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Tuesday, 30 December 2008 10:46

Visionary or Voodoo?

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Visionary or Voodoo?

Daniel Amen's Crusade Has Some Neuroscientists Up in Arms

by Mary Sykes Wylie

Psychiatrist Daniel Amen is a trim, elfin figure with a puckish smile and the staccato delivery of a stand-up comic. The winner of a Distinguished Fellow Award from the American Psychiatric Association, a clinical professor of psychiatry and human behavior at the University of California, Irvine School of Medicine, the author of 20 books and as many peer-reviewed papers, and a hugely popular public lecturer and workshop leader, he sounds, somewhat paradoxically given his own sum, a bit like a wiseacre underdog impudently challenging a reactionary establishment. He cheerfully rails against the self-satisfied stuffed shirts from the worlds of academic psychiatry who, in defiance of reason and good sense, don't accept his view that a brain-imaging method called SPECT is an invaluable tool for understanding and treating psychiatric disorders.

"I just don't get it. Why are we the only medical specialists who never look at the organ we treat?" he asks, his voice rising in exasperation before a jam-packed audience of 500 therapists drawn to a full-day workshop on his work. "Why is it controversial to get more information on people who suffer? The images are really easy to understand. What's the problem with having more data?"

And then the "piece de resistance". We're always being told that the brain is so terrifyingly, irreducibly complex that nobody except Nobel-caliber neuroscientists could ever begin to understand how it works. But Amen says, in effect, that it really isn't that hard for anybody--with a little training--to get a good sense of what all those brain modules are actually up to. "The images are really easy to understand--you don't need to make it any harder than it is," he says, as if explaining a new recipe to an insecure cooking student. "All SPECT does is measure three things--areas of the brain that work well, areas that are underactive, and areas that work too hard. Then you just gear the treatments to rebalance these areas."

So why not just take a look? What's the harm? His case is helped by the elegant, crisply articulated, brain images he shows that, in concert with his simple explanations, seem to luminously reveal what's actually going on upstairs.

Amen flashes two computer-reconstructed, three-dimensional, exquisitely tinted color scans, each of a different brain. One, a "healthy" brain, is a smooth ovoid shape, with some softly modulated rises and depressions; if it were a landscape, it would be a gently rolling pastoral scene. The other brain looks an awful mess. With its deep fissures, crevices, and "holes"--areas of severely low activity--it looks as if uneven chunks of it have been eaten away by a voracious rodent. This latter brain, Amen dramatically announces, is the brain of Kip Kinkel, the 15-year-old boy from Oregon who, in 1998, shot to death his mother and father and then drove to his high school, where he shot 24 more people, killing two.

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