This Day in Jewish History

1922: The Psychiatrist Who Did Not, Repeat Did Not, Deny ADHD Is Born

Leon Eisenberg was an empiricist who noted the dearth of evidence that talk-therapy achieves much, but also opposed kneejerk drug therapy.

Leon Eisenberg, in a photo taken by a friend at a faculty meeting, wearing glasses and bow tie and smiling: An early student  of autism, he did not dismiss ADHD as a disorder, but argued against treating all cases the same.
Wikimedia Commons

August 8, 1922, is the birthdate of Leon Eisenberg, the psychiatrist and medical educator who was one of the first physicians in the world to study autism scientifically.

Eisenberg was as much a humanist as scientist, and as such, was an early advocate of using drugs to treat child psychiatric patients, with an eye to alleviating suffering rather than high-mindedly insisting on talk-therapy. He also carried out the first clinical studies in the United States of psycho-pharmaceuticals.

It is ironic, therefore, that today, seven years after his death, a Google search of Eisenberg’s name will yield dozens of articles citing an interview in which Eisenberg purportedly called Attention Deficit Hyperactivity Disorder a “fabricated disease” while bemoaning the over-prescription of drugs for its treatment. Eisenberg, after all, had done the first clinical trials on such medications as Ritalin and Dexedrine, establishing their usefulness in treating young people with “overactivity” disorders.

In truth, Eisenberg spent much of his career urging an eclectic, non-dogmatic approach to psychology, one that equally took into account both biological and environmental factors for disorders, and a variety of treatment methods. An obituary in the British medical journal The Lancet noted that Eisenberg, late in his life, warned psychiatrists against what he called a “reductionist model of mental disorder.”

Jews not welcome

Leon Eisenberg was born in Philadelphia, Pennsylvania, and was the first child of Russian-born immigrants Morris and Fannie Eisenberg. He graduated from Olney High School, in North Philadelphia, in 1939, and then attended the University of Pennsylvania, graduating in 1944.

Despite his near-perfect academic record at Penn, the Jewish Eisenberg was turned down by every medical school he applied to, until a state legislator intervened, at the same University of Pennsylvania, on his behalf. He went through medical school in two years (studies were often accelerated during World War II), and was valedictorian of his graduating class in 1946. Nonetheless, Eisenberg and the other seven Jewish students in his class were subsequently turned down for medical internships by Penn.  

Eisenberg interned at Mt. Sinai Medical School, in New York, which is where he first found himself drawn to psychiatry.

Proof sorely lacking

Psychoanalysis fascinated him intellectually, but he quickly concluded that it was “politically unacceptable,” as he noted some years later.  “How could you use a treatment that would take so long per person when the burden of mental illness was so high?” he asked rhetorically, and to that, added, “there was no real evidence it worked.”

After two years in the U.S. Army Medical Corps, and a psychiatric residency at the Shepard Pratt Hospital in Maryland, Eisenberg became a psychiatric fellow at Johns Hopkins University, in Baltimore. There, he worked with Leo Kanner, who was (together with Hans Asperger) one of the first psychiatrists to describe autism.

Eisenberg conducted the first longitudinal study of 63 children earlier identified by Kanner as suffering from autism. He also designed clinical studies to test the effectiveness of both psychotherapy and of psychopharmacological treatment.

Eisenberg followed Kanner as chief of psychiatry at Johns Hopkins (1959-1967), and then moved to Boston, where he became head psychiatrist at the Massachusetts General Hospital and a professor at Harvard Medical School. There, he pioneered a program of affirmative action, which brought many more African Americans into the school, and he developed the field of social medicine, which looks at macro-medical issues through the lenses of the social sciences.

Following the failure of his first marriage, to neurophysiologist Ruth Harriet Bleier, Eisenberg married the former Carola Blitzman, an Argentine-born psychiatrist who had been a co-founder of Physicians for Human Rights.

Leon Eisenberg died of prostate cancer, on September 15, 2009, at the age of 87. About a half year before his death, he spoke with a reporter from Der Spiegel, for an article about the over-diagnosis of mental disorders and the excessive use of medication to treat them. It was there that he spoke of ADHD as a “fabricated disease,” a phrase that was picked up, three years later, when Spiegel ran its article, by a number of sensationalist publications as evidence that the “father of ADHD” had, in a “deathbed interview” disavowed the very existence of the condition. What he was really doing was questioning the wholesale prescribing of medication for a problem that often had other-than-biological roots.