Art of Storytelling: The Human Experience of Being a Psychiatrist

this job we need a chair and a pen and your brain that's really all you don't you don't need any stuff you don't need any staff you know depending on where you work but you can just be you know you could just do you you learn about so many other worlds that certainly each patient was in their own world and you get to inhabit it and I find that endlessly satisfying the art of psychiatry is that we have to have another dimension to how we see patients and how we interact with patients how we gather information how we diagnose and what sort of surprised me was the the role of therapy and not just it's not just medications there's a science behind the power of words there's a science behind listening I was part of a whole harm reduction community and the days when you know back giving syringes out to people who are injection drug users was was considered to be inappropriate and so I realized I was a person look ease sort of edgy social justice ideas and unless I had a degree and some social standing to back me up that I wouldn't really be able to get very far with those ideas for very long and that was that was the point and people supported that idea that that if I were to be a successful and go to medical school but I could you know then do work the kind of work that I wanted to do and it's it sort of worked out didn't look exactly the way I thought it would look if you look at the etymological roots of the term psychiatry it's being a doctor to the soul healer of the soul why did you become a psychiatrist needs to be in there somewhere that was that's pants that's poor who certainly needs oh I'm writing him on earth oh good here so we can see them all together okay so what what like why did you become much like my interest everybody can put that in their own words we have some expertise in taking a history but we take a psychiatric history the big picture of what we're hoping to achieve here is to get a cohesive narrative of what it means to be a human being and this experience of being a psychiatrist right as a human so we're trying to tell this story both through individual acting individual narratives and then putting them together and seeing kind of what is our group narrative where we come from where are we going this you know people who practice this profession span you know it's been 50 years right not that I want to tell your story so I want you to tell your story tell me something about the beginning and who you are where you came from and what it was like in your earlier developmental years well we could spend an awful lot of time on that probably weeks but the short version is this I am and where were two baby born and raised in Athens Greece I was born at the beginning of World War two my mother was terrified by the way I am a psychiatrist because of my mother the intragenic transmission of trauma is what I grew up with plus my own traumas so my mother wanted to be a doctor appropriately so and rammed that into me but my inclinations because I was a very livewire who was to be an actress a historian but I knew one thing I had to leave Greece no matter what and my mission was to leave Greece to save my soul that's how I saw it my father was 10 years old when his father came to America in Chicago I to this day I go to Chicago and I always think what did he do for 15 years and what he did was he sent money sorry to educate the sons and not the one and only daughter so I'm the beneficiary of all of these hard-earned painful lessons very painful lessons it is very important to understand that what I just told you has taken me 30 years to put together and this is what I have learned that it isn't just what you have suffered or what you are now suffering whether it is adversity or illness but it is what strengths do you have that makes the difference the stories that we will tell about ourselves today will be different next week or different next year so someone's oral history changes over time right and so we're taking like our goal is to take kind of this like cross-section of people's stories at this moment in their lives but it's really cool to take it in that context of like you know you're not just getting facts in fact facts are like the least important thing in this it's just somebody's retelling you know of their of their story and that it changes over time and depending on where they're on their life and depend on who they're talking to also talking about like negotiating our goals like we come in with our expectations and our goals what we would like to hear and then they have their goals and what they're willing to give so just negotiating that would be interesting and kind of worrisome so if you youtube like the history of psychiatry youtube psychiatry a lot of stuff comes up that's just really negative and it's dark and it's scary and it's ominous and the art of what we do like the magic of what we do is so personal it's so interpersonal right when someone gets better it's you have a personal connection it's not always just the pill especially at the time that I was being trained our tool of psychiatrists were ourselves our reactions you know how you know the transference countertransference how we were responding to the patient and how we were able to establish effective communication or not but you know one of my biases too they couldn't sense the bicycles I haven't really tested yet I think a lot of people see me and get better quickly because there's not a lot of this transference that people make up hmm okay by this I mean I think we can really talk about issues directly as opposed to going back to tracing back to what mom said or did or whatever but deal more directly in the ongoing transference that's there which is more palpable in real I think to both both of us sure I mean I don't mind sort of helping patients trace things back with me I don't see all this terrible negative transference stuff that happened people come in they do the therapy they get better and they go live their lives they're not in therapy with me for 50 years I think at this point I like to say that I'm still psychiatry resident I'm still in training so I don't know officially what it feels like to be a psychiatrist yeah I don't let myself think that way you have to look at each person with open mind and be ready for where they're gonna take you describing their problems in the session or in the room it's a challenge it can be very fun it can be maybe scary at times a little bit dangerous sometimes I work in like a I work in to jail I work within the women's jail and sometimes you have to go back four or five times before someone will even interact with you appropriately without cussing you out or making a racial slur at you or telling you they hate you I was actually born in a small town in Douglas Wyoming ended up finishing high school in another small town called Chowchilla my high school was like six hundred kids the high school you you said you went to you are one of three among 600 who went to college yeah yeah the other did one or two things you rather a farmer or you were the owner of perform and so you either fit into one of those