Memoirs have been all the rage in recent years (though not by psychiatrists). Psychologically, memoirs help put a perspective on one's life from which others can learn, too.
Psychiatrists and other mental health professionals likely are more reticent because of the private and confidential nature of our work. In describing our work life for the public, we would have to significantly and sufficiently disguise patients.
However, I may have found a solution. You can create a work-related memoir, as my wife suggested I do. I just finished mine with the working title: Oethipal: Stay on the Ethical Way and Get Off the Oedipal Way! Yes, “Oethipal” is a made-up word. It is a combination of Oedipal (as in the Oedipal complex) and ethical. Here is some of what I learned.
1. Find your bliss
A term popularized by Joseph Campbell,1 “bliss” can be described as the mental state that brings a deep sense of joy. In psychiatry, there are many opportunities to find what you like to do best and have the skills to do so. You may recognize a state of work bliss when you are feeling passionate, energetic, creative, experience synchronicities, and the sense of fulfilling the meaning of your life.
2. Find a workplace that values your bliss
With the physician burnout rate at epidemic levels, mainly because of oppressive systems, finding a suitable workplace is not so easy anymore. Look to find a workplace that engages staff and places an emphasis on supporting their ego-ideal of being a healer. Of course, such a place can be a private practice, where you are your own boss, though having a successful private practice seems more difficult nowadays.
3. Take chances
When I was asked to develop a new academic managed care system, I received as many—or more—cautions from colleagues, compared with recommendations to “go for it.” After being called a "Nazi" and "evil" in public, I wondered if it was worth it. It was. How else to learn the benefits and harm of for-profit managed care than being a participant/observer? I then had the opportunity to write a fictionalized history of the experience.2 The same chance had similar resulting benefits when I agreed to work part-time in a state prison.
4. Know your ethical principles
In my experience in writing and teaching about psychiatric ethics, most of us assume we know what is ethical without checking our more detailed accepted principles. On top of recognizing, as we all do, that patient needs come first, we at the very least should keep in mind that the secondary obligations are to society, colleagues, and ourselves.
5. Learn from friends—and enemies
It is crucial to have the support and constructive criticism of colleagues you can trust. Yet, enemies can point out your weaknesses and where you are vulnerable.
6. Discover new ways to find your bliss
Cultivating a joyful life outside of work can help to counteract undue stress and burnout and provide another opportunity to use one's talents. The key is not only to follow common sense wellness activities, but to find a hobby or other activity that fits who you are. Most important of all is to find bliss in an intimate relationship.
7. Save artifacts of your career
This may be most underappreciated of all these findings. I found it striking how much I forgot or repressed about my career. Perusing old and newer documents brought back many situations to life. Fortunately, I kept reminders of nearly everything, including some photos from work successes and work failures, the memorable and the mundane.
There is no better time than now to begin this process. May is Mental Health Awareness Month. Making a beginning on a work memoir is one way to enhance your mental health.
Starting earlier than I did may have profound ramifications, since self-awareness and counter-transference are so important to our work. If you haven't kept documents until now, consider visiting some of your prior places of training and work, or talk to colleagues who you previously worked with.
Experiment with different ways to do this, such as periodic or mini-memoirs. Personal journals can contribute. If you go all the way and decide to write a complete work memoir, it can just be for loved ones—as mine currently is—or even for publication if you carefully consider patient confidentiality and/or potentially libelous material.
In the final analysis, processing a work memoir may be most important and meaningful for you. Nevertheless, conveying what you learned to others in some sort of summary, say as commentary to this blog or your own blog, can be valuable and fulfill a related ethical priority.
Why not start today? You are unlikely to regret it.
1. Campbell J. The Power of Myth (With Bill Moyers). New York: Anchor Books; 1991.
2. Moffic HS. The Ethical Way: Challenges and Solutions for Managed Behavioral Healthcare. San Francisco: Jossey-Bass; 1997.