During the holidays, my daughter asked me what I thought the most important technological advance has been during my lifetime, and without much thought, I said the cell phone. What I really meant was cellphone/iphone/ipod/wireless/email/texting/blogs/twitter/facebook/ and the list keeps growing! It does truly amaze me to see oceans of humanity in every metropolitan center in the world, almost all of whom have personal communication devices that don’t interfere with each other. And then to see photos of remote locations, say the Serengeti or the outback, with a lone figure, also on a cell phone. Communication technology has truly changed the world.
But communication is what psychiatry is all about, since it has to do with interpersonal human behavior, and I have always been struck with how hard it is to do it well. How quickly anxieties, opinions, or misperceptions can fuel rumors that gain momentum and become “established facts!” I believe that one of our biggest challenges is to remain open to and interested in the views of others, even when they differ radically from our own, but to reserve the right to respectfully question and “fact check” any information, and to keep our balance along the way. We do this, of course, routinely in our work with patients. At the Menninger Clinic, we find the language of “mentalization” a helpful communication framework in individual, family, and group therapy, encouraging patients to “see themselves from the outside and see others from the inside.”
Organizations are collections of individual people. Large group dynamics and systems dynamics are real and important, but they emerge from the interactions of individuals. I have never forgotten the words of one particularly astute Air Force officer, who was among many returning former Viet Nam prisoners of war, when I was on active duty. He described that after Ho Chi Minh died, the prisoners of war had been brought together in compounds of about 40, where they stayed for several months. He recalled thinking “I just wish a shrink could look through the window. All of us were convinced that all of the problems we had back home were thrust upon us by society. Here we were, after 7 years in solitary, and within about 3 weeks we had re-created every one of those problems among ourselves!”
The American Psychiatric Association is a large and complex organization with many important goals and agendas—from proactive and effective participation in the nation’s healthcare reform, to concerns for reasonable compensation for psychiatrists, to fighting the steady drumbeat of stigma, to the very specific needs of each individual patient. I am proud to be a member of the APA and to have had opportunities to work with colleagues on these and other tasks. In the end, I believe that we all have the same fundamental goal—to improve the quality of care (prevention, early intervention, treatment) for our patients. We can do this most effectively by respecting each other, just as we respect our patients as partners, and by always striving to listen, to want to understand the passions of others, and to do the best job we can, however imperfectly, to work toward this shared goal.
Knowledge transfer now occurs at warp speed, and worldwide electronic collaboration is a reality. But we must remember to come up for air, to notice and talk to the people in the room instead of texting under the table, and to remember that as information transfer accelerates, so does the potential for wide and rapid dissemination of inaccurate information, or of words, later regretted, sent in the heat of the moment.
The holiday season is a time of year, however, when communication is at its best, when we put aside our disappointments and pet peeves, and when we reach out to each other. In the spirit of the season, let me communicate to all of you my sincere wishes for a happy and healthy New Year!
