Paula J. Caplan, Ph.D. is a Visiting Scholar at the Pembroke Center for Women, Brown University, Providence, RI. Previously she was full professor of psychology, assistant professor of psychiatry, and lecturer in Womens Studies at the University of Toronto, and was chosen by the American Psychological Association as an "eminent woman psychologist". 

She is the author of "The Myth of Women's Masochism" and "Don't Blame Mother", plus a number of other books. A clinical and research psychologist, she was formerly a consultant to those who construct the DSM - the Diagnostic and Statistical Manual of Mental Disorders.

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Being exceptional may include significant social challenges and reactions.

"It's hard enough to be gifted and creative in North America, where (unlike in Europe) if you're anything other than the typical person, it's inexcusable," Dr. Caplan notes.

"Unforgivable in some ways. You can't be considered eccentric. Being creative is considered no big deal, and artists just aren't respected in the same way here as they are in some other parts of the world, nor are particularly intelligent people; it's a threat. 

"One possible explanation is that in a country founded on individual freedom, and where all of us are supposedly created equal - well, what if it turns out some people are smarter than the others? Does that mean they're going to get more land, more chance to pursue happiness than the rest of us? 

"So this idea is threatening. And more so for women, because, first of all, women aren't supposed to be smart enough to be threatening to a lot of men and to other women, and secondly, one of the myths is that a woman can be competent or smart, or she can be nurturant - but she can't be both. 

"So if you find some woman who's a genius, or is gifted, people automatically assume that she's going to be a bitch, or that she's going to be deficient. It's like a zero-sum game within that person: the more intelligence she has, the less humanity and warmth." 

She notes that "because high intelligence has been associated so much with men, and because the traditional male role in the United States has been to be detached and objective and cerebral, the idea of a woman being that way is really unspeakable, it makes her not 'womanly', not 'feminine'. 

"The U.S. along with Canada has the same model they have in Europe, that a creative person - usually male - is some sort of mad, tormented artist, suffering all the time. And people don't want to hear about women's suffering, they don't want women to be anguished. 

"There's a wonderful book called 'Reflecting Men at Twice Their Natural Size' - a marvelous title - and one of the things in it is they asked women, when they went into work, to try an experiment and just don't smile; don't be mean or rigid, just don't smile. The women who did this were such targets of hostility. 

"Guys would walk by and say, 'Well what's wrong with you?' So, women are supposed to be cheerleaders, right? We do not have room in this culture for a woman to be what's considered self-indulgent, that is, to take the time away from being supportive of other people to indulge in doing whatever she can with her own gifts and creativity. 

"Those are the reasons that we then have to say nasty things about women who are gifted and creative, and one way to say a very nasty and dangerous thing is to say they're mentally ill."

She acknowledges there are "a lot of people who have a lot of anguish, and there are some people who are dangerous to other people or themselves" but says, "I just don't find the term 'mental illness' particularly useful. 

"When I was writing the book, I had thought I would make it clear that I wasn't going to go so far as to claim that there's no such thing as mental disorders, because I thought there must be, although the definitions aren't really good." 

Dr. Caplan says that as she was writing about this, the newest issue of American Psychologist arrived, "and in it was an article by one of the world's experts on schizophrenia research, and he said that everyone presumes that schizophrenia has been proven to exist, that we know what it is, that we know it is genetically and biochemically caused, because of the studies on twins, and the contents of schizophrenics' urine and all that.

But, she cautions, "Actually, if you really read the research, you know it's terrible, and we don't really know much about what we're calling schizophrenia. And unfortunately we can say it's still a wastebasket term. 

"What matters here is that the American Psychiatric Association, that produces the manual of mental disorders that everyone uses, the DSM, markets it as science, even though it isn't.

"My own experiences with the DSM committee, and my own research prove that. There are things in there that have even been proven not to exist. And when they were writing the DSM and trying to come up with a definition of 'mental disorder', they are on record as saying, basically, they had a heck of a time. 

"And if you read the definition they used, there are loopholes you can drive a truck through. So I don't think we can just blindly say, yes, there are things called mental disorders."

Again, she notes there are some individuals "who are out of touch with what most people would consider reality, like if you think your child 'has the devil in him' and that sort of thing." 

But, she concurs that a number of people, including mental health professionals, treat some of the characteristics of many gifted or creative people as signs of mental disorder. 

"I can tell you about one of the most creative and gifted women I've ever known, who came to me for psychotherapy," Dr. Caplan recalls. "She was telling me things like her boyfriend wasn't being nice to her, had been terrible - and she had been taught never to get angry. 

"This woman was a poet, musician and just a brilliant scholar. She told me she had been walking down the street one day and suddenly saw blood dripping down, about three inches in front of her face, in the air. 

"And I thought, 'I'm so glad she's seeing me and not somebody who's going to put her on antipsychotic medication' - because it was so clear to me that this was a very powerful representation of the anger she was feeling, that she's never supposed to express, because she's supposed to be a 'nice girl'. 

"It would have been easy to pathologize her. Actually she'd been told she was manic depressive. And often she would be very depressed, but it was always because of something that would make anyone depressed. 

"At one point, she was telling me about something that had deeply affected her, and I said, 'I understand your responding that way, because you're a very sensitive person' - well, she burst into tears, huge sobs, and said 'I know I'm overly sensitive' and I replied, 'That's not what I said; I said you're sensitive, and that was a descriptive term, not a pejorative one; if anything, it was an appreciative term.'"

About a week ago, the New York Times had an article on Zelda Fitzgerald, Dr. Caplan notes, in which Peter Kramer, who wrote "Listening to Prozac", wrote an introduction to letters that F. Scott Fitzgerald had sent to his wife's psychiatrist when she was hospitalized. Kramer asserts Zelda had a mental disorder, probably manic depression. 