two categories and maybe if you were lucky you would go to Fresno State there was a lot of resources there was a lot of opportunities my mom has a second-grader education actually I take it back our dad has a second grade education my mom has a sixth grade education which in Mexico in some communities that's considered almost like college a lot of times I was a interpreter for mom and dad I guess my dad was gonna lose his job so the boss wanted me to tell that you know explain that to my dad so you sort of become mature very quickly yeah and then just the other day I had a patient who just disclosed a secret that she had held for like 45 years I hadn't told anyone who had lived her entire life with this horrible horrible secret and she just met me and been within five minutes she was disclosing this and it was those moments where you feel like wow like this is a privilege this is a privilege and it's a gift that someone would feel comfortable to tell you that they sort of gave me like a validated like that what we do what I do is important and that we do impact people and do we do help people and a lot of times like they say like your patients help you you know and then that's instance that that's exactly what happened I am extremely grateful to my patients for a change that they've brought brought about in me I've learned over the years actually to say more or less the right things well now you you said they changed you mm-hmm and you've acknowledged the change but you haven't told us what the change is well of course everybody's gonna change in their own unique ways I'm far more relaxed than I used to be I mean I'm not saying I don't get anxious but I enjoy life much more I'm able to enjoy people I feel more directly connected with people than I used to those would be some of the things I don't want to leave out for a minute the fact that I was in psychoanalysis four times a week for about more than 10 years and then two years more twice a week and then I went once a week basically till my analyst retired his wife told me I did quit working and so he stopped so I stopped and that was that back when I trained we were all encouraged to get our own psychotherapy we all have issues it's just do we do the work or not yeah yeah yeah yeah but today that's not encouraged it's it's the rare resident that has their their psychodynamic psychotherapy okay so I was born in San Francisco I grew up in Nigeria oh-oh yeah 9:00 yet I can't remember any time that wasn't gonna be I can't remember any time when I wasn't gonna be a doctor so I don't know at what point I don't know who it was I don't know what it was but I do know that I come from you know a lot of my maternal side of the family is a lot of health care providers I have a grandmother who in what my grandma dies in her 90s she had a father who believed so much in education and allowed how push you had dreams and this was like unheard of and had time osai care to my parents like what why our family medicine how about everything else well not psychiatry actually I have a friend after the time I got into a photo she she was like oh really you're serious about a psychiatrist wish I had known that I wanted to be a doctor and I discovered that I wanted to be a psychiatrist while I was in high school I was reading about hypnosis which I thought was exciting and in the library where the books on hypnosis were as I went along the next one was Freud's psychopathology of everyday life so I read that and I have wow that's really exciting I applied to several medical schools including Harvard and went up to Boston to find out why I hadn't heard from them and I was told that they hadn't received any reports from the to interviews I had had while I was at Michigan with two Harvard graduates that turns out they had not sent in their report and apparently they were not interested in having a woman apply that got straightened out but by the time a Harvard accepted me I had already visited Montreal and loved it and so I decided to go to McGill you know hon Saudi a very important in the discovery of of courtesan and his wife was a doctor from the US she's an American and she had a tea for women who were entering the first year at McGill and I had never seen a woman doctor before and so I was imagining that she would be wearing a he had boots and carrying a revolver or you know I had all kinds of images and she was a very sophisticated good-looking and stylish woman and that was nice to see did you have strong female role models growing up to you I didn't have any Road no no no role models weren't uh had not been defined at that time but no I didn't have any Bruhl months no women in my family had been professional so as soon as I could escape Orange County I went straight to San Francisco and I went to college in San Francisco and there I really that's really I think how I became the person I am now with with all of my experiences there I arrived in San Francisco in the late 1980s and the AIDS epidemic was raging and a lot of friends and colleagues were sick and dying and we didn't have a lot available in terms of resources and I became very politically active and became an activist and my whole life changed to one of just social justice everything I did was around so justice issues the other big thing that happened in my life I think that's led me to this place is that when my aunt had her first break and I was young she came to live with us and she just was an intellectual and a kind kind person and she was my hero and she she had schizophrenia I remember just how kind of I almost wanted her to be off of the medications because she was so weird on the medications because she was so glossed over and shaky and as a kid that looks weird right I don't I almost liked her better when she was a little psychotic good actually the night that she died I was at Harbor on a psych er shift as a resident my fellow residents on the shift at the time I told them what was happening and you know a five-minute story about who she was and what she meant to me and they just said here go see her and I saw her I said goodbye and I went back to my shift but what I didn't think about that moment I I mean I I'm a psychiatrist working in an emergency room I couldn't help my own aunt I went to say goodbye to her she was really the person who put me in the place that I was in as a physician there was nothing I could do for it was really tough but better to be doing something I went right back to work yeah the field of Psychiatry has gone through an interesting history you know earlier in the 20th century it was dominated by the psychoanalysts who had this very very slow drawn-out intensive process that was never really definitively demonstrated to have efficacy and the model that they were using I think was very limited it was also it was a model where the analyst was somewhat distanced it was not a cost-efficient model even under the best of circumstances so by the 70s into the 80s the pharmaceutical industry began to exert more and more influence over the practice of psychiatry they began to pour money into you know into organization psychiatric organizations and to research programs and basically co-opted