Robert Spitzer’s Legacy

by Phil Hickey on January 6, 2016

Robert Spitzer, MD, the architect of DSM-III (1980), died of heart disease on Christmas Day, 2015, at age 83.

Most major media outlets published obituaries in which Dr. Spitzer was praised on the grounds that he had brought scientific rigor to psychiatry by naming and defining the various psychiatric illnesses.

Here are a few illustrative quotes:

“Dr. Robert L. Spitzer, who gave psychiatry its first set of rigorous standards to describe mental disorders, providing a framework for diagnosis, research and legal judgments — as well as a lingua franca for the endless social debate over where to draw the line between normal and abnormal behavior — died on Friday in Seattle.”  (New York Times, December 26)

“Robert Spitzer, the influential American psychiatrist credited with establishing a modern classification of mental disorders, has died at the age of 83.” (BBC News, December 27)

“Dr. Robert Spitzer – a psychiatrist who played a leading role in establishing agreed-upon standards to describe mental disorders and eliminating homosexuality’s designation as a pathology – died Friday in Seattle. He was 83.” (Independent.co.uk, December 27)

“He [Dr. Spitzer] added dozens of mental disorders to the psychiatric lexicon: anorexia, bipolar disorder, panic disorder, PTSD and many other now-familiar maladies. It’s not that these ailments didn’t exist before the 1970s — but they had no agreed-upon names or definitions until Dr. Spitzer branded them in two new editions of the DSM. The book tripled in size (from a 134-page paperback to a 567-page doorstop) and at least as much in influence under his leadership.” (Washington Post, December 26)

Obviously, I don’t share the various obit writers’ enthusiasm for Dr. Spitzer’s work on the DSM-III.  In fact, I would describe the DSM-III as the turning point that steered psychiatry into the irremediably spurious, expansionist, and destructive situation in which it now finds itself.

I had been planning to write a post on this matter in the near future, but I noticed this morning that Bonnie Burstow has published an article on Mad in America that says everything I had wanted to say on the matter, with her customary skill, sensitivity, and erudition.

Here are two quotes:

“To be clear, it is always sad when someone dies — and I in no way wish to detract from the personal tragedy. Nor do I intend to make any pronouncement about Spitzer the individual. What concerns me in this article is one thing only — how to understand his ‘psychiatric contribution’ to society. Now no one denies that Spitzer was enormously influential. However, it is precisely because his legacy endures and because vulnerable people are forced to live with what was set in motion that I felt compelled to write this article.”

“…they [Dr. Spitzer and his colleagues] set psychiatric diagnosing decisively on a path where it would look scientifically rigorous; where it could claim the authority of medicine on the basis of appearance, while in point of fact being vacuous.”

You can link to Bonnie’s article here.  It’s well worth reading and passing along.

  • Spamlet

    James Davies of CEP also has some interesting stories on how Spitzer went about setting up the DSM, here:
    http://m.youtube.com/watch?v=6JPgpasgueQ

  • bulbous1

    “To be clear, it is always sad when someone dies.”

    Yeah, I know, I shed oceans of tears when Pol Pot died….

    I am truly, truly, devastated by this loss, or whatever we are supposed to say on such occasions.

    ” ‘I am amazed that so remarkable a philosopher could have died,’ I once wrote to a philosopher’s widow. I realized the stupidity of the remark only after mailing it. To send another would be to risk a second blunder. With regard to condolences, whatever is not a cliche borders on impropriety or aberration.”

    Emil Cioran

    Coming back to the article.

    “Once again I would remind readers that a human life has been snuffed out.”

    Which equivocation should read, “don’t say the wrong thing, or it or you will be removed”.

    Or, “Big brother is watching you!”

    Nevertheless, I’m sure he’s gone to a better place, that’s assuming you think a grave is a better place.

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