I’ve been rereading my Psychology Today columns since I began writing them over two years ago. It’s something I’m doing while I’m finishing up writing a chapter on psychology for my online book, The Overweight Brain: How our obsession with knowing keeps us from getting smart enough to make a better world. I came across this early column, and want to share it with my readers here as a reminder of how seductive the disease model can be.
A Diagnosis the DSM-5 Forgot—Physics Envy
In his May 27, 2013 New York Times column, cultural and political commentator David Brooks reprimanded the compilers of the DSM-5 and contemporary psychiatry for presenting their field as scientific. At the same time, Brooks praised psychiatrists for their artistry, calling them “heroes of uncertainty” and “daring adapters, perpetually adjusting in ways more imaginative than scientific rigor.”
Brooks is not the first to point out the often-vast differences between the philosophy of a social institution and the philosophy and practice of the actual people who work in a given field. (It’s commonplace to read about teachers who teach in the face of the mandate of the institution of education to raise test scores, for example. And caring doctors who listen to their patients. ) But he does it well—so well, in fact, that readers might rush to make an appointment with a psychiatrist.
According to Brooks, the behavioral sciences—of which psychiatry is one—is not really a science, and so it shouldn’t pretend to be one. But it does pretend—these days, with a vengeance. It’s an obsession. Brooks calls it “Physics Envy.”
“If the authors of the psychiatry manual want to invent a new disease, they should put Physics Envy in their handbook. The desire to be more like the hard sciences has distorted economics, education, political science, psychiatry and other behavioral fields. It’s led practitioners to claim more knowledge than they can possibly have. It’s devalued a certain sort of hybrid mentality that is better suited to these realms, the mentality that has one foot in the world of science and one in the liberal arts, that involves bringing multiple vantage points to human behavior.”
I couldn’t have said it better (although my mentor and co-author, the late philosopher and social therapist Fred Newman, and I said it many times over in our books and articles since the 1990s; see especially, Unscientific Psychology: A Cultural-Performatory Understanding of Human Life). To pick up on one of Brooks’ important points, human behavior is uncertain. Our emotionality is incredibly complex—infinite combinations of mind, body and brain activities that act, react, mix and create with and in uniquely individual and social and cultural contexts. To misunderstand or ignore that is to mis-treat us.
Brooks goes only so far, still holding fast to a disease model: “It’s more important to know what sort of person has a disease than to know what sort of disease a person has.” In doing so, I think he’ll lose the argument every time. (Do you want an artist treating your disease?) More than that, though, he’s reinforcing the belief that there’s something wrong with how we’re feeling and that the doctor knows how to fix it.
One of my favorite philosophers is Ludwig Wittgenstein—a brilliant, eccentric and, by his own account, tormented man. No doubt he would have been diagnosed with a mental disorder were he alive today. In his writings, he showed how trying to create an objective science of the subjective gives us “mental cramps,” causing great confusion and pain. He said, “We can fight, hope and even believe without believing scientifically.”
Another of my favorite philosophers is Fred Newman. Following Wittgenstein, he created an approach to helping people in emotional pain with a subjective science of the subjective. He said, “Therapy should be a culturally transforming experience, teaching us a new, and developmental, way of seeing and creating a new life.”
If psychiatry heeded Wittgenstein and Newman, they might well be cured of Physics Envy.
copyright Lois Holzman, Psychology Today, A Conceptual Revolution