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Interview By Jose Vito, MD
JV: What was it like being the NY County DB President in 2007-2008?
PL: Overall, I would say it was a pretty smooth year. And it was so smooth and productive because of the hard work of so many committed members of the Council. Seth Stein, Esq., Donna Gajda, our Executive Director, and Dr. Hunter McQuistion, our treasurer, did a great job keeping us in the black. Dr. Ann Sullivan made sure that we are always abreast of state and local legislative issues so we always felt we had a voice when it mattered most. You and Dr. Jack Drescher put together an outstanding newsletter, both on paper and on the web. And of course, Drs. Kenn Ashley, and Herb Peyser provided invaluable wisdom and guidance for my year as president.
JV: What was the toughest challenge you faced?
PL: While the Council is truly an extraordinary group of enthusiastic psychiatrists, we have been chronically challenged in our efforts to engage the general membership. This past year, we dedicated the bulk of our efforts on how to best get our members—and especially our members-in-training and early-career-psychiatrists—to feel that they are part of the APA. We revamped some “tried and true” educational, political, and social events, like the Legislative Brunch, the Annual Meeting (formerly known as the Night of the Committees), and numerous Movie Nights under the leadership of our dynamic duo of resident representatives, Nina Urban and Alan Schlechter. Inspired by the awesome energy of Drs. Henry Weinstein, Ann Sullivan and Silvia Hafliger, we started an Ethics Conference and a mentorship get-together, which hopefully will become a tradition at the District Branch. Finally, the Information Technology Committee has also been meeting frequently and working very hard to bring the website up to speed as another avenue for networking and exchanging ideas among our members.
JV: You recently published a new book, Sober Siblings: How to Help Your Alcoholic Brother or Sister—And Not Lose Yourself (DaCapo Books/Perseus, 2008, www.SoberSiblings.com). How did this project come about? What message did you want to convey to your readers?
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Jacqueline A. Basha, MD
Clinical Instructor, Department of Psychiatry
Columbia University
If I had a millions hands, each with five fingers, I probably still wouldn’t have enough to count the number of times I moaned to myself or to my mother that my psychiatric residency was way too long. “Whose brilliant idea was it to make it a four full years?” I’d gripe. “Three would be plenty, two even, don’t you think? After all, this isn’t brain surgery we’re learning, it’s Psychiatry.”
So I graduated feeling at least a year, maybe two, overcooked and more than ready to be out in the big world, free of supervisors and classes, free of someone looking over my shoulder and asking me why I hadn’t asked the patient to do serial sevens, or why I’d picked this drug over that one and if I’d considered other options. By this time I was more than qualified…wasn’t I? All I really needed was a job and I was off to heal the world.
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Petros Levounis, MD, MA
President, New York County District Branch
Addiction treatment in the 20th century essentially revolved around three efforts: (a) facilitating the engagement of the patient with mutual-help groups, mostly Alcoholics Anonymous, (b) confronting the patient’s denial and dysfunctional defenses, and (c) providing methadone for heroin addiction. Addiction Psychiatry in the 21st century has kept (a), discarded (b), and greatly improved on (c).
Many of us in the field of Addiction Psychiatry firmly believe that Alcoholics Anonymous and other mutual-help groups offer a tremendous—but not sole—vehicle to recovery; in fact, millions of people around the world have found support and healing trough 12-step programs. When it comes to providing psychotherapy and counseling, our field has moved from confrontation to motivation, the latter method being best exemplified by the Motivational Interviewing approach. Along with cognitive-behavioral techniques, motivational enhancement therapy is more focused on working with ambivalence and fostering self-efficacy than on breaking down defenses. Finally, while methadone clinics continue to provide invaluable treatment to heroin addicts, there is now a powerful alternative to methadone: buprenorphine is a partial agonist to the mu opioid receptor, with superior safety and tolerability profile and can be prescribed on an outpatient basis in a physician’s private office.
Twenty-first century Addiction Psychiatry has added two more elements to our work with the addicted person: (a) treating co-occurring psychiatric disorders, and (b) using an ever-expanding list of medications that directly address substance dependence.
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