the outcome of the fight, and the specific consequences. Fortunately, the authors provide an excellent summary in the last chapter, and weave those threads back together.

More than once in reading this book, I found myself thinking that every political or social issue fight needs its policy wonks. Kutchins and Kirk may be our wonks.

10 of 11 people found the following review helpful:

5.0 out of 5 stars Well argued, Well Written, A Work With Vast Implications For the Mental Health Industry, December 8, 2005

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Justin M. Teerlinck - See all my reviews
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This review is from: Making Us Crazy: DSM: The Psychiatric Bible and the Creation of Mental Disorders (Paperback)

This expose represents the most thorough documentation that psychiatry is a psuedo-science to date. The proof that psychiatry is no more (and possibly much less) than the mere sum of its internal politics is amply provided by the authors in the form of personal correspondance between the brightest minds and most powerful leaders of the discipline. For the impatient or the semi-literate, a long, slow read lies ahead. For those with an eye for detail, prepare to witness the unraveling of the most influential scientific institution in America, decades in the making. According to this book shouting matches, voting, back door meetings and boycotts were the "data" that came to comprise what most people believe is a scientific definition of mental illness, the DSM-IV in a process that better resembles the way a legsilature works as opposed to scientific research. The authors take great care to not inflate the value of their findings. The book is written by a journalist and a social worker and was not vetted or peer reviewed by Scientologists, angry parents of drugged kids, or psychiatrists--and this provides the most convincing evidence of its overall credibility. Really, this is a rare work of valid, honest journalism covering a subject that is mostly the domain of anonymous hotheads and arrogant "experts" all of whom are making claims without evidence in service of their own personal or professional objectives. In this sea of muckety-muck, this book is an island of reason.

12 of 14 people found the following review helpful:

5.0 out of 5 stars An extremely important book, January 28, 2006

By 

Russell W. Carrington (Leonardtown, Md. USA) - See all my reviews
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This review is from: Making Us Crazy (Hardcover)

Those who give this book a one star rating most likely have interests that are being threatened. Drug company representatives? Drug prescribers? So, pull down the average rating and reduce the number of people who buy it. It's what the republicans try to do to Al Franken's books.

The book conveys facts in a neutral, understated tone, and from those facts develops reasonable beliefs. Which ideas did you disagree with? That the diagnostic categories lack reliability and validity? That DSM has been shaped more by special interests than by science? That the criteria for each diagnosis are purely arbitrary?

Read the book. You'll think twice about letting someone you care about be diagnosed.