Some of my readers quickly chimed in to say some of the things about the Diagnostic and Statistical Manual of Mental Health that I have been thinking. Kelly astutely pointed out that only four editions since the 1950’s didn’t seem like very many revisions. I agree. The reading I’ve done about this is that the DSM revision process can be highly political and froth with lots of time-consuming review, debate, analysis of research, etc.

The DSM is definitely a lightning rod for controversy. In the 1970's, after groups rallied to protest, homosexuality was dropped as a diagnosable disorder. Many today criticize the overlapping symptoms in several disorders. The process for updating the next edition of the DSM started in 1999, but the publication date isn’t scheduled until 2011. Think about how long professionals have been talking about Fetal Alcohol Syndrome, Sensory Processing Disorder and others…and how many more years we have to wait to see these things in print. Meanwhile, what’s happening to these kids?

And then there’s the whole issue of psychiatrists’ egos. I hear they are notoriously large. I have to plead ignorance to that because LuLu has an awesome psychiatrist, who has been open to identifying her multiple problems and working with all the other professionals on our healing team. Although cautious about our biomedical interventions, she isn’t opposed, just wants us not to waste our time and money. And I find that she’s constantly reading and updating her own knowledge.

I’ve heard horror stories though. But neurology and psychiatry are medicine’s final frontier, and while I have great faith in psychologists, I believe that psychiatrists have one decided advantage (if they’d just use it correctly). And that is that they ARE medical doctors. The brain is a biological organ. Dr. Daniel Amen (a psychiatrist) of the Amen Clinics is always quoted as saying that the brain is the only organ we treat without looking at it. It’s true, in today’s medicine we routinely look at all other parts of the body – hearts, lungs, kidneys, intestines – through various evaluation tools before diagnosing. With brain disorders, symptoms are the main criteria.

Of course, Amen has a personal agenda in promoting the SPECT scan technique he and his clinics have pioneered. But he has a very valid point. The focus of psychiatry and neurology should be on figuring out how to observe what is happening in the brain and basing the diagnosis (and subsequent treatment and medications) on that.

Thank God that mavericks like Amen exist! He has his critics, as do the SPECT scans. How accurate are they? Well that’s a debate for academics in my opinion, because I’ve heard countless parents explain that their child’s SPECT scan pointed to the right medication combination or the need for certain types of therapies and protocols that were life-changing. And as a mom, that’s good enough for me.



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