Catching Up

And so much to catch up on. First has to be the David Brooks column from earlier this week, in which he called psychiatrists “heroes of uncertainty,” praising them as “daring adapters, perpetually adjusting in ways more imaginative than scientific rigor.” Take away the sermonizing and the sentimentality, take away Brooks’s compulsion to turn every event he writes about into an object lesson in the virtues Burkean social theory leavened by his half-baked notion of negative capability, and what you’re left with is only the damning praise. Psychiatry is not a science, Brooks says, but a “semi-science” (I’ve never heard that one before either), one that suffers from Physics Envy (and note the capitalization here; the Times style book says you don’t capitalize the names of mental disorders, but I guess they make an exception for op-ed columnists) and needs to stop claiming more knowledge than it has.

Now where have I heard this argument before? I have no idea if Brooks read my book. He’s surely not saying, and I don’t blame him. AFter all, writing in the Nation I did call his last book “the love child of Malcolm Gladwell and Kilgore Trout,” which¬† wasn’t terribly kind, even if it was true. I also don’t blame him for going out of his way to mention Al Frances’s Saving Normal, as I’m sure he recognizes Frances’s underlying notion that psychiatrists can (and should) moderate their power as a version of his own noblesse oblige, his faith in the aristocracy to limit their own power. The irony here, by the way, is that Frances and I spent a fair amount of time parsing our mutual dislike of Brooks, and he might loathe Brooks (and by this I mean his work, not his person) more than I do. Not only that, but I suspect Frances would reject this idea that he and his colleagues are heroes of uncertainty as just so much bullshit, especially to the extent that it demotes psychiatry to a semi-science.

But whatever Frances thinks, it’s hard to imagine that the folks at the APA want to accept the David Brooks Medal of Uncertainty, even if they agree with him. It’s a tight spot. Acknowledging the uncertainty of psychiatric diagnosis, ratcheting back its claims, is at once honest and dangerous. To the extent that psychiatry is, scientifically speaking, in its infancy, the honesty is refreshing and even necessary. That’s why Tom Insel’s comments were so important–he was only saying out loud what he and other psychiatrists have been saying for years, and what is undeniable. But to the extent that psychiatry must command the confidence of it patients and patrons, acknowledging its immaturity is very risky. That’s why Insel’s comments were also inflammatory.

Brooks, of course, is completely tone-deaf when it comes to this last point. His instincts are anti-political, so he doesn’t understand, or even perceive, the complex dance that goes on between a public desperate to believe that psychological suffering can be understood and treated like pneumonia and a profession desperate to fulfill that hope.

One Response to “Catching Up”

  1. Marcos Hardy says:

    Suggesting, as you do, that Brooks, by classifying Psychiatry as a “semi-science” (whatever that means) is demoting it, is totally misleading. To apply to Psychiatry the word ‘Science,’ even as a ‘semi’ one, actually is a promotion. Psychiatry is pure ideology, and a risky one at that. Besides, Brooks doesn’t think that Science will ever explain the workings of the brain. He stated that “the mind is not the brain.” Maybe the mind is something floating somewhere nearby? Spiritual Cartesianism is Brook’s mantra. By the way, love your Book of Woe.

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