NEWPORT BEACH, Calif. — Daniel Amen is, by almost any measure, the most popular psychiatrist in America.
He is 58, lean, married, a father and grandfather, soft-spoken, balding, given to wearing black from head to toe, and possessed of a small, compact frame, weighing just under 150 pounds. He’s energetic and personable. Patients adore him.
He has arisen, like a modern-day American myth, from the fields northeast of San Francisco, where he ran a small-town clinic, to become the creator, chairman and CEO of the Amen Clinics, an empire that includes a string of psychiatric practices, a line of nutritional supplements, book publishing, DVD sales, and television and speaking engagements.
He says his businesses, including four clinics — three on the West Coast and one in Reston — employ 100 people, among them 16 psychiatrists, and grossed about $20 million last year. The clinics together see 1,200 patients per month. Two more clinics, one in New York and one in Atlanta, are scheduled to open later this year.
Some of his more than two dozen books, such as “Change Your Brain, Change Your Life,” have hit bestseller lists and, combined, have sold more than 1 million copies. His six PBS programs based on those books, including “Magnificent Mind at Any Age” and “Your Brain in Love,” are used during the nonprofit stations’ fundraising drives. He says the shows have aired some 50,000 times and generated about $40 million for PBS stations.
High-end motivational and business speaker Brendon Burchard features Amen at conferences, introducing him as “The number one neuroscience guy on the planet.” Joan Baez and Bill Cosby tout him. He has been on “Dr. Phil,” Larry King, “The View.” He is working with former pro football players, trying to help them recover from head trauma likely caused by hard hits on the field. Rick Warren, pastor of the massive Saddleback Church in California, which Amen attends, enlisted him to help create the church’s health and nutrition program.
This rise to fame and fortune has been accomplished in curious fashion. Amen is a distinguished fellow of the American Psychiatric Association (“Excellence, not mere competence, is the hallmark of a Distinguished Fellow,” the organization says). Yet he assails — if not ridicules — his own profession.
“Psychiatry is broken,” he is given to say, and psychiatrists “remain the only medical specialists that rarely look at the organ they treat.” He scoffs that diagnostic methods have scarcely progressed since “the days of Abe Lincoln.”
Those, however, are only jabs.
The uppercut of the Amen combination is the assertion that he has harnessed a type of brain imaging to transform psychiatric practice itself.
This is single photon emission computed tomography, SPECT, a type of nuclear imaging test that measures blood flow in organs of the body. Using a radioisotope injected into the bloodstream, it illuminates a path for a camera to record the flow. The technology is commonly used to detect cardiovascular disease and cancerous tumors. In neurology, it is mainly used to research broad outlines of brain function in groups of patients. In clinical practice, doctors use it to uncover evidence of strokes, epilepsy, trauma, some types of dementia and heavy drug use.
Amen says this is only the beginning.
He says he has taught himself — by scanning 45,000 people a total of 70,000 times — to apply SPECT, alongside clinical evaluations, as a diagnostic tool in 90 percent of his patients.
The brain activity he says he sees in these scans — areas of high and low activity — allows him to target those areas with specific treatments and medication, he says. A full initial session, including two scans, costs about $3,500.
Amen says this method has helped him identify new subtypes of anxiety, depression and attention deficit disorder, categories far more specific than even the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the benchmark of the field.
This is heady stuff — using brain imaging to find biomarkers for mental illnesses has been the great hope of psychiatry for at least two decades. In “Healing Anxiety and Depression,” published nearly a decade ago, Amen wrote of the thrill of this breakthrough: “We could change brain patterns, see it on a follow-up scan, optimize brain function, and subsequently help people heal from the inside out.”
The implications, he says, are vast.
One of his studies showed that although his patients had tried multiple doctors and medications before coming to Amen, 77 percent improved across all measures with his SPECT-enhanced treatment — remarkable success in such a difficult patient population.
“It will soon be malpractice to not use imaging in complicated cases,” he recently told a symposium at the American Psychiatric Association.
From his Web site: