Making Us Crazy

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.