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Through the Times With Peter Kramer, M.D.: Page 2 of 3

Through the Times With Peter Kramer, M.D.: Page 2 of 3

Kramer served as a senior editor and contributing editor for PT through 1997. His work in community psychiatry, hospital psychiatry, liaison psychiatry and research oversight helped prepare him to write the column.

"I wrote the column from the point of view of someone practicing psychiatry every day, but also someone who was aware of a range of experiences in psychiatry," Kramer said.

"Psychiatrists really read that column," he added. "John did a [readership] study once ... and at that moment, it was the most read part of the paper. People would actually come up to me at psychiatric meetings and look at me as if they had seen me somewhere and ask where they had seen me; I would say, probably on your bathroom floor."

The column led directly to Kramer's first published book, Moments of Engagement: Intimate Psychotherapy in a Technological Age (New York: Norton, 1989; Penguin paperback, 1994), which presented case histories and revelatory encounters with patients and discussed the tools--from medicine to empathy--used to help patients change.

Kramer explained that a book editor at Norton who read his "Practicing" column in its first year invited him to write a nonfiction book for her. The irony of the request was obvious to Kramer. "Here I had been walking around with a copy of my novel and not getting anyone to read it," he said, "and I got an offer from a publisher to sit down and write a book."

Indirectly, the "Practicing" column also led to the publication of Kramer's bestseller Listening to Prozac (New York: Viking, 1993; second edition, Penguin, 1997). In the active private practice he maintained through the years, Kramer observed "changes in my patients that looked to me like changes in personality." What's more, many of those patients attributed particular powers to fluoxetine (Prozac). "I wrote a couple of columns about those issues for PT, and I think in [one of] those columns coined the phrase 'cosmetic psychopharmacology,'" he said. Those columns led to his being interviewed about Prozac in Newsweek and other publications.

Kramer then developed a book proposal and got an agent for what became Listening to Prozac, a book about the "biology of personality" that also explored the ethical questions surrounding a drug that many of Kramer's patients said made them feel "better than well," like different people.

When the book came out, it evoked high praise and strident criticism. Some mental health professionals claimed it dismissed psychotherapy. In statements in Psychology Today, Kramer warned that many have misinterpreted his book, that it is "really more a philosophical book about how the self is redefined in a culture that has biological instruments for changing things that previously were changed through religion or talk therapy" and that psychotherapy remains an important treatment for anxiety disorders and helping patients live with depression (Epstein, 2001). In fact, Kramer has been a member of the editorial board of the American Journal of Psychotherapy for many years.

Because of the book, Kramer was interviewed nearly every day for a year and became, according to The New York Times, possibly the best-known psychiatrist in America. Despite his celebrity status, Kramer sees psychiatry and writing as "humbling professions."

"The fact that you are well known doesn't make your patients get better faster and doesn't make the sentences more felicitous. I think you just have to work at these things every day," he said.

He admits to having "mostly the same life for 20-plus years," which involves writing in the morning and seeing patients in the afternoon. "I did it when it was hard to make a living doing that, and I do it now when it is a little easier to make a living at it," he said. "I do speak more around the country than I would have."

Fame's primary benefit for Kramer is that it has enabled him to write several books. His third published book, Should You Leave? (New York: Scribner, 1997; Penguin paperback, 1999), introduces readers to modern theories about relationships. It features relationship dilemmas of fictional patients, using them as openings to discuss various views of giving advice. The views range from Harry Stack Sullivan and Sigmund Freud to columnist Ann Landers.

Kramer's next book, Spectacular Happiness (New York: Scribner, 2001; paperback, 2002), is a novel about a thoughtful, passionate community college teacher who becomes increasingly disgruntled as he underachieves in midlife, his marriage disintegrates, his beloved son leaves and he sees society becoming increasingly driven by meaningless consumption. He expresses his dissatisfaction by deciding to blow up beachfront homes on Cape Cod.

"The themes of my last four books are some cultural construction of happiness that relates to psychiatry," Kramer told PT. Listening to Prozac is really about what we demand of people in terms of personality traits and how much happiness we have a right to expect, he said. Then, Should You Leave explores how our notions of happiness are connected to our notions of intimacy or autonomy.

The novel, Spectacular Happiness, is about how we understand happiness in a culture that also emphasizes wealth and celebrity, and Against Depression is about how a particular disease affects our vision of what the good life is and what the good life might look like if we were better at treating the disease.

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