"But even if you didn't know anything about the Fitzgeralds," Caplan explains, "if you read the letters, they are infantilizing and patronizing and contemptuous about her writing. Fitzgerald was saying things like 'Zelda thinks she can write, and what she does is take things I've written and claim she wrote them.' Now, scholarship has well established that it is the exact opposite: he used to steal stuff that she wrote, and pass it off as his own. 

"I just emailed a letter to the editor of the Times, saying how disturbing Peter Kramer's unargued claims about Zelda Fitzgerald were, and that he seemed unaware of this scholarship, and I said that anyone who read Scott Fitzgerald's letters could see that any woman who was treated with that degree of infantilizing and contemptuous treatment, it would be amazing if she didn't feel despair. 

"And if you knew that your husband was stealing your work, and being acclaimed for it, it's not surprising you would alternate between depression and elation. If you knew you had to choose between your own integrity and protecting your husband by not exposing his dishonesty, that would be enough to make any woman feel crazy. But to call her crazy is victim-blaming, and a cover-up of our knowledge of the great range of causes of emotional pain."

This is, Dr. Caplan says, an example of "a woman who's very talented and very sensitive and creative, and I thought it was sort of miraculous she had periods where she could struggle up from under, and be cheerful and loving, and do some more writing or practice her dancing. That's a real tribute to her. Why do we have to call it 'the elation of mania'? People do get in creative spurts where they don't want to sleep." 

There are other psychiatric labels and diagnoses that may be misused with respect to gifted women, Dr. Caplan finds. 

"'Hysterical' is a big one, and 'borderline' because any woman who is very emotional and doesn't give the therapist what he wants - if it's a guy - is in danger of being diagnosed as histrionic or hysterical. I remember a friend of mine who said something about my being very dramatic, and I thought she meant histrionic, and I was devastated, but she said no, what she meant was when I tell a story she could really picture what was going on. 

"This whole diagnosis of Borderline Personality Disorder is made up anyway, and is usually applied to someone who had been terribly abused. The description is 'someone who alternates between being very distant and wanting to be very close; between being very emotional and emotionally flat, and seeing everything in black and white terms, seeing any person at any given time as all good or all evil.' 

"But, you know, people may think in metaphors, or have very vivid images, or get very emotional when engaged in their work, and might get drained and go emotionally flat afterward. When I'm finished with a play that I'm acting in, there's a period of flatness - after giving and giving and giving, a feeling of being depleted. 

"And also, the structure you've been used to for all those weeks is gone. I mean, there are all kinds of non-pathological reasons for any person to be showing what are then called the symptoms of 'borderline personality'. 

"One of the members on the Psychology of Women Resource List [an email discussion newsletter], Cynthia Veldhuis gave a psychology class of hers [in the Dept. of Psychology, University of Oregon] a checklist of symptoms for different disorders, and 75% of the students fit the criteria for having Borderline Personality Disorder, and guess what - 100% of the men fit the criteria for Premenstrual Dysphoric Disorder! 

"The current DSM4 [the latest edition] has 374 categories of alleged mental disorder, including things like 'Stuttering', and 'Caffeine-induced Sleep Disorder', and 'Major Depressive Disorder' - if someone close to you died two weeks ago and you're still grieving. In other words, every conceivable form of human behavior is in there; 'Hypoactive Sexual Desire Disorder': if you don't have as much sexual activity, or as many sexual fantasies as your therapist thinks you should, then you have that."

With such a large number of categories, she points out, anybody "who walks into a therapist's office is going to fit probably a very large number of those descriptions. And this is all the more true because so many of the criteria for these labels use terms like 'marked' or 'deficient', so there's this huge scope for subjectivity on the part of therapists. 

"If you want to know if there's something wrong with you - let's try not to use words like 'mental disorder' - what I think is the single most helpful thing to do is to write down your story, write down what you think is 'crazy' and why you're feeling that or doing that; then, instead of putting in your name, use the name of your mother, your sister, daughter, best friend etc.

"And then ask yourself, 'Well, if she did that - if her boyfriend did X to her, and she was so upset, and to deal with it she decided to write it all down, and stayed up til four in the morning' - or whatever the story is, would you think 'This woman is crazy, we've got to get her to a therapist, get her on medication'? Probably not. 

"Women especially are taught to pathologize ourselves, to undervalue ourselves, to think there's something wrong with us. Men are to some extent as well, but in a somewhat different way. 

"Women who are survivors of sexual abuse, for example, all think it's their fault, that there's something wrong with them. But in a group with others, hearing everyone else's stories, they say, 'Well she's not crazy, and she didn't bring it on herself.' After hearing ten of these, they have this 'click' experience, and think "Maybe I'm not crazy.' 

"In my own experience, and I wouldn't describe myself as gifted, but just as a woman - and I think this applies to women in general - every time I think there's something weird about my feelings or my experience, every time I've thought that, from the time I was an adolescent, whenever I've checked it out with someone else, it turned out it was not weird and not unusual. 

"I went from assuming my feelings were weird to assuming they weren't so weird, to realizing that if I had a feeling, not only is it not weird, but probably it's universal." 

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book: Paula J. Caplan, Ph.D.  They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal

for Caplan's video: "Call Me Crazy" contact Call Me Crazy Videos, 95 Slater Ave., Providence, RI 02906, or e-mail Paula J. Caplan, Ph.D.: Paula.Caplan@post.harvard.edu

See her site www.psychdiagnosis.net about psychiatric labeling and the problems with it.
 

interview by Douglas Eby - resumé

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