Dr. Mike challenges Dr. Amen

[PsyDr]

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Dr. Amen says that he would not stop using SPECT if RCTs showed it's not effective. Also says that he doesn't need RCT evidence because he's seen more cerebral SPECT scans than anyone else.

 

[brosa]

I mean, of course he would not stop, that is how he makes most of his money, isn't it? I don't think he does this for the sake of good science. I watched some parts of it and Dr Mike is a great influencer, although I haven't had the time to watch the whole thing yet.

Just to be polemic, but do people think about "therapeutic" SPECT? I refer to extremely anxious patients, who won't accept any explanations and no amount of psycho education works. People who have done a CT and an MRI, and will still be anxious about not having done a SPECT because he had a cousin or something that did one and found a cancer. I don't order in cases like this btw, just curious if there are some pro arguments there.

 

[Stagg737]

I mean, of course he would not stop, that is how he makes most of his money, isn't it? I don't think he does this for the sake of good science. I watched some parts of it and Dr Mike is a great influencer, although I haven't had the time to watch the whole thing yet.

Just to be polemic, but do people think about "therapeutic" SPECT? I refer to extremely anxious patients, who won't accept any explanations and no amount of psycho education works. People who have done a CT and an MRI, and will still be anxious about not having done a SPECT because he had a cousin or something that did one and found a cancer. I don't order in cases like this btw, just curious if there are some pro arguments there.

I mean, that’s a pretty dang expensive placebo, but if they’ve got the money and feel like it really worked…

 

[psydocc]

Dr. Amen says that he would not stop using SPECT if RCTs showed it's not effective. Also says that he doesn't need RCT evidence because he's seen more cerebral SPECT scans than anyone else.

It's refreshing to see someone, especially someone with a large following, call out Daniel Amen right to his face.

 

[splik]

Amen clinics are very popular in my area for my particular patient population. You also have qEEG which is a poor man's SPECT and there's quite a few psychologists and chiros jumping on that bandwagon. I see a lot of iatrogenic harm from this, not to mention patients putting in debt so they struggle to afford the care they actually need. I recently read a note from the Amen clinic that sounded like it was written by a naturopath. Then I looked at the signature, and it was written by a "naturopathic psychiatrist" (no MD, just naturopath degree but serving in the same capacity as an psychiatrist). I would consider Amen akin to other "integrative" or "functional" approaches to psychiatry and medicine. It's no surprise he collabs with Mark Hyman and the rest of those. He's loved by the naturopaths and EMDR therapists. birds of a feather and all that.

 

[FatherPsychiatry]

It's refreshing to see someone, especially someone with a large following, call out Daniel Amen right to his face.

Can I get an A-MEN!

 

[Merovinge]

It's refreshing to see someone, especially someone with a large following, call out Daniel Amen right to his face.

To be fair, he gets called out in every AACAP meeting I've ever attended, it's just not widely disseminated. This video is great of course, but I'm not sure I've ever met a single child psychiatrist describe Dr. Amen as anything other than a pseduoscience entrepreneur.

 

[oliversacks4thewin]

I have been listening to this podcast on and off for the past week. It's been hard. You can literally feel the used car salesman vibe drip off of every response from Amen. His dodginess on being questioned directly about his supplement line, alone, made my physically cringe.

 

[Merovinge]

I have been listening to this podcast on and off for the past week. It's been hard. You can literally feel the used car salesman vibe drip off of every response from Amen. His dodginess on being questioned directly about his supplement line, alone, made my physically cringe.

The wild part is that is his response after all these years and preparation for the question. It's incredible what human brains will do for the almighty dopa/dollar. We see what people who are far gone with addiction to alcohol, meth, opioids, cocaine etc will do, but then we get surprised what people will do for $$.

 

[oliversacks4thewin]

The wild part is that is his response after all these years and preparation for the question. It's incredible what human brains will do for the almighty dopa/dollar. We see what people who are far gone with addiction to alcohol, meth, opioids, cocaine etc will do, but then we get surprised what people will do for $$.

Actual quote from 1:47:
"I think it's an important question to ask. If we do that randomized controlled study that we just talked about, and it turns out that it's not useful, would you give it [SPECT scans] up?"
"Absolutely not."

My head exploded. I mean first, from Dr. Mike having to explain to a veteran physician how a randomized controlled study works, but then also from his brazen vocalized disregard for even the suggestion that his theory may be bunk.

 

[splik]

Actual quote from 1:47:
"I think it's an important question to ask. If we do that randomized controlled study that we just talked about, and it turns out that it's not useful, would you give it [SPECT scans] up?"
"Absolutely not."

My head exploded. I mean first, from Dr. Mike having to explain to a veteran physician how a randomized controlled study works, but then also from his brazen vocalized disregard for even the suggestion that his theory may be bunk.

This is the world we live in now. It will come as no surprise that Dr. Amen was invited to the White House and is working with RFK jr.

 

[FlowRate]

Amen clinics are very popular in my area for my particular patient population. You also have qEEG which is a poor man's SPECT and there's quite a few psychologists and chiros jumping on that bandwagon. I see a lot of iatrogenic harm from this, not to mention patients putting in debt so they struggle to afford the care they actually need. I recently read a note from the Amen clinic that sounded like it was written by a naturopath. Then I looked at the signature, and it was written by a "naturopathic psychiatrist" (no MD, just naturopath degree but serving in the same capacity as an psychiatrist). I would consider Amen akin to other "integrative" or "functional" approaches to psychiatry and medicine. It's no surprise he collabs with Mark Hyman and the rest of those. He's loved by the naturopaths and EMDR therapists. birds of a feather and all that.

