On the Rationale for a Diagnosis

There is an article on attention problems in the NY Times (April 13/2014. “Idea of a new attention disorder spurs research.”; http://www.nytimes.com/2014/04/12/health/idea-of-new-attention-disorder-spurs-research-and-debate.html) There is the claim of an entirely new diagnostic category: Cognitive, Sluggish Tempo (CST). The brain seems not to be active enough to focus and concentrate; another facet of ADD.
 So what is wrong with that? A new category? Everything is wrong with it. .

First of all the diagnosis should inform us, not simply describe. So OK the person’s mind works slowly, does that help tell us why? Which brain is sluggish and where? The same can be said for ADD. She can’t pay attention. OK. Anyone on the street can make that diagnosis: He muses; she seems too active, her mind is racing and she cannot sit still. So what? Is that indeed a separate category? In what way?

Description alone is not a proper diagnosis. The bacteria below infection is. So if I say, he sweats, has a high continuous fever, shakes and often seems to chill that is still a description; not a diagnsos…….no cause. If I say he is depressed, that is not a diagnosis; it is a description. What is depression? What is behind it? Oh, I see, he seems sad and down, has no energy and moves in labored fashion; is that any different from what the ice cream vendor could say about him? I doubt it. If we find that the vendor’s description parallels the doctor’s, throw them both out; no, save the vendor’s.

And there is then the other type of error in diagnosis. “His locus ceruleus is too active and there is an anomaly in his hippocampus”. In short, he is only a bunch of neurons and some seem deviated. No connection to his life, now or previously, no human touch; pure neurology. What’s wrong? It is a diagnosis in a vacuum. The same for biochemistry. We are not just cortisol; we are humans who respond to EVENTS with changes in biochemistry. No event, no real diagnosis. Unless we really do live in a vacuum.

And how about psychology?

Yes we have made all the diagnoses and see that the brain runs too fast and with far too high amplitude……he is therefore “”. And once we are certain of our diagnosis we rush to give drugs that are proven to slow down the brain? And they do achieve that and the person is far less anxious.
I forgot to ask, does he have a history? Traumas, lack of love, etc? Was there a key traumatic experience? Was there a trauma at birth or during gestation? When we have no frame of reference on the human level we are wandering in the dark, acting on half truths. …seeing only part of the brain and only part of the human.

We need a diagnosis, especially in psychology that is more encompassing; that goes below the obviously observable. That really explains and tries to find origins. It is not enough to find medicine to ease anxiety without ever knowing what it is and how to deactivate and decouple if from pushing our brain so hard. Until we do that we are forever in danger of recidivism; of it coming back again and again so long as the cause remains intact.

Worse, so long as the primal source remains intact there will be a need to drug the symptom and that is partially what this discussion is about: drugs for symptoms. Big Pharma at work. They have no incentive to find causes and put themselves out of business; so long as they dominate research and medication we become the losers. The source is what provokes the symptoms into life. The problem is that the source and origins are imprinted and can stay for a lifetime. And that is not just in the brain; the cells are found throughout the system, which is why cognitive therapy is lame against early imprints. It is not just ideas; it is in the lungs and kidneys, in the heart and blood vessels.

Let me tell you about a sluggish brain. In my earlier books I describe 2 kinds of birth; sympathetic nervous system dominance due to child successfully struggling to get out; and the parasympathetic birth where there was no possibility to move through the canal easily—a blockage. This describes the active person with an active brain versus a slugish person with a sluggish brain and that works more slowly….the sympath versus the parasympath. This is a complete systemic event and is not limited to brain function.

 There is more: a mother taking drugs or painkillers or tranquilizers while carrying can produce a down loaded baby who is very sluggish; I have seen it so many times during relivings. And that same mother drinking a lot of coffee or cokes can up load the baby and make him hyperactive. It becomes imprinted as a normal way of life, first for the mother and then the baby. The baby begins to adapt to his environment, which in this case means either too much stimulation or too little. It becomes “normal” and he adapts accordingly. So “sluggish” has very early effects. And a diagnosis needs to include that possibility.

 Oh my! Did I mention that this new diagnostic category is supported by Eli Lilly? That means financial support. They also pay him for speaking tours. It is good for them that a diagnosis requires drugs, but not so good for us. We need a real diagnosis not supported by drug companies.