the field but the biological model as valuable as that treatment can be with some people and we can see that in our work with patients it's still is limiting and it's almost distances of psychiatrists too much by the late 80s the handwriting was on the wall with managed care and suddenly certain patients there was as if they're plucked away from you after maybe you know a week in the hospital I mean it was almost it was a shock apparently society's only all too ready to pay for very expensive like liver transplants or heart transplants or doing you know quadruple bypasses on people in their 90's and yet things that could really help people who are much younger with full life yet to live that are troubled in many ways they don't get an opportunity for that kind of support or help I grew up in Ohio where my dad's family ran a psychiatric hospital a private hospital and it was a family hospital and we called my family was the Harding's and so it was Harding Hospital and so I grew up across the creek from the hospital and so psychiatry was a part of every single part of my life yeah I mean we went when I was born we were in Joplin then they moved to minun Gers where my dad did his residency and he trained there and then took us back to Ohio and and he and his brother and his father and his uncle we're all running the hospital of course every once while there were some scary things like my dad would get called and he'd have to go find a patient that had eloped and and so they'd be looking around the creek or wherever they were and I always remember kind of waiting and wondering a bit and then my dad would come home and I'd be okay and sometimes it wouldn't but you know the the patients would would come to services like at Thanksgiving and Christmas and so and we would be in church with them we would go and eat in the cafeteria and they would be there so for me it was just a part of my life I think as a young person I can't ever say that I really had the stigma at all until he was older in life and I realized that the stigma was there obviously that we need to get rid of that stigma that mental health is something embarrassing or secretive or you know we're trying to you know ruin people's lives with it I mean we're really just trying to get people functioning better so they can go out and live their life what do you think motivates a person to actually become a psychiatrist I think they want to help people like any other doctor and I think all of all doctors intentions I think are good but I think once they enter the medical establishment they realized that it's a force beyond their control a good friend of mine a ghost Harvard Medical School and you know he's in his second year and he realized that it's more economical to keep a patient sick than to make them better and I think a lot of medical professionals realize that that they're just part of the system that's beyond their control I think a lot of people see psychiatrists like a source of help I mean it still is great to talk about your things a lot of times people get a lot out of it just from you know being able to talk about the problems and kind of think through things systematically if people have problems they need someone to talk to they really do just having someone sit on a couch and have a very specific sort of criteria that they're checking off about somebody's issues or problems I think trying to pinhole people and label people doesn't necessarily work it's really no different than any other job I mean a lot of jobs are taking advantage of people to make money so a business as a business regardless of if it's you know science or if it's you know making movies or if it's you know selling a grocery to somebody at a farmers market you know it's all business in the end there's a tendency modern medicine to hide behind our machines hide behind our laboratory assays but in the end you know they're there there are two mortal beings interacting one in the role of facilitating providing service the other in the role of really needing that service provided and that's where the magic lies I mean I was raised in a home and and you know our religious beliefs really were in line with that that you you're only as good as the service that you can provide if you're not useful and honestly both of my parents were public servants if you're not if you're not providing a service like what are you doing well I'm very good with bipolars because there are my people I understand them you see I grew up with chaos and I understand it and I navigated it and I survived it and that's how I came to understand defenses defenses are not there to make your life miserable they're there to help people survive because the first order of business is survival you worry about quality of life after you are survived so that's the world that's the way it works I grew up up until the age of 16 in a small town in South Georgia called Bainbridge Georgia which at the time was a lynching capital of Southwest Georgia this was doing the days of Jim Crow so my early education experiences they were in separate schools separate schools from the schools of white kids went to so I started off 1st grade and when I was 4 years old I liked it stayed there always the smallest and youngest guy at my class this is the 1940 is 1950 1951 yeah I was born in 47 my father never liked me I didn't like him mmm he had ways of very closely demonstrating that I learned how to live and get out the hell out of there my mother was afraid of him everybody was afraid he's a crazy son of a for coming from World War two you know it was so yeah well he was in the one of the Negro divisions they they did the latrine duties and buried the dead because they didn't feel black people could fight the world or they had fought in the American Revolution the Civil War World War One etc man I wanted to get the hell out of the south so I graduated high school at 16 there was a young man who graduated the year before I looked up to him and he went to a school called Morehouse College in Atlanta Martin Luther King is on the school there he went there at when he was 16 at Morehouse College yeah yeah you were one of the first psychiatrists and psychoanalysts of color in in the country I think Wolfe won there were a couple of older people one when I was in training and some high tree we were taught that blacks didn't get depression for example this was in textbooks because we had Mami's and these memories made us immune from mental illness the notion then that blacks don't need treatment for mental mental disorders we didn't have books so although I couldn't understand what all the wards were and nobody could help me with them either I could get the picture and try to make things up about the picture and I think that's what life is about it's about seeing things and making things up out of what you seek to create stories and create narratives and then you sort of check them out and see whether they make sense over time and such is what we do as psychoanalysts psychotherapists I ended up doing two years of general surgery residency that was where I started but I was very unhappy I thought this isn't a lifestyle I can really get on board