The one that got me around here was the place that does what looks like standard TMS but they also add on qEEG's and ECG's for absolutely no reason other than extracting additional OOP cost from the patients.

 

[Merovinge]

The one that got me around here was the place that does what looks like standard TMS but they also add on qEEG's and ECG's for absolutely no reason other than extracting additional OOP cost from the patients.

Where's that MBA to describe "bundling" services and maximizing "revenue per person". We can see their "customer acquisition cost" and figure out how to get that solid double digit "growth rate" in no time!

 

[comp1]

I watched it and I get being annoyed at Dr. Amen for basically poo-pooing the entirety of the scientific method based on anecdotes. However, I also believe he helps people (while making a lot of money). For ego dystonic mental health conditions/concerns, which I'm sure is all he sees, people are going to benefit from validation of their suffering and being listened to. That's essentially what the placebo effect is. Importantly, the placebo effect no more or less of a real thing than an effect from prescription medications or manualized talk therapy. The degree of efficacy might vary, of course. I'd prefer if we could accept that attention by itself is healing without having to pile on things like supplements or hyperbaric oxygen that might actually be harmful, but at least he's making people feel better (and making a lot of money).

 

[oliversacks4thewin]

I watched it and I get being annoyed at Dr. Amen for basically poo-pooing the entirety of the scientific method based on anecdotes. However, I also believe he helps people (while making a lot of money). For ego dystonic mental health conditions/concerns, which I'm sure is all he sees, people are going to benefit from validation of their suffering and being listened to. That's essentially what the placebo effect is. Importantly, the placebo effect no more or less of a real thing than an effect from prescription medications or manualized talk therapy. The degree of efficacy might vary, of course. I'd prefer if we could accept that attention by itself is healing without having to pile on things like supplements or hyperbaric oxygen that might actually be harmful, but at least he's making people feel better (and making a lot of money).

I appreciate the sentiment but, and that's a big but, Amen is dangerous to the field as a whole. His popular views undermine a great deal of the work that we, as a collective field do. To say, psychopathology has to have a correlated lab finding, is in itself, still stigmatizing for psychological conditions. His push for non-evidence based modalities further erodes trust with the public for all of us. And don't even get me started on his theory of "7 ADHD's" that is the most illogical mess of a "theory..."

 

[PsyDr]

This is the world we live in now. It will come as no surprise that Dr. Amen was invited to the White House and is working with RFK jr.

The previous secretary of education tried to get her neurofeedback company into public schools. After that failed, her brother started building concentration camps in China.

 

[oliversacks4thewin]

Just coming back on here to comment after finishing the podcast listen.

Hoo boy, the deflated sounds made by Dr. Amen when Dr. Mike continues to question his reliance on the SPECT scan cannot be understated. He attempts to handwave away all inquires with "If you don't look how do you know?" which is a horrible defense... He literally stops answering most questions about RTC's, at one point admits the conversation is "not fun," and asks if he can go back to just talking about his new book. *Shudder*

 

[FatherPsychiatry]

He literally stops answering most questions about RTC's, at one point admits the conversation is "not fun," and asks if he can go back to just talking about his new book. *Shudder*

Oh yeah. Bet he's not used to being confronted much, and in situations where he is he probably just gets out of them (does he even go to APA / AACAP meetings anymore?). Sticks with yes-men/women like the Kardashians and football players who don't/can't push back scientifically on what are otherwise very appearing images and a narrative about the rest of us shmuck shrinks "flying blind." Bet he figured he would go into this interview with a popular youtuber to sell his book, not expecting to be called out. NO FUN!

I have an acquaintance C&A psychiatrist who used to work in a children's hospital, doing consults to all those kids with cancer and other horrible illnesses. Very noble stuff. Guess he got burned out by that and went over be an Amen guy, went to the DC with them taking pics with that crowd etc. Now its non stop TikTok reels about best diet for ADHD and undiagnosed Autism and all that stuff.

 

[Merovinge]

I have an acquaintance C&A psychiatrist who used to work in a children's hospital, doing consults to all those kids with cancer and other horrible illnesses. Very noble stuff. Guess he got burned out by that and went over be an Amen guy, went to the DC with them taking pics with that crowd etc. Now its non stop TikTok reels about best diet for ADHD and undiagnosed Autism and all that stuff.

Like I know I shouldn't judge these docs and everyone has to support their families and all, but man those stories just boil my blood. Eyes wide open selling out is status quo for politics, law, and finance, I really hope it doesn't edge that way for medicine.

 

[shoomer]

Like I know I shouldn't judge these docs and everyone has to support their families and all, but man those stories just boil my blood.

I disagree, I think we should judge these docs. I don't truly believe anyone needs to practice unethically to support their families. Realistically, even "low paying" psychiatry jobs will make you comfortably middle class at the worst. These sorts of practices all come down to greed, people would not be starving if they stuck to respectable clinical work.

 

[Merovinge]

I disagree, I think we should judge these docs. I don't truly believe anyone needs to practice unethically to support their families. Realistically, even "low paying" psychiatry jobs will make you comfortably middle class at the worst. These sorts of practices all come down to greed, people would not be starving if they stuck to respectable clinical work.

You are right, I practice non-judgement on a daily basis for work, but there are probably times outside of work where a little judgement is the correct response.