December 28, 2004
Who is Robert Spitzer?
According to The New Yorker, Robert Spitzer “revolutionized psychiatry.”
Make that, “according to Alix Spiegel, writing for The New Yorker.” The distinction is important, because a cursory Google-fueled traipse through the Internet reveals that Alix Spiegel is Robert Spitzer’s chief (only?) biographer. Spiegel-authored pieces on Spitzer also appear on NPR and This American Life.
The question “Who is Robert Spitzer?” is important, because if you believe Spiegel, Spitzer might be the father of modern psychiatry. So if Spitzer turns out to be a genius, then this psychiatry business may have something to it. But if he’s a quack, who’s to say his baby’s not as well?
The big problem with modern psychiatry (or not!) is exemplified in the debate over Attention Deficit Hyperactivity Disorder. Intelligent people disagree on whether the disorder exists. Other intelligent people disagree on whether it can be fixed by Ritalin, or any drug.
The deeper problem here is that ADHD is an emotional disorder, only dubiously detectable, and generally unquantifiable, like many (most? all?) emotional disorders. Spitzer’s lasting contribution to modern psychiatry was his effort to standardize the detection and quantification of all emotional disorders. There’s the rub.
Spitzer’s recent notoriety is almost exclusively due to his 2001 study on whether gays can be converted to straights (the study indicated we can). And his former notoriety hinges on his participation in the 1973 removal of homosexuality from the American Psychiatric Association’s Diagnostic and Statistical Manual of Emotional Disorders (DSM) — the APA’s Bible, basically.
Spitzer’s study tells us nothing. Here’s an accounting of its flaws. Here’s an unconvincing defense. It really only poses another question — namely, why would a Columbia professor author such a pointless, thankless study?
The Spiegel article only raises yet more questions. It begins by celebrating the order Spitzer brought to the task of psychiatric classification — basically claiming that Spitzer gave psychiatry whatever legitimacy it has today. It concludes by almost entirely subverting the notion that modern psychiatry has any legitimacy. (Along the way, it turns into jargonese, and becomes insufferably boring.* Suffice it to say that Spiegel’s concluding paragraphs question both the “validity” and “reliability” of the DSM.)
And the general impression I get from Spiegel’s characterization of Spitzer is of a somewhat egomaniacal, not-especially-brilliant, browbeating sort of man who happened upon a popular thing (the DSM-as-we-know-it).
So who is Robert Spitzer, really — a genius or a quack? Or, to put the question another way, what is modern psychiatry worth?
That the NY-er article is insufferably boring should not discourage you from listening to Alix Spiegel’s wonderful and fascinating This American Life episode, “81 Words,” or her other TAL episodes, especially “Pray.” And the pronunciation is a-LEEX SHPEE-gull, by the way.