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Child psychiatrist 

RICHARD LIVINGSTON

click to enlarge LIVINGSTON: Child psychiatrist.
  • LIVINGSTON: Child psychiatrist.

Dr. Richard Livingston uses the analogy of a slot machine to describe why some children — even toddlers — need suffer from depression, post-traumatic stress, anxiety: Combine a genetic disposition with difficulties in and outside the home and three lemons can come rolling up.

Livingston, a professor at the University of Arkansas for Medical Sciences, sees children at Arkansas Children's Hospital and maintains a private practice that takes him around the state. A typical week's schedule finds him in Malvern one day, Fort Smith the next, in Little Rock and back to Fort Smith. Sometimes he works in a trip to Jacksonville.

His is an understaffed specialty: There are only 19 board-certified child and adolescent psychiatrists in Arkansas. The most the state ever had, Livingston said, is 31.

In the opinion of Lenore Terr, the author of a seminal study of children involved in the 1976 school bus kidnapping at Chowchilla, Calif., Livingston is one of the top child psychiatrists in America. In her book “Magical Moments of Change,” published in 2007, she describes him as a gifted doctor “with both optimism and drama inside his soul.” She cites Livingston's work with Cedric, a 15-year-old who'd been described by staff in the juvenile justice system as a “3M kid” — “mentally retarded, mentally ill and mean as hell.” The “magical moment” in Cedric's treatment came when Livingston observed Cedric snicker at a poor chess move made during a game being played by a couple of boys in the day room of the facility he was being held in. Livingston understood that Cedric was playing dumb, and whispered to him, “Your secret's safe with me.” It was a move that earned Cedric's trust; with therapy over several months, Cedric began to cast off the persona he'd assumed for protection. 

Livingston, 58, is himself an author; he published “Impulse: A Handbook for the Moral and Spiritual Challenges of ADHD” in 2005. It includes a chapter discussing whether St. Peter had ADHD; “you can make a pretty good case for it,” he said.

Drug treatment for ADHD and other psychiatric disorders has come under fire from various camps. Livingston says leaving children with psychiatric disorders untreated “isn't an option.” He cited research by Nobel laureate Dr. Eric Kandel that suggests experience can alter the molecular structure of neurons. The brain, that suggests, changes its structure in response to stimulus. “There's a lot more potential harm in leaving a child depressed or with anxiety,” Livingston said.

Because of the higher likelihood of a cultural fit with patients, Livingston would like to see more minorities go into child psychiatry. He is himself an eighth Cherokee (and a smidgen Creek) and a member of the Association of American Indian Physicians. He tries to get Indian students interested in the profession giving a talk called “The Coolest Job in the World.”

 

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