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Psychiatrists, Self-Disclosure, and Suicide
“No one who has not been there can comprehend the suffering leading up to suicide, nor can they really understand the suffering of those left behind in the wake of suicide. It is devastating to all who are touched by it…….” (1)
In an earlier blog entry(2), I wrote about Dr. Quinn Leslie and the many ways in which she has helped medical students and physicians by her gracious piece in JAMA on living with bipolar illness. Now I want to honor three psychiatrists who have lost family members to suicide. They participated in a workshop that I put together at the recent annual meeting of the American Psychiatric Association in Toronto (3).
Dr. Akshay Lohitsa, final year resident in psychiatry at New York Presbyterian Hospital Cornell in New York City, lost his younger brother Pranav to suicide in 2011. Dr. Lohitsa recounted his brother’s derailment, going from a freshman at Case Western with a 4.0 GPA and being “the coolest kid on campus” to a suffering young man with symptoms of OCD, tics, depression, hyperreligiosity, and psychosis. He showed photographs of the two of them growing up, handsome boys with big smiles. My eyes misted over—as did most of the attendees.
Dr. Lohitsa ended on a hopeful note—with a nod to the salutary effects of psychotherapy, passage of time and love. An affectionate paean to Pranav—and all young folks felled by major psychiatric illness.
Dr. Morisa Schiff-Mayer, a psychiatrist in private practice in New York City and voluntary faculty member at The Ican School of Medicine at Mount Sinai, lost her mother to suicide during medical training. She called her presentation “Anger, The Good, The Bad and The Misunderstood” and it was full of lessons for all of us. Her mother’s illness was characterized by unpredictable anger and rage alternating with the loving attentiveness expected of a mother. As confusing as this was for Dr. Schiff-Mayer during her formative years, her mother's clinical presentation at a final psychiatric consultation was not understood or properly interpreted. Her rage was not seen as fear and helplessness after being suddenly widowed but was treated with defensive, detached contempt by the psychiatrist, which exacerbated the problem.
Bearing witness to her mother’s mental illness and ultimately losing her to suicide has enabled her to realize that “as psychiatrists we are not omnipotent. Recognizing our limitations as doctors allows us to approach the treatment of our patients without pretense and with a healthy dose of reality.”
Dr. Karen Miday, a psychiatrist in private practice in Cincinnati Ohio, lost her physician son Greg to suicide in June 2012. He was about to start a fellowship in oncology. Greg suffered from a dual diagnosis – severe alcohol dependence co-morbid with an anxiety disorder. He lived with fixed and unrelenting shame about his condition, which fueled denial, and profoundly ambivalent feelings about treatment. Her personal narrative and self-recriminations as a mother and psychiatrist losing a son to suicide were gripping and powerful. Once again, misty eyes prevailed in the room. She is calling for—and justifiably so—much more psychiatric input and oversight into our nation’s state physician health programs. Far too often, they follow a reductionistic 12-step recovery model without recognizing underlying non-addictive mental disorders and unaddressed psychosocial stressors in ailing physicians.
These three extraordinary psychiatrists are trail blazers. By sharing their personal and painful stories they are fighting the dangerous stigma attached to suicide that for far too long has silenced all of us in psychiatry. I am proud to call them friends.
Michael Myers, MD
References
- Jamison KR. From the Foreword. Myers MF and Fine C. Touched by Suicide: Hope and Healing After Loss. Gotham/Penguin Books, New York, 2006.
- Myers MF. The gift of self-disclosure. February 19, 2015. https://www.psychcongress.com/blogs/michael-myers-md/gift-self-disclosure
- Psychiatrists who have survived the suicide death of a loved one: their insights. Psychiatry.org/annual meeting. Page 146.
Dr. Myers is Professor of Clinical Psychiatry and immediate past Vice-Chair of Education and Director of Training in the Department of Psychiatry & Behavioral Sciences at SUNY-Downstate Medical Center in Brooklyn, NY. He is the author of seven books the most recent of which are “Touched by Suicide: Hope and Healing After Loss” (with Carla Fine) and “The Physician as Patient: A Clinical Handbook for Mental Health Professionals” (with Glen Gabbard, MD). He is a specialist in physician health and has written extensively on that subject. Currently, Dr Myers serves on the Advisory Board to the Committee for Physician Health of the Medical Society of the State of New York. He is a recent past president (and emeritus board member) of the New York City Chapter of the American Foundation for Suicide Prevention.
The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.
