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Dr. Phil – SIDS, Substance Abuse & Infant of a Substance-Abusing Mother (ISAM)??

Originally published September 3rd, 2011

This may be unpopular in psychotherapy circles, but, I really love Dr. Phil.

Dr. Phil, just please throw your fellow therapists a bone, and, once in a while, put it out there that psychotherapy does not really look like what is happening on stage.

I mean, Dr. Phil, I know YOU know psychotherapy is a very personal and slow process. The therapeutic relationship is by definition intensely personal, private and confidential. This therapeutic relationship is what facilitates emotional and psychological change in individuals. Psychological and emotional change does not take place in a few days; it is more likely over a few months or a year, or even longer. And of course, your shows are not intensely personal, private nor confidential, and move very quickly!

Maybe one day you’ll mention that on your show!

BUT I truly respect that Dr. Phil does a great job of raising awareness of mental health issues.

His “Break the Silence on Domestic Violence” and his “Dr. Phil Foundation” are great community causes. I also admire that he educates people about healthy family functioning. There are lots of people out there who were not brought up in emotionally healthy families, and it’s great to have someone talking about healthy family vibes, healthy family communication and boundaries.

But I think that you missed the mark on a recent show.

Dr. Phil recently featured a very sad show about a young family and Sudden Infant Death Syndrome (SIDS). The young mom, Liz, had been abusing drugs for many years; she says since her college days. Her husband, Sean, is angry and disappointed that his wife is a drug addict. He didn’t seem to really understand the extent of her addiction, or what addiction is really all about.

Their four-month-old baby, Brennan, died of SIDS while taking a nap with his mom, Liz. It was unclear whether or not Liz was under the influence of drugs at the time the baby’s death, or during the pregnancy. So, it is unclear whether or not Brennan was an infant of a substance-abusing mother (ISAM).

It is been about a year and a half since the baby died. Liz has been unable to visit Brennan’s grave-site in all this time. She has been taking drugs such as painkillers and heroin to numb the pain. Liz feels responsible for the baby’s death. The autopsy showed the cause of death was SIDS, not suffocation due to Liz rolling on him during the nap. There was no mention in the show whether or not, at the time of autopsy, Brennan was classified as an infant of a substance abusing mother (ISAM). Classification as an ISAM would mean that Liz was taking drugs during her pregnancy.

I felt there were many facets of the story that were left unexplained.

I was disappointed that Dr. Phil did not educate the public about SIDS, so there was confusion as to the cause of the baby’s death. I felt like Liz was being implicated in his death. The show really focused on substance abuse intervention and mitigating family denial about substance abuse with education.

Here are some facts about SIDS:

The occurrence of SIDS has been documented for 3000 years. SIDS is a leading cause of death in infants under one year old. It is most likely to occur in infants between two and four months old. It is most likely to occur in males, and Native Americans and African Americans are at higher risk. It occurs more frequently in the winter months, especially January.

Researchers are now seeing evidence that SIDS might be caused by the infant brain’s inability to control arousal or detect high levels of carbon monoxide in the blood. The more knowledge researchers can gather, the closer researchers are to finding ways to hopefully prevent this tragedy from occurring.

But the exact cause of SIDS is not yet known. A diagnosis of SIDS is made by gathering information from the autopsy, from an investigation of the death scene, plus an investigation of the infant and family and family history. From this investigation, if there is no information indicating another cause of death, a SIDS diagnosis is made.

Although it is not known what SIDS is, we know SIDS is not caused by choking, vomiting, a minor illness or by vaccinations. SIDS is not contagious.

Risk factors are behaviors and environmental influences that may be associated with a particular condition, but risk factors do not necessarily cause the condition.

It is important to realize that risk reduction does not prevent SIDS, and conversely, the existence of risky conditions does not mean that SIDS will actually occur.

Some of the risk factors associated with SIDS are:

  • maternal cigarette smoking during pregnancy

  • maternal substance abuse during pregnancy

  • exposure to secondhand smoke after birth

  • babies who sleep on their stomachs

  • babies who had a brother or sister who died of SIDS

  • maternal history of sexually transmitted diseases

  • teen mothers

  • premature babies

  • poor prenatal care

  • poverty

  • overheating

  • soft bedding

  • unsafe co-sleeping arrangements which include:

    • sleeping on sofas or chairs with the baby

    • parent alcohol or substance abuse and sleeping with a baby


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