sociatry91007b

[Adam Blatner]

That's fine, I don't have any needs for specifics or writing from you Rebecca, but it 
makes for a more interesting conversation---this is sort of an invitation to 
everyone---when we have case examples.

   RW: many examples of kids being diagnosed with all sorts of disorders rather than look 
at the problems  as being indicative of the disorders of society.
       Or take the PhD psychologist who had his daughter put on Ritalin because she was 
daydreamy and not getting straight As in school. She was 7.
            AB: What concerns me is who are the physicians (psychiatrists, GPs?) who would 
go along with such a reckless pseudo-diagnosis?
       What is the family think? Does anyone get corroborating information? From more than 
one teacher? (Some teachers who have negative tele with a kid will "diagnose" the kid as a 
problem when that kid has no problems with other teachers.)
       Does everyone agree? And what kinds of follow-up happened. How good of a history 
was taken?
 What I agree with is that often professionals don't do half-good-enough of a straight 
careful history, really getting a sense of what's up. How happy is the kid, what 
recreational outlets? What are peer experiences, etc.
          I agree that there are many horrible examples of mis-diagnoses, too-easily done.

 RW  The director of a local child day treatment said to me that when children get 
diagnoses bipolar, often the parental reaction is that because the disease is biological 
there is nothing they, the parents, need to do, it is the child's problem, no need for the 
family to be in treatment, etc.
       AB: Once again, there seems to be a near-epidemic of this diagnosis, and I am 
wondering about what really goes on with the diagnosis---not just categorizing, but really 
assessing strengths, weaknesses, different kinds of stress.

       I sometimes do what I call the "Oprah Winfrey" test: If I could portray this kid's 
life to an audience of daytime television show viewers, sort of be a fly on the wall, 
would an average observer end up saying, "Whoa, if I lived in that situation/ home/ 
neighborhood/ I'd be crazier than that kid!" then I go back and dig more for details. It 
increases my resistance to a "biological" diagnosis. On the other hand, if, as I get the 
history, I imagine an uneducated audience viewing a documentary and wondering, "Well, the 
home may not be perfect, but most kids I know about would do okay in it." Then I consider 
biological etiologies, including food allergies.