with and and I don't think I was so amazing at it that I had to be you know the world is okay that I'm not a surgeon it's fine and I ended up doing a year of surgery actually at the same hospital here our harbor went through my rotation and just knew that surgery was not for me I would have been a surgeon yeah I rather thought so really know how you thought that but I make ulis to detail I like detail I honestly didn't feel my hands were good enough I also felt I had a bit of a creative spin to me an imaginative spin to me that wouldn't necessarily have fit that well as a surgeon but it might have been fine I just did I never trusted my hands that well I've never been nimble a little bit of a trim or a combination of things I thought you know that that probably isn't optimal for me I had finished school I went into medical training after medical training I went into neurology and and I was very unhappy in neurology you know I felt sticking pins and people who could not talk was it just broke my heart and they're so little at least back then you know late seventies early eighties that you could do in Neurology and then one day in the Stanford Medical bookstore I wandered in and there on the shelves were stanislav grof first two books realms of the human unconscious and human encounters with death and he and Groff was one of the the great researchers of psychedelics going back to the 50s and Czechoslovakia I think I read through both of his books in a single weekend and then I realized I really need to get back to psychiatry because that was my original goal going into medical school to become a psychiatrist but I had been influenced away I remember my first day of psychiatry went in to see the training director and he said Charles this is an exciting time for you to enter psychiatry and I was thinking yeah right psychedelics we're gonna study psychedelics right I didn't say that that's not thinking and he's a wonderful time to go into psychiatry so exciting I have here my desk a copy that was just released just published last week of something that'll change the destiny of psychiatry he picks up a copy of the DSM three and my heart sunk but this is what it's all about are you kidding me so I actually I kept I kept my interest to myself for years and years and then I've done research which is now getting a lot of attention and I'm feeling I'm able to have an impact on the course of our field and in the process the course of our culture because I feel that these compounds if used optimally under ideal conditions have great potential to facilitate healing individuals families communities worldwide if we could only learn how to utilize them as safely and as responsibly as possible I am the fifth born in a family of seven mother father and four older female siblings I was the youngest and that's a very important set of facts so I grew up essentially in a I would say a female-dominated home and with a very strong feminizing influence on the children and particularly the youngest male so I'm mentioning that because it clearly B speaks a high potential for conflict and confusion okay how did that work out for you that's the story of my life this is just going to be a brief interview we were a left-wing family and my mother was verbal about it that for instance I know that she wanted me to grow up to be a labor organizer and her I would say I have a passion for social justice I know that this is derived from the parental influence and particularly in a sort of more focused way from my mother people function in groups and that their even their individual psychologies will be more profoundly influenced than their current whether they're rich or poor by what's embedded in them through identification with parents and the broader culture from training as a psychiatrist how did you end up in psychoanalysis and practicing that for well psychoanalysis was really my subversive interest psychiatry was sort of the vehicle for getting to become a psychoanalyst because if you you may not be aware of this but in the United States at that time psychoanalysis was the exclusive province of medical people I hope that psychiatrists continue to want to understand other people not just diagnose them but diagnosis is like having a cold hardly it defines you be a whole person with a cold the whole person is the interesting part of it when we talk about Marriner mirror neurons and the attunement that comes when when people truly are connected my patients and I know when the tingle I call it the tingle test when it starts to happen in the room when things are really changing or when they are experiencing incredible connectedness or they have had an AHA experience I experience it so critical to have your own imagination and your own creativity engaged with the patient and that that's vitalizing for patient and doctor alike that's what's so beautiful about being a psychiatrist says that it's part of the nature of my work and I feel part of our obligation is to bring in all of the experiences we've had into what we do I was on call and Christmas this was six months into residency I was on calling the Christmas Day think of mine tenure would African American boy from first like a I remember I don't remember exactly what the story was but something about our views and he was crying and I found myself like tearing up and I was so heartbroken because here I was it was Christmas morning I left my kids to go take care of this boy and my kids like Elmo you're working it's Christmas and there was this other kid it was almost like no one wanted him like he was in psychiatric on a psychiatric ward on Christmas morning and it was just too much and I had a lot of people who kind of dr. Schaefer who was my program director also you know had a few input at the time so I kind of started allowing myself process what that would mean and I think at that point I was also in therapy I had just you know started psychiatry and if you supervisors had recommended that it would be good to do some therapy I said well just kind of get more insight about myself and who I was and what I wanted to do so I didn't allowed myself go through that and I got to the conclusion that I probably wanted to be working with kids and and I guess over the last what five six years fell that yeah that's my life's work youth empowerment have a very strong belief in in God in in meaning and purpose in life and how I'm trying to find meaning and all that I do so I I would say for the most part I'm constantly like reflect like I have this almost like how a car I'm company aware what's going on you know like a sense of oh yeah like something's mini shift in my piece or my you know my comfort level or what is it about that person I'm constantly aware of things like that because what I find is I mean of course sometimes I'm not and I crash and get into all kinds of trouble and of course I have an 18 I have you know my husband my kids the my parents always stepped up to the plate when I needed to whatever even though my kids would have preferred me to be there certain times but that is always someone there who was covering sort of being a good substitute my father is a psychiatrist which is a