The Last Word On Nothing

David Brooks has done it again. In his New York Times op-ed column last Monday, Brooks portrayed psychiatry as a “semi-science” suffering from “Physics Envy.” He pointed to the publication of the latest edition of the Diagnostic and Statistical Manual—or DSM-5—as evidence that psychiatry misrepresents itself as hard science. The column opens, “We’re living in an empirical age,” and it goes south from there. (Does he really not know that empiricism as the basis of science dates at least to the seventeenth century? Or is his definition of “age” so broad as to be meaningless? “We’re living in an empirical age,” declared William Bradford, as he stepped off the Mayflower, citing the observations of the moon, sun, planets, and stars over the previous decade by the Italian astronomer and mathematician Galileo Galilei.)

Physicists and biologists, Brooks continues, “have established a distinctive model of credibility,” whereas “the people in the human sciences have tried to piggyback on this authority model.” If by “piggyback on this authority model” he means “emulate the scientific method,” then yes, I would agree. In my experience, scientists do tend to try to be scientific.

Brooks has been clueless about the workings of the brain before. My first post for The Last Word on Nothing took issue with a column by Brooks regarding the movie The Social Network, which had just come out. Brooks used the movie’s characterization of Facebook founder Mark Zuckerberg as a pretense for criticizing what Brooks saw as the collapse of the social order: “It’s not that he’s a bad person. He’s just never been house-trained. He’s been raised in a culture reticent to talk about social and moral conduct. The character becomes a global business star without getting a first-grade education in interaction.”

That interpretation, I responded, overlooks a more tangible, more immediate cause of the character’s behavior: “He’s wired that way. The Zuckerberg character displays the three classic symptoms of someone who falls on the autism spectrum. He lacks social skills.  He has trouble with empathy.  He finds his greatest fulfillment in restricted behavior.” Did the possibility that nature might have played a greater role than nurture in the evolution of Zuckerberg’s behavior really not occur to Brooks?

So strikingly backward was Brooks’s interpretation that in our book The Autistic Brain Temple Grandin and I cite that column as an example of how prevalent ignorance about autism remains. “The ‘training’ of the character,” we write, “would have had to somehow accommodate a brain that can’t process facial and gestural cues that most people easily assimilate, and that finds its greatest fulfillment not in the fizzy buzz of forming a personal relationship but in the clickclack logic of writing code.” 

Now Brooks is hearing voices, and they belong to straw men. “To be an authoritative figure, you want to be coolly scientific. You want to possess an arcane body of technical expertise. You want your mind to be a neutral instrument capable of processing complex quantifiable data.” Yes, yes, and yes. Unless, of course, you don’t want to be that kind of authoritative figure, perhaps because you understand that you’re working in a field that doesn’t (yet) lend itself to the kind of predictions and independent replications of results that biology and physics do.

Brooks: “The underlying reality [the behavioral sciences such as psychiatry] describe is just not as regularized as the underlying reality of, say, a solar system.”

No shit? I acknowledge that, living as I do in an empirical age, I should offer hard evidence for the following assertion, but indulge me: There is not a single psychiatrist alive today who believes that science will be able, in anything remotely resembling the near future, to map the passageways of the brain with Newtonian precision.

Brooks: “The recent editions of this manual exude an impressive aura of scientific authority.”

Actually, they don’t. That’s why there have been editions, plural. That’s why a diagnosis like Asperger disorder can vanish from one edition (DSM-IV-TR) to the next (DSM-5). Brooks just as easily could have argued the opposite: The recent editions of this manual exude an impression that psychiatrists are just making it up as they go along. That argument, at least, is one I could imagine considering.

I’m no fan of the DSM-5. In The Autistic Brain Temple and I criticize it extensively for being not empirical enough. We argue that in diagnosing autism, for instance, the time has come to abandon a predominantly behavioral approach, which is highly subjective, and to begin to incorporate a biological approach, which would be more objective, or at least far less subjective. We cite areas in which neuroimaging and genetics are beginning to allow psychiatrists to make this shift from the behavioral to the biological. Brooks, however, criticizes the DSM-5 for passing itself off as already being a pillar of empiricism. Once again he’s gotten his analysis strikingly backward.

Maybe he really doesn’t understand the history of science or the scientific method. Maybe he really doesn’t understand that psychiatrists recognize that they’re not yet performing science in the same manner, and at the same level of precision, as physicists or biologists, and that maybe they never will.

Or maybe he’s being intellectually dishonest, and, whether he’s using Zuckerberg’s behavior to support a hypothesis about widespread parental leniency or he’s using the publication of the DSM-5 to bludgeon behavioral scientists, he is fudging the data in order to ensure he’ll arrive at a predetermined conclusion. In which case, somebody ought to tell him: We’re living in an empirical age.

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Scarecrow: Library of Congress, via Wikimedia Commons; original uploader was Biruitorul at en.wikipedia (detail). Interpretation: mine.