Things I’ve Learned This Week

 

I timed my teeth brushing and was way under the recommended 2 minutes. Time yourself.

I was told by the advisor for the Brain/Gain program – a large campaign to bring scientists back to Israel – that my “age may be a problem” in finding employment.

Studying for the Geriatric Psychiatry boards is tedious and most likely useless.

I can eat sardines for dinner and be perfectly happy.

Even some of my closest friends don’t read my blog.

My hand surgeon can cure things – my carpal tunnel symptoms have disappeared since the surgery – unlike psychiatrists who can barely cure anything. If only we could treat anxiety and depression as easily.

The last season of Girls (HBO) is brilliant.

Bahá’í New Years was March 20-21.

10 Reasons to Visit Japan (that you won’t find in the guide book…)

1. Bathrooms

Once you leave home, finding a bathroom can be a challenge. In Japan, they are everywhere and are taken to a whole new level. Even in gas stations toilets have heated seats and music for privacy, and most of them will give you a wash and dry also.

2. Coffee shops

Dark and quiet and classy. You can sit there for hours and no one cares. Today I had a great latte, a nap, and plum liquor with soda on the rocks. Check out Sowgen and Cafe Bibliotec Hello.


3. Vending machines

When is the last time you saw beer in a vending machine? And quality coffee, in cans, that come out hot!

4. Baskets

A place to throw your stuff when you sit at a cafe or bar. Your hat, jacket, scarf. In Japan everything has its place.


5. Made for sharing.

Food is bite-sized and communal.


6. Ben Fiddich

The coolest bar I have ever been to. 1 Chome-13-7 Nishishinjuku, Shinjuku-ku. 9th floor. Tokyo.


7. Fruit sandwiches

Strawberry shortcake in a sandwich form for breakfast.


8. Cooking Classes

Whenever I travel I like to take a cooking class. This one was one of my favorites. Everybody prepared their own Bento box. This is the one – www.cooking-sun.com

9. Recycling

Japanese are serious about recycling. Not only is there no litter on the street, garbage cans are scarce and people bring their trash home. That’s how much they care.


10. It’s the perfect meeting spot.

If you go off season (steer clear of cherry blossom time and vacations), the airfare is reasonable, considering the distance. You can fly nonstop from most continents.

There is one big detraction I must mention. Although smoking is banned on the streets, it is allowed in bars, restaurants, schools and hospitals ? But that should not stop you from visiting this phenomenal place full of history, charm, Zen and some of the most delightful people you’ll ever meet. 

The Psychiatrist in Film

In residency, I spent a good deal of my time analysing the portrayal of the psychiatrist in film. At that time, Prince of Tides, a movie based on a book by Pat Conroy, was huge and certainly convinced a good number of confused medical students to go into the field of psychiatry. Who didn’t want to be that glamorous Barbra Streisand treating Nick Nolte in more ways than one? She portrayed Dr. Susan Lowenstein and was highly criticised for everything “from the length of her fingernails to the way she crossed her legs.” People could not reconcile that women who get medical degrees can also get manicures. She also showed a vulnerable side, very un-doctor like. She was both a healer and in need of healing.

Cinema and Psychiatry both developed around the 1800s. The first motion picture was in 1885 and shortly thereafter Freud’s “Studies in Hysteria”(Anna O.) was released on film. According to the book Psychiatry and the Cinema, “Both movies and psychiatry focus on human thought, emotions, behavior, and motivation- making the link between the two subjects inevitable”.

The way psychiatrists are portrayed in film gives us insight into the field of mental health care and the prevailing attitudes in society at that time. Hollywood can’t resist the mystery of psychotherapy in a voyeuristic way, like the dark refuge of the confessional. Sometimes we are portrayed as omniscient. Even tough guy Tony Soprano became vulnerable around Dr. Melfi, portrayed magnificently by Lorraine Bracco. Other times we are portrayed as foolish charlatans. Perhaps the most realistic portrayal of a psychiatrist and the psychotherapeutic process is “In Treatment”, an HBO series adapted from the Israeli series. Gabriel Byrne is seen in weekly sessions with patients as an intelligent, intuitive and thoughtful therapist. Silver Linings Playbook portrayed a psychiatrist who used anxiety-provoking treatment methods. Bipolar disorder and Borderline/Dependent personality were presented quite accurately but the illusion that love cures all ills is misleading and over simplified.

While there certainly are psychiatrists that blur boundaries, they are overrepresented in film because that is just what Hollywood does. It’s like the old joke:

Patient: Doctor, since it is our last session, can I just have one little kiss?

Psychiatrist: A KISS?? I shouldn’t even be lying here on the couch with you!

Today, few psychiatrists are practicing psychotherapy. This is relegated to psychologists, who are largely much more adept at it and who receive more training in therapy, while the psychiatrist handles the “medication management”. I believe this is an insurance-driven issue rather than a patient-centered one, but I don’t think this model is going away any time soon. In film, as in real life, many people use the term psychologist and psychiatrist interchangeably. Many people just don’t know the difference (a big one–medical school). I wish I had a nickel for every time I was assumed to be a psychologist (implicit bias as a woman).

The fascination Hollywood has with psychiatry is here to stay. If we will be portrayed differently now that our role has changed is a question. Psychiatrist and therapists need to be aware that patients are coming in with preconceived beliefs and images that are created larger than life on screen. It is quite the hurdle to come for help-the stigma of a psychiatry visit persists. Singling out mental from medical health leads to lack of parity in the heath care system. Sure would be nice if Hollywood could lend a hand in portraying a more realistic image.

I love this clip from Annie Hall (1977). Needs no introduction.

Ask Dr. Annie K: Being There for a Friend

A dear friend of mine lost her father a year ago and consistently brings him up in conservation. It’s hard when she goes on and on about how great he was and how she lost six significant males in her life within one year. My dad passed away ten years ago and I haven’t had one male in my family I could ever count on. My dad was, to put it lightly, a horrible person for the things he did to my mom and family. Every time my friend brings up her dad, it hits a dark sour spot for me. I’ve tried to talk to her about finding a way to find peace with what happened, but everyone handles things in their own time and in different ways. Is it insensitive of me to tell her that I don’t want to hear it so much? It’s ok when she would bring it up every now and then, but it’s very consistent now. I want to be a good friend and be there so I keep my mouth shut, and suppress my own personal feelings. Any advice would be greatly appreciated. Thank you!!
– Anonymous Reader

Love+Medicine

Thank you for this thought-provoking question. It is so hard to see a friend in pain. 

My initial thought is that you need to just listen. There is no time limit on grief and it sounds like the hurt gets reenacted every time another man leaves her. Her psyche isn’t given the chance to heal. Part of being a good friend is to listen to her for as long as she needs you to. We all need to listen more and advise less. While we are wracking our brains trying to give the best answers, all people really want is to be heard. 

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