Kinkel, Amen explains, had been seeing a psychotherapist and taking both Ritalin and Prozac, which only made him worse--more volatile and unreachable. His demoralized parents had taken him off his meds, after which he went on his murderous spree. "If a scan had been done on him before the killings, it would have shown an extraordinarily abnormal brain," says Amen. On the SPECT scan, he tells the audience, Kinkel's prefrontal lobe--associated with impulse control, judgment, and planning--exhibits extremely low activity. At the same time, his temporal lobe, controlling such functions as temper and mood stability, also showed abnormal patterns of blood flow, which can make a person more prone to aggression, emotional volatility, and violent suicidal and homicidal thoughts.
"If his therapists had actually seen his brain, they could have put him on mood stabilizers, and the odds are they'd have diminished his violent thinking dramatically." Amen pauses to let this sink in. "But because the current 'state of the art' in psychiatry is not to look at the brain, his doctors were simply throwing darts in the dark. Today you can try to kill yourself or kill other people, and nobody will look at your brain. But if your brain's not right, you won't be right."
Amen has a vast fund of salvation stories about people misdiagnosed and mismedicated, often for years, whose real problems are only finally revealed through the combination of intense clinical detective work--the kind any good therapist would do--and the nuclear magic of a SPECT camera, which, literally, casts light into the hidden recesses of the brain. "Giving a diagnosis of 'major depression' or 'ADD,' is like giving a diagnosis of 'chest pain,' or 'belly pain,'" says Amen with some asperity. "These are symptoms with many, many possible causes. And one treatment will not fit every person with similar symptoms. We need to start looking at the brain, to begin seeing the underlying physiology of what's going on. Scans aren't the answer, but they're certainly part of the answer. A psychiatric profession that doesn't look at the brain is archaic, dated, and stupid."
Amen now has the audience in the palm of his hand, laughing at his jokes, moved by his stories of troubled little kids whose lives were either saved or ruined, depending upon whether their underlying brain problems were discovered and treated. He seems to be as much on a personal crusade as a professional quest. But, periodically, a note of unabashed salesmanship and self-promotion intrudes--the repeated references to his "cool" books and their worldwide distribution; his bestseller, Change Your Brain, Change Your Life ; his column for Men's Health ; his media appearances on The Today Show, The Leeza Show, CNN ; his recent gig at the National Security Agency. For some in the audience, it's enough to induce emotional whiplash: are we hearing from a fearless pioneer dedicated to transforming the mental health field or a salesman whose most important product is himself?