They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal

Paula J. Caplan, Author Addison Wesley Publishing Company $22 (355p) ISBN 978-0-201-40758-7

Self-Defeating Personality Disorder, Nicotine Dependence, Hypoactive Sexual Desire Disorder, Premenstrual Dysphoric Disorder-these are some of the 400 ``mental illnesses'' described in the American Psychiatric Association's diagnostic bible, Diagnostic and Statistical Manual of Mental Disorders (DSM). Caplan (The Myth of Women's Masochism), a psychologist and former consultant to the DSM, compellingly argues that ``much of what is labeled `mental illness' would more appropriately be called problems in living.'' In a disturbing insider's look at how the mental health establishment decides who is normal and who is ``sick,'' she charges that the DSM board's decision-making process, dominated by a handful of conservative white male psychiatrists, is arbitrary, condescending, profit-driven and riddled with personal biases and political consideration. Facile labeling of personality problems, she shows, can cause personal suffering as well as material harm because DSM categories figure prominently in who wins child custody, who gets hospitalized against their will and whose psychotherapy is covered by insurance. Author tour. (Apr.)