This comprises the physical entity of the patient. I believe that effective management of mental health problems involves a comprehensive evaluation and understanding of the physical aspects of the patient. This evaluation includes a detailed analysis of the symptoms they are experiencing, any genetic predispositions, previous and current medical problems, medications and supplements that they are currently taking and those that they have taken in the past. A comprehensive understanding of these elements facilitates appropriate selection of potential pharmacologic interventions.
I developed an appreciation of human physiology during my graduate studies and medical school training. My graduate school research was funded by a fellowship of the National Science Foundation. My focus of research was a category of disease referred to as inborn errors of metabolism. I participated in the isolation and characterization of the enzyme responsible for Tay-Sachs Disease. We then isolated and sequenced the gene responsible for that inevitably fatal disease. I collaborated with a neurosurgeon, whom was pioneering novel approaches of delivering medications and other substances across the blood-brain barrier. These investigations are summarized in a neurosurgical textbook for which I had the honor of co-authorizing sections. I performed genetics research for six years.
I became increasingly focused on the clinical applications of that research over the course of those years. I subsequently made the decision to proceed to medical school, which was supported by the U.S. Army. I graduated second out of ninety-six students in my medical school class. I strive to maintain that broad medical knowledge and apply that expertise to the understanding and treatment of my patients.
This refers to the unique mental and emotional nature of an individual. It determines the manner by which a given individual understands and relates to the world. It comprises their ego defenses, inherent biases and motivations and a multitude of other factors. It can be conceptualized as the mental gestalt consequent to all of their life experiences.
I had the honor of serving as a psychiatrist in the U.S. Army Medical Corps for eight years. I worked with active duty soldiers, retirees and their families. I rapidly discovered that focusing solely on the biological aspects of a patient is inadequate. I developed the following analogy: Take a runaway train that is going one hundred miles per hour (the mental illness). Turn off the engine (give a medication), but don’t put on the brakes (therapy). That train will continue to travel many miles before finally coming to a stop. Medications alone might be “good enough” treatment, but will not generally lead to full resolution of symptoms. I subsequently sought postgraduate medical training, ultimately becoming a Fellow of the American Psychoanalytic Association. I also studied therapeutic modalities to include Insight-Oriented Psychodynamic Psychotherapy, Cognitive Behavioral Therapy and Brief Reactive Therapy.
This refers to the current life circumstances of the individual. It includes elements that are supportive (e.g., healthy relationships), as well as those that are detrimental (e.g., unemployment). Various domains include interpersonal interactions, phase-of-life transitions, bereavement, spiritual beliefs, cultural norms and many others.
As a department director in the United States Army Medical Corps, and in private practice afterwards, I had the opportunity to work with a broad range of mental health colleagues. These have included psychologists, social workers, chaplains and mental health educators. I have supplemented those experiences with volunteer work in the religious community and serving underprivileged clients. These experiences have reinforced my belief in the importance of conceptualizing individuals in the context of their over-all cultural milieu.