Eulogies for Psychiatrists Around the World

PSYCHIATRIC VIEWS ON THE NEWS

(Optional Musical Accompaniment: Franz Schubert's "Winterreise," aka Winter Journey)

Like other areas of study, psychiatry is becoming global. That includes many psychiatrists outside of the US who make important contributions to the field.

In large part because of the Internet, we learn about-and communicate with-colleagues from around the world, a process that allows us to hear about the deaths of our global colleagues. Therefore, this edition of “Eulogies for Psychiatrists Who Have Inspired” will go well beyond members of the American Psychiatric Association.

I hope that adding what these psychiatrists meant, or mean, to me personally, will be appropriate. Here, too, you may add your own perspectives if you know any of them.

[[{"type":"media","view_mode":"media_crop","fid":"31489","attributes":{"alt":"Global psychiatry","class":"media-image","id":"media_crop_4867342384688","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3330","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":"","typeof":"foaf:Image"}}]]Elsa Cayat, MD
Dr Cayat reportedly began her psychotherapy sessions by saying to her patients, “So, now, tell me.” Allow me to mirror that by telling you a little about her.

Dr Cayat did not die a natural death. She was one of the Charlie Hebdo writers recently murdered by terrorists in Paris. Besides being a psychiatrist and psychoanalyst, she wrote a bi-weekly column for the magazine titled “The Couch.” I do not know if she agreed with some of the extreme satire of the other writers, the kind of humiliating satire that seemed to me to be the antithesis of therapeutic.

Fifty-four when she died, Dr Cayat was a daughter of a Tunisian Jewish father and apparently had received threatening calls, not only due to her column, but because of her religion.

Her family name, “Cayat,” means “tailor” in both Hebrew and in Arabic. Let us honor her and her name by trying to weave together these and other people who are clashing.

Jack Dominian, MD
Dr Dominian was a British psychiatrist and Roman Catholic theologian who died at the age of 84 in 2014. He long battled the Catholic Church’s emphasis on marital chastity, arguing that genuine love validates any sex, including love between same-sex couples. He correctly predicted long ago that same-sex marriages would someday be possible.

Dr Dominian’s social activism emerged from the experience of many of his patients having unhappy and/or dissolved marriages. He concluded that prevention would be more effective than trying psychotherapy after longstanding discord. Preventive tools would include developing “companionate” love. He himself practiced what he preached, having a marriage which reached its golden anniversary.

He wrote 40 books! Probably the best known covered his interest in marriage and religion, for example, these two books: Marriage: The Definitive Guide to What Makes a Marriage Work (1995) and One Like Us: A Psychological Interpretation of Jesus (Darton Longman & Todd; 1998), explores the early life of Christ from a psychoanalytic perspective.

What particularly got my personal attention was my own interest in the overlap of psychiatry and religion, in my case due to my son being a rabbi with a new book out, What Every Christian Should Know About Passover (Abingdon Press; 2015) . If you take this Passover theme of freedom from slavery broadly, we can all work, with or without psychiatry, at removing the mental symptoms that limit a person’s personal freedom. It has also seemed to me that clergy have the best opportunity to instill the prevention ideas that Dr Dominian advocates.

Henry Grunebaum, MD
Psychiatrists who seem less interested in family psychiatry in our age of biological psychiatry and in a country that values individualism need to be reminded of the life work of Dr Grunebaum, who died at the age of 87 on April 11, 2014. Since the 1950s, he helped in the development of the new field of family psychiatry. In this connection, he was a long-term member of the Group for the Advancement of Psychiatry (GAP) Family Committee.

Perhaps not surprisingly for someone dedicated to family health, he came to value love and compassion, as did Dr Dominian, but what may be surprising is that Dr Grunebaum came to believe that love and compassion were important for our psychiatric work.

That was a conclusion that I separately made for psychiatric leaders. In an in-press book chapter on Ethical Leadership for Psychiatry, I conclude that in essence a leader of a staff is like a leader of a family, and the well-being of the staff should be the highest ethical priority of the leader. That means to lead with love and compassion, coupled with clear and realistic expectations. I would hope and think that Dr Gruneberg might agree.

Juan Jose López-Ibor, MD
On January 12, 2015, this Spanish psychiatrist died at the age of 74. This notice, in fact, was the inspiration for this blog. He was most well-known for being the President of the World Psychiatric Association.

In January 2002, he was featured in a Psychiatric Times article, “Psychiatry in Spain,” [link to pdf] by Jose de Rivera, MD. There, the rise of psychiatry had been disrupted by the Spanish Civil War. Like Germany, psychiatrists generally had to side with Franco or leave.