whole different discussion I suppose but having done research with him having just followed or observed his precedent all in all being said I'd always had in my major in college was philosophy to having a spiritual sort of inclination and then this is a spiritual science and I think it's just not even thinking just an attraction that that pulls you there I think psychiatry also needs to acknowledge and recognize that the psycho spiritual dimension of individuals lives are a great import and traditionally psychiatry tends to lend a deaf ear to that aspect of humanity my identity was so well it was just I was a Harding girl and when I went to Europe I was just Marianne and I realized I was the same person and so at that time I did it at that time when we got when we decided to get married I basically I still had my dream I was gonna do medicine and I found out that I was pregnant that I had gotten pregnant very early on but what was happening was I realized that if I was going to have a child that I wasn't gonna do medicine and so I thought okay that dream that's over because I still have the mindset that if you were a mother and I just I knew that I was excited about the life that was growing in me so there was two things going on it was like my dream was going and my child was coming but what I didn't realize that myself was coming with that child so at age 36 I started medical school oh my goodness yeah I thought so much my friends thought I was crazy I had my kids were in fifth and sixth grade I was crazy and it was the best thing the first child is the result of the fruit of the benefit of psychoanalysis because I had five miscarriages before him you see the traumas at the beginning of my life and the repetitions thereafter screwed up my pituitary adrenal axis so I had to feel secure before I could carry a pregnancy sounds like you know a lot about post-traumatic stress disorder science and research well I'm a poster child and the word is it's treatable but you need a container without my husband and my family and my profession I wouldn't be here the biggest award I've ever gotten is my middle son who is now getting a degree as a counselor in mental health he said to me mom you are no longer crazy I passed I passed that's it I got certified I never thought I'd be a mom I I'd have a child ever and that's really changed me everything that I was able to kind of swim by even even as a care provider because I had my daughter in residency it impacts me so much hard but more deeply now it's like a part of my heart just really is now totally raw and exposed and that's what motherhood did to me and I just that opportunity I never thought I had I just I'm not straight I you know I didn't think I'd be in a ever be in a traditional relationship where I would have a child I thought maybe you know I might adopt a teenager at some point yeah it wasn't need but I just never thought I'd have my own child that was the biggest surprise and then all the changes it really makes you different I was about 14 or 15 and far enough back that we still read this Saturday Evening Post and there was an interview there of I think two of the Menninger brothers they talked about you know what it's like being a psychoanalyst and topeka at that very distinguished Menninger Foundation and one of the things on the like the second page was what does it take to be a psychoanalyst you know you want to be interested in history you want to be interested in science you want to be interested in literature you want to be interested in poetry politics for sure and it was a list of things and I looked at that and I thought I think that's who I am I think I'm that curious about a lot of things in the world that this would match well with my the way my mind works and what I would be most interested in spending my life doing and so that was my compass heading there was to be a psychoanalyst at that very tender age that set the course of a life there really and my life as much as anything has been organized around you know how the mind works and working with people to help them understand their own mind not to mention understand more about how my mind works and the the you know the reality is you can't really help people in this field and lych unless you let your mind merge to some degree and experience with the people you're treating my own life experience is an a copious abundant and endless resource because I feel there's very important to start identifying immediately with the patient and out of that to have some activation of my own impinging narrative theme and that is what I call the subordinated subjectivity of the therapist when I'm working with people I use a lot of stories because growing up in the south the truth is very difficult to apprehend but a story you can get across information to people I guess Christians will call that like telling a parable or something of that sort so that's something that's really helped me a lot in being able to understand the human condition and presented in terms of small vignettes was more akin to Aesop's fables or something of that sort and I think that helps open people up that's the thing you you have to get sometimes a little creative with your patients because they're not going to fit into you know sort of a cookie cutter mold of what medicine should be or what the doctor-patient interaction should be so sometimes and I work with some young adults and sometimes with them like they can't even tolerate sitting in the office because they're too anxious or it's just too clinical for them so sometimes you just be like let's just go for a walk we'll just do this session on a walk if you're okay with it you know I think I have a very casual style so sort of the way I talk to patients is just like I would talk to almost like a friend without you know sharing some about myself but like dude what were you doing why are you doing that what's going on you know tell me what's happening with you and sometimes that can work the key element is reinstalling a sense of purpose and meaning and we found this also with the subjects in our research study who had advanced metastatic cancer were close to death we treated them with psilocybin session one session moderate dose and it really facilitated a reconnected to who they were which they had lost in the throes of the crisis of the illness I had a series of remarkable experiences and the Brazilian Amazon when we were conducting our study and ayahuasca was a topic of our study and in a religious context it was government sanctioned so we were invited to participate in ceremonies and yeah I think it would have been very rude to say no you know so I participated in ceremonies and they were up and they were extraordinary you know just having these you know powerful psycho-spiritual experiences having heart-opening experiences also gaining insight into my dynamics the dynamics of my life those around me and tremendous inspiration to continue to work both with the research as well as as a healer as a doctor as a psychiatrist it I think it really helped me access more of my potential at this point in my life I'm kind of quasi retired from being back that adventuresome but the