One of the hallmarks of providers of alternative or unproven medical treatments is the warmth, respect, and kindness that they display to patients. This comes up again and again in stories about them, and it probably goes a long way toward explaining why such providers attract a lot of patients, even if there is little or no evidence to support their treatments.
Here’s an example from a post on the PsychCentral psychology news site:
I was really struck, not just by the rigor and thoroughness of the Amen Clinics’ exams, but by the respect and understanding that all the clinic’s staff showed us. Adults, teenagers, and small kids were all treated not just politely and humanely, but with genuine pleasure and warmth.
That comes from the second of two guest posts by Shawn Ladd, an adult with ADHD who reports on his visit to one of the clinics run by Dr. Daniel Amen, a psychiatrist who claims to have his own way of diagnosing the six–or is it seven?–varieties of ADHD that he has identified.
Ladd begins by saying that he was diagnosed with ADHD five years ago, but who writes in his first post that he had noticed he “was still struggling to initiate and follow through on projects, and was prone to bouts of depression.” He decided to go to one of Amen’s clinics for three days of evaluation. There he was given two SPECT scans (it stands for single photon emission computed tomography) and a quantitative electroencephalogram. He describes the scans, and the visits with a “medical historian” who reviewed his history.
In the second post, he describes a visit with someone who evaluated his electroencephalogram, and a psychiatrist who collected the data from the scans and the history to make a diagnosis and offer treatments. In the end, he was told to drop his Aderall prescription from 30 mg per day to 25, and he was given recommendations for nutrition, exercise, supplements, and therapy. All of this was contained in a 100-page binder he was handed as he left.
The evaluation cost him $4,000, he writes, and he doesn’t know how much of it his insurer will reimburse. ” But if I don’t get a penny back, it will still have been worth it to have a clear road map for treating my ADD and anxiety, and avoiding future bouts of depression,” he concludes.
Unless Ladd is leaving something out, it doesn’t seem that he got much for his $4,000–except that he was taken seriously and treated with respect. Considering the experiences many of us have had with American doctors and hospitals, that alone might be worth thousands of dollars. But it’s a long way from a treatment based on evidence.
Ladd does not say how he is doing following his visit.
PsychCentral describes itself as “today’s modern voice for mental health information, emotional support, and advocacy.” It proudly notes that it acts as an advocate on behalf of the mental health community, but for many who read it, it serves as an important source of information. I use it as a tip sheet myself, and I know of other reporters who do, too.
But in this case, PsychCentral has failed its readers. Others had much different things to say about Amen. Here’s what Neely Tucker wrote in The Washington Post in August, 2012:
“In my opinion, what he’s doing is the modern equivalent of phrenology,” says Jeffrey Lieberman, APA president-elect, author of the textbook “Psychiatry” and chairman of Psychiatry at Columbia University College of Physicians and Surgeons. (Phrenology was the pseudoscience, popular in the early 19th century, that said the mind was determined by the shape of the skull, particularly its bumps.) “The claims he makes are not supported by reliable science, and one has to be skeptical about his motivation.”
Others agree. ““A sham,” says Martha J. Farah, director of the Center for Neuroscience & Society at the University of Pennsylvania, summing up her thoughts on one of Amen’s most recent scientific papers.” And: “I can’t imagine clinical decisions being guided by an imaging test,” says Steven E. Hyman, former director of the National Institute of Mental Health and current director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard.”
At the blog Science-Based Medicine, Harriet Hall wrote in March, 2014, “Amen has just published an article in the journal Alternative Therapies entitled ‘It’s Time to Stop Flying Blind: How Not Looking at the Brain leads to Missed Diagnoses, Failed Treatments, and Dangerous Behaviors.’ It amounts to poorly-reasoned apologetics with false analogies, testimonials, and pretty pictures that don’t prove what he thinks they prove.”
And yet, as Tucker writes, Amen’s empire “includes a string of psychiatric practices, a line of nutritional supplements, book publishing, DVD sales, and television and speaking engagements.” Tucker reports that Amen lives in a $4.8 million home overlooking the Pacific Ocean.
And here’s what I wrote, in The New York Times Magazine, in 2005:
Sam Goldstein, a neuropsychologist at the University of Utah who has known Amen for a decade, is skeptical of Amen’s apparent ability to diagnose almost any psychiatric illness. ”If you have an ailment, he can find it,” Goldstein says. ”That’s one aspect of pseudoscience — it claims to do everything.” Stephen Hinshaw adds that Amen is exploiting families who are desperate for help. ”Making claims before the evidence is out there does families a lot of harm,” he says.
PsychCentral should have included this viewpoint in its posts. Maybe Amen is on to something; maybe he isn’t. But PsychCentral’s posts didn’t give its readers the information they need to decide that for themselves.
And here’s one last oddity: A documentary produced by Amen touting his work is regularly shown as part of fund-raising appeals by public television stations. Who is responsible for that blunder?
-Paul Raeburn
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