Author: artsmuklermd

Art Smukler, MD was born and raised in Philadelphia, went to college and medical school in Pennsylvania, and completed his psychiatric training at UCLA. He is a board-certified psychiatrist, specializing in the treatment of adults with a subspecialty in adolescents. As a member of the UCLA faculty, he ran an award-winning psychotherapy conference for psychiatric residents and received the coveted “Golden Ear” award. He has published in psychiatric journals, and won the award for excellence in creative writing at The Santa Barbara Writers Conference. Now a full-time author, he applies his deep understanding of the human psyche to the motivations of his fictional characters.

IS PSYCHIATRY DYING? A REPRISE, by Art Smukler, author & psychiatrist

by artsmuklermd, posted in Psychiatry, Self Examination, World events, a psychological view

Since publishing this post last October, and living through the tragedy of Robin Williams suicide, my thoughts seem even more immediate and important. We can’t just watch our wonderful profession sink into mediocrity. Too many people need our expertise…

Once upon a time, psychiatrists spent uncountable hours during their training learning how to do psychotherapy. They studied the vagaries of the unconscious, had intensive training presenting cases to highly trained supervisors, read volumes on how the psychiatric greats treated their patients, and helped train psychologists, social workers, MFTs and other therapists to do therapy.

Then Insurance companies sold the concept of managed care. The mantra was simple. Treat symptoms not people. Don’t take time to understand someone, just take the depression and anxiety away. Time is money. A good psychiatrist is one who doesn’t use time, but fixes things quickly. Medication is the cure. Psychotherapy? Leave it to the other therapists.

Well, the insurance companies did what they set out to do. All the money they were paying psychiatrists (and I can assure you that those fees were nowhere near what surgeons or other specialists made) now went to the middle managers who were paid to limit care. Big business defined what was good psychiatry and what was bad psychiatry.

So what does it all mean? Should psychiatrists be happy prescribing medication and just let other therapists do psychotherapy?

To me, psychiatry is a specialty that is a combination of medicine, psychology and poetry. Only psychiatrists go to medical school and have the opportunity to understand the complete person. The mind and the body always work together. One can’t exist without the other. To just prescribe meds is the equivalent of removing only the top of the iceberg. What about the main part of the person, the part that was formed back in childhood, the part that psychotherapy reaches.

In Brave New World, the dubious answer to human pain was the drug “soma”. We can’t let that happen in our society. Just using drugs because they are a cheaper way to calm the masses and save money is short-sighted and hurtful.

Psychiatrists used to be masters of the mind. They used their unique skills to help all psychological professionals understand what people were all about and how to help them combat the psychological torture that was ruining their lives.

Limiting a psychiatrist’s skills to prescribing medication starts at the top. If training programs let this happen, they are short-changing all of us. If psychiatrists just want to make more money and not learn how to be masters of psychotherapy they are no longer masters of their profession. Master carpenters, master electricians, master cardiologists and masters of anything are an important part of creating a society based on excellence. Excellence is what we should strive for.

Is psychiatry dying?

Not in my office…

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

HARNESSING OBSESSIONS TO WRITE BOOKS & STORIES, by Art Smukler, author & psychiatrist

by artsmuklermd, posted in Childhood Trauma, Psychiatry, Self Examination, Writing

Experiences that play over and over in our minds are often the ones that authors can turn into books or stories. Like the lyrics or tunes from a catchy song that you just can’t stop humming, an event or encounter can also keep replaying.

Rather than tuning out the obsessive thought, consider doing everything possible to flesh it out and examine all aspects of the experience. Often, our mind latches on to something for a reason. If we force ourselves to look deeper, there can be a surprising array of explanations that clarify why the experience just won’t go away and leave us alone.

A number of years ago, a patient suffering from intense bouts of depression described how he was placed at bed-rest at the age of six in a pediatric hospital for one year. He was suffering from Legg Perthes Disease, a congenital hip dysplasia, which if not treated appropriately would have led to severe crippling.

I couldn’t get the image of this little boy, trapped in a bed and hooked up to weights and pulleys, out of my head. At first I tried ignoring the image, but it just kept reappearing. Eventually, I sat down and forced myself to examine why this image was haunting me.

The explanation was a lot closer to my conscious mind than I realized. My patient was hospitalized at the Children’s Seaside House in Atlantic City, New Jersey. I had spent my childhood summers not far from where the hospital was located and actually remembered seeing children playing on the hospital grounds. As a child, the sight of those crippled children horrified me. Obviously, even as an adult physician, the memory was still disturbing.

So, one thought led to another and my character, Joe Belmont, a tough Italian medical student, with a traumatic past, was born.

From multiple hiding places within the Philadelphia neighborhood where he grew up, to the Jersey shore hospital where he was placed at bed-rest for 12 nightmarish months, to the financial district of Zürich, Switzerland, Joe desperately tries to unlock the secrets that have marked him for death. Finally he realizes that his only hope of survival lies in the one place he has always avoided, the darkest corner of his own mind.

With a lot of research and work, my obsession with a helpless little boy trapped in a hospital bed, was turned into a novel.

Obsessions are intense feelings about a particular person, place, feeling, or way of life. Many authors follow their obsessions from one book to another. Pat Conroy is obsessed with Charleston and the South, John Grisham is obsessed with renegade lawyers who risk their lives fighting evil attorneys, Lee Childs, in the form of Jack Reacher, is obsessed with the freedom that comes from not being attached to any possessions, except his toothbrush.

Using obsessive thoughts and harnessing them as writers is a means of hooking into our passion and using it in a positive way. How else can a person sit down and spend months and years writing unless they really care about the subject and the person they are writing about?

Art Smukler is an award-winning psychiatrist and author of Chasing Backwards, a psychological murder mystery, Skin Dance, a mystery, and The Man with a Microphone in his Ear. All are available as paperbacks and eBooks.

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