memories are there and that experience is still with it and I and I can kind of reconnect to it that that's right that's the path that's what I need to keep focusing on the role of love is crucial in all of this that the glue and the engine that promotes both organization and function is the process of human love now I didn't invent this I mean I can mention and this is a controversial figure Martin Heidegger but you know Heidegger said we are born we are thrown into relationship we are heading to death but what saves us from instant grim depression is relationship the relational bonds and processes are I would say based on loving potentials and actualities so that love is crucial a loving self emerges under favourable circumstances one could say that the therapeutic process in my opinion is the progressive emancipation of the loving self tell us when did that accident actually occur or tell me well it happened on a Friday afternoon on May 16 2008 like I said right on front of the building here I was crossing the street on a Friday afternoon I pushed the walk button the traffic on Wilshire had stopped I was in the crosswalk and there's that low electronic count on was going 17 16 15 and I said the sense something was coming at me I looked to my left and here a motorist was coming up Westgate about to make a left turn to go west on Wilshire and did not see me clearly and I had no idea my mind worked as quickly but these are the things that happened in a split second you don't have time to go forward you don't have time to go backwards if this car hits you you're gonna get thrown like 50 feet and it could be the end of you you've got one play here I threw myself up on the hood of the car and kapowee and what did the person say did you ever hear them apologize or well I did actually which is a rather sad and rather poignant as I'm laid out on the sidewalk there's a semicircle of people formed around me it was like three or four there must have been 50 people I'm not exaggerating at all it was Friday afternoon a lot of foot traffic and people are yelling all kinds of things don't give up somebody yells out you're gonna live you're gonna live yeah that's nice and I'm just laying there and within no time at all I could hear the whine of the paramedics you know the siren coming and but then from one of the back ranks oh my god I'm sorry I didn't mean it I didn't see you it was a woman you know probably in her 50s who was completely distraught you know she was the driver of this vehicle and I said right I already even then as bad off as evidence ladies in bad shape and yeah so that was my apology and it was heartfelt I had a pretty good recovery out of first-hand experience of post-traumatic stress though I went through these periods why I'd have like it was like surges of anxiety my heart would start beating and I'd start sweating and any time I got near an intersection where I was crossing in my pedestrian my head was on a swivel that wouldn't stop yeah and then I got depressed for a while and I went through this kind of crazy line of thinking like you know maybe somebody is out to get me or maybe that's a little paranoid or how about the depressive side maybe I deserved it I mean I think oh my god you're having these thoughts this is insane I was very clear I was coming to do psychiatry and I was clear that I was going to go back to Ohio to our home hospital and during my medical school studies we merged emerged with Ohio State University and then essence the Harding Hospital became part and parcel of Ohio State University and so I really didn't have a home to go back to so that all changed and when I was at UCLA doing my fellowship my father was actually recruited to come to Loma Linda and so the thought that ah I would never be able to work with my my family all the sudden became an opening here at Loma Linda I think coming and working with my father who is actually having the the language that he spoke I learned French I learned German I could speak to French I could speak to German people but what was George what was psychiatrist George and and the men in our my life what was their language and I think that at working with my father I learned and I I was fluent and started learning that language so that experience was priceless I think all of us go into psychiatry for a reason we like the quirky myths of people and you know the sort of offbeat kinds of conversations you might run into I think it's made me less judgmental and I think it also makes me more humble because no matter what your problems are in your life it's there relative I think in other specialties you know the doctor can be almost you know more friendly with the patient and it wouldn't be as strange to talk about your personal life you know in a doctor-patient interactions with us there's there has to be that space but without being a completely blank slate like they used to teach us to do but if there's one tiny bit of humanity or you know some personal info I think it can just help the patient trust you it can let them know you know you have more going on than just what's in the office it was discouraged you were never allowed to hug your patient yeah shake hands sometimes don't ever touch mm-hmm yeah no touching touching right touching is so important Dutch is so touching is so important can you imagine a patient is doing this yeah and you say I'm not allowed to shake hands right there goes everything you might as well just hang up their coat and you know you and I train together and we remember that little back room that back room is so important to my own sanity that's where we all connect as because our jobs are hard and the things that we see are traumatic I wouldn't say the most unexpected but the most startling I mean has been like patient suicide that's that's something to deal with we know that's someone with their first break of schizophrenia he's gonna be high risk for suicide well we've learned that over time we've learned that from just scientific method looking at cases getting the properties that are similar and understanding that so that being said I feel like the training program has done an incredible job of preparing for that type of thing you know when you take on a certain case that sort of high-risk emotionally knowing what's gonna happen ahead of time what the possibilities are really made that particular situation dealing with it so much easier and better than if it was kind of like well that's a bad outcome and you you know c'est la vie or whatever it was prophylactically treated you know we knew about it and it doesn't take away from the pain of losing someone that it doesn't take away from that so you know it was not easy afterwards can sort of make people feel very scared to take on patients like this again the litigious nature of things and coping with that can be difficult you know someone comes into your office with depression they're going to be suicidal for a long time and if you write that down you know someone's gonna say well why do you're suicidal before they came in your office you know and why don't you do anything and so there's this I mean I don't know as a resident I'm a little bit protective I could