Dr López-Ibor led the resurgence of psychiatry in Spain, especially during the 1970s. His books were influential, including being the senior editor of One World, One Language: Paving the Way to Better Perspectives for Mental Health (Hogrete & Huber, 1999). This book contained seminal papers presented at the World Congress of Psychiatry.

Once upon a time, I sponsored an award with the American Association of Community Psychiatrists (AACP) for Ethical Practice in Public Sector Managed Behavioral Healthcare. I felt particularly connected to the Juan Jose López-Ibor Award, which places a special emphasis on the enhancement of human dignity of patients and their families. Given the high prevalence of humiliation in personal and international relationships, dignity is essential for interpersonal and international peace, well-being, and mental health.

Yehuda Nir, MD
Dr Nir died at the age of 84. As a Jew, he had to pretend to be a Roman Catholic in German-occupied Poland. He wrote a memoir titled The Lost Childhood: The Complete Memoir (Schaffner Press, 1989 and 2006). After the war, the family went to Israel, where he attended medical school before coming to the US in 1959.

That childhood experience informed his treatment of those traumatized. Many of his patients were Holocaust survivors and their children. Also related to the traumas of childhood, he served as Chief of Child Psychiatry at Memorial Sloan-Kettering Cancer center from 1979 to 1986.

It is only recently that I clearly realized that I would not have been born without the Holocaust. We should be grateful to Dr Nir for not only surviving, but thriving, as a psychiatrist treating the trauma he himself had experienced.

Albert Stunkard, MD
Dr Stunkard died on July 12, 2014, after a career as a world-renowned obesity psychiatrist and researcher. As a Professor of Psychiatry at the Perelman School of Medicine, he pioneered advances in understanding night-eating genetic contributions to body weight, the use of behavior modification for altering eating and activity, the role of serotonin in weight loss medications, and the usefulness of bariatric surgery.

Not long ago, I was asked to speak on obesity on an Internet broadcast. Reading more about Dr Stunkard’s studies, I realize how little I knew.

Emanuel Tanay, MDDr Tanay, like Dr Nir, was a Holocaust survivor, also pretending to be Catholic and ending up in the US. He transformed that experience into becoming a world-renowned psychiatrist. He greatly enhanced our understanding of PTSD, Holocaust survivors, and, interestingly enough, murderers, like the murderers I saw in my work in prison.

He chronicled his life in his book Passport to Life: Autobiographical Reflections on the Holocaust (Forensic Press, 2004). What a model he was of resilience and transforming tragedy into triumph.

John Urbaitis, MD
I knew Dr Urbaitis best among the psychiatrists mentioned here. He was a gentleman, a gentle man, a gentleman psychiatrist. He died in August, 2014.

We exchanged emails now and then. The last one was in response to my request for help on that book chapter on ethical leadership in psychiatry. Shortly after, he wrote back: “Steve, please send me your draft. John.”

He was a model of ethical leadership in psychiatry, especially community psychiatry and the Maryland Psychiatric Society.

I found out that he died suddenly at the age of 72 from a heart attack while attending a music festival in Edinburgh. To my bittersweet delight, I only then discovered that he too loved jazz.

Another colleague, Ken Thompson, MD, gave me permission to reprint part of his toast to Dr Urbaitis:

I see he died suddenly while at the Edinburgh Festival. Too early but a fine way to go for a lover of the mist and pipes. Raising a wee dram to him.

Psychiatrists around the world
We psychiatrists in the US can be provincial at times, so let us learn from the lives of psychiatrists around the world. Some of the ones I have known within and outside of the US can teach us about:

• the importance of love and compassion
• personal and professional resilience
• the power of the pen
• the strength of humility and dignity over hubris and humiliation
• the important overlap of religion and psychiatry
• the keys to general health and well-being

These are the dark, cold days of winter, at least in my hometown. Nearly everything in nature seems dead, but much will return to life in the spring. These psychiatrists are dead and will not spring back to life, except for what they left to psychiatry and to their personal lives.

It is winter in composer Franz Schubert’s Austria. As Schubert, the composer of the song cycle Winterreise mentioned at the outset, once said, “When I tried to sing of pain, it turned to love.”

We invite readers to add their own eulogies in the comments section.

Note to readers: We ask that all readers include their full name and professional titles with their comments.

Disclosures:

Note: As with all blogs on PsychiatricTimes.com, the opinions expressed in this commentary are solely those of the author.