imagine you're kind of like a lot more worried when your patient dies it's a lot more rare event and you have this close relationship with them and people don't even know what you're doing in that room therapy-wise you know it can be a lot more controversial it shouldn't be though and I don't think it really is and I think that that part of that has to do with sort of the stigmas with related to psychiatry in in the sort of non scientific community do you think psychologists are different from psychiatrists not really I mean I feel like both of them you know obviously one can prescribe medicine but I feel like both of them can if you can't prescribe it you can at least convince somebody to prescribe it or to want to need it or you know they'll do the follow-up to you know go on WebMD or do the Google searches and then say all right we want you to find someone that can get me like a drug or something like that I guess I would be afraid going to one that medication could be prescribed too quickly without exploring other other avenues because I definitely preferred it to not use medication so I guess I'm a little afraid of it but uh but otherwise I definitely think it's necessary and something some people do need I have a cousin of mine she's she's like a sister to me and we grew up together and you know maybe about a couple of years ago she had some serious mental health breakdowns and she was diagnosed as bipolar schizophrenic and I guess I was very upset that she was given this huge drug cocktail but I noticed some positive changes in her life she started to sound like the person that I grew up with but now I realized that she's relied too heavily on the drugs and when they're not working she really doesn't have someone to talk to about it you know I've never heard her talk about the person if there's a person because she really talks to I never heard her mention it in a human way it's more like the doctors give me these pills for anxiety this pill makes me go to sleep this pill keeps the voices out of my head I've never heard her talk about the person behind the counter behind the desk every single person that comes into my office has like I say in honoring myself go honor them I'm gonna do my absolute very best and I'm gonna also be willing to say I'm not the doctor for you when they come in and they say to me doc I only I want this and this and this and just give me a script and I'm out of here kind of thing that that is fine it's not what I can do for you well since medication has become so important it's an entirely different field I don't think I would go into psychiatry today not I I think medication is wonderful when it works I'm fascinated with what's going on and the chemistry in the brain but I'm not interested in providing medication except very simple medication the growing perception that psychiatrists are simply there to write prescriptions is troubling I find I mean our medications can with some people be a great help but there's there ought to be more to that work than just writing scripts first place I mind and brain are integrated I mean I don't think you can ever think of them as polarized they it's a bi-directional influence that they have mind clearly affects brain structure and brain structure clearly effects mind and how mind functions I mean just the fact that I prescribe medications for people that I work intensively with psycho dynamically I I'm tipping my hat there to the biology of the of the of the brain and continue to believe that's an important part of what we have to offer so what you're saying to the younger psychiatrist would be you must have a good found knowledge of the science for your prescribing I would say so absolutely what else I would also say to those people I hope that isn't all you do I cannot fathom a career where I just had people coming in and a line out the door for maybe 10 or 15 minute meetings after the initial one where they're a med management means I just can't even imagine what that would be like I I think my my imagination would pass away I wouldn't want that and then what do you think it would be like to actually be a psychiatrist I think that a psychiatrist would actually need a psychiatrist because after hearing all the stuff that they have to hear a lot of psychiatrists are sort of held in either held up is like a somebody that's unapproachable or somebody that's evil and it's gonna be hard and you tell someone you're a psychiatrist at a bar you know they run from you it's like you know you're on fire or something you know people are like I don't want to talk to you bye or they tell you everything about their life story that you didn't want to know you know well it used to be oh you can see into my mind that I'm idea seemed to be very prevalent that I was seeing into their mind or that I would want to um I think that people think I know a lot that I don't know I think I don't think I'm smarter than I am first of all and I think that they assume that we know so much about human behavior and interaction and they can ask us questions like why do people do this or why does this happen and you're like oh I don't know I'm doing yeah there's a humility to the I think underlying sometimes physician Lee grandiosity there's a deeper stratum I think of humility look at the jokes what's the definition of a psychiatrist a Jewish doctor who's afraid of the sight of blood now there's a core of humility a sense of the limitations that we humans have which I think gives us a more sharp-edged judgment if we know our limits if we recognize our weaknesses we're more likely to be effective in formulating our approach for me what's worked for me and I you know I think it might work for others is facing your fears I think the more you face your fears easier becomes to feel comfortable with yourself and it becomes easier to challenge yourself and to do things that help build who you are and build your self-esteem and build your ability to be an individual and it's not easy because it's a lot of times easier to sort of walk away from what's scarier unknown like this interview but so I started doing some comedy stuff did you not know this I didn't tell you this oh I never told you that was great okay so fourth year of residency I was chief resident I had a little more time so I decided I'm kind of boring I need to find myself again and just the old you know the little things I used to like to do it was three hours of laughter therapy a week but I got into a comedy show last summer and it was on for the whole summer and it was really fun and I did it you know Monday nights for a couple months and I mean it was awesome it was so much fun and I put I think comedy is like comedy is pain in a strange way and a lot of people who are very good comedians are pretty serious depressives and they have a lot of really good psych minded they're very cyclically psychologically oriented and they really kind of understand the human condition but you know one thing I've come to understand is that life is so complex if you try to find a formula for it you have to be prepared to have mud in your face over and over it's just but I think just having an openness to experience and not being too afraid of it and not being too afraid of being wrong I mean it's beginning to seep in that there is no life without mental health it's beginning okay so my dream devised an approach to educate about mental health in all of its complexity to the leaders of all countries mandatory education the moment you become a press that you have to take that course and have a practicum I'm very hopeful about psychiatry I wish I could be around for another hundred years to see the immense changes as we recognize more and more of our brain function and develop therapies similarly ones that Freud talked about that we can use more directly to what the issue is and how we can get it to work for that specific patient those patients instead of just throwing one therapy at everything do the right thing do the right thing that are in accord with your values do the right thing that will benefit those around you and then do do service to justice to yourself and your own lineage do the right thing in honor of your ancestors I'm very connected to the concept of ancestors you do enough hallucinogens and you study the cultures from whence they came you appreciate that in many respects this is ancestor medicine it allows you to connect to generations that preceded you and there needs to be a human population that has a sophisticated loving attitude towards other human beings not just their own narrow circle with an awareness of Mother Earth's need for loving care and while this is a huge task and I'm pessimistic about whether it can be effectively addressed I think that there is an urgent need for psychotherapy on a much broader scale so I definitely want to do some psychiatric work in Nigeria I think it was dr. Byron that told me that they are for child star catchers in Nigeria yeah and I mean Nigeria is always gonna be home you know so the idea that we have for us that catchers in him I think our population now is how many billion yeah one thing with a lot of developing wall is just this whole notion that you want food handed out to you Oh a manner handed out to you for lack of a better word but just moving from that mindset to the mindset of if I can I'm able you know so that's what I thought what that's what I really love about this whole idea of training the young adults to then do the support themselves so essentially you're saying you're able you have what it takes within your community to do what you know to take care of your problem versus oh we're gonna send you aids like everybody else has done all the governments and they have good intentions but I think that the shift should be okay you are able I think you know the media has heard us a lot just in different TV shows and different movies has given us you know kind of a bad name and in the media I think that part of the stigma that we have is one of Stoicism that were removed that it's sterile that we don't get personally involved that we really don't even know who many of our patients are I mean to be fair and managed care psychiatry that's that is actually the case you don't really know you forgot and that's part of the stigma too is that a lot of people think that psychiatrists are just trying to make them into one thing to bake them well or to make them not have voices to lose their personality if I take this medicine I'm gonna lose Who I am and that's not true because we're trying to actually work with the choices and their freedom to make them the best that they want to be and I think that's a misconception of psychiatrists that we're trying to make them like everyone else if anything we value individuality I think out of anyone what was unexpected that you learned from this process like what about us and what about you it's amazing how many of us are so similar mm-hmm the similarities are incredible I always thought I was much more different so that changed me in a large way I just can't believe how similar I guess I was a little paranoid [Laughter] many of the people we interviewed they were kind of fueled by their own personal traumas to go into the field and seeing that in other people was really comforting like wow like I'm not that special in a really good way you know like oh my trauma or my like hardship like really isn't that's special it's part of what makes me like everybody else and not unlike everybody else I really liked what Kristin was talking about with touch because I think like I totally agree with you the theme of love is very important and I think there's a stigma with love that love is sexuality right and a lot of psychiatrists are afraid of touch and afraid to say love and afraid to cry and afraid to have this kind of like human interaction with people because of the dark history that psychiatry has and now we're like super regulated there's a lot of supervision and we're still I think to this day we still live with that dark history we're so careful with the way we interact with patients and I really like how she talked about that because it also distances us from our patients and when we get more human when we're able to use terms like love and to cry and to touch that's when we can be effective I feel like with my generation it's there's less religion but there's more spiritual that's me too yeah and because you don't believe in a higher power doesn't mean that you can't still be spiritual yeah yeah yeah I mean we all have numinous experiences we all have experiences of things that are beyond us we're probably in a minority but I agree to me spirituality is a mainstay of what I do as a psychiatrist I couldn't function without it when I hear the older guys saying like oh you know the newer generation isn't getting therapy they're not that you know they're doing the biological model blah blah blah blah blah I don't see it that way ICS is like we're taking it to a whole other level like we're taking it way even beyond how has being a psychiatrist changed you well it's made me much more patient things go slowly changes come slowly I hope it has made me more thoughtful I hope it has made me more conscious of what goes on unspoken and under the surface I think the positive impact has been that I really appreciate life I think I've become more humble I think I've come to realize there's a lot about human beings I don't know and don't understand I try sometimes I'm successful in in trying to understand a lot of times I'm not well the thing that keeps me hopeful is that we keep trying to understand each other and it usually we do come to some clearing there the only answer really is to help to facilitate a reawakening and our motivation to reconnect and and a realization of the value of human connectedness and connectedness to the planet [Music] you [Music]

Channel: SoCalPsychSociety

Views: 862

Rating: 5 out of 5

Keywords: psychiatry, psychiatrist, psych, psychology, documentary, career, mental, health, illness, los angeles, l.a., LA, therapy, psychotherapy, transference, psychedelics, video, film, medical, school, medicine, storytelling, child, adolescent, greece, nigeria, mexico, counseling, spirituality, medication, suicide, santa monica, interviews, scps

Id: fQjA_2eVGPA

Length: 74min 32sec (4472 seconds)

Published: Tue Mar 03 2020