Reporting from Canada, #4: The Art of Speaking Out

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

“I often test a person by his attitude towards Jews . . . The Jews are a symbol for me.” - Dimitri Shostakovich¹

We have been attending the concerts of the Ottawa Chamberfest, which will last 10 days. Serendipitously, right on the heels of yesterday’s news column inspiration on the Holocaust, a music piece of great political resistance was played. Though music is often abstract, sometimes the composer’s desired meaning had to be both implied when there was political risk, and at the same time remain superb music. The second piano trio of Dimitri Shostakovich, from 1944 in the middle of World War II, proved to be such a piece. The Oxbow Piano Trio gave it a searing performance.

Shostakovich himself later conveyed that the piece calls out the extreme in anti-Semitism during the Stalinist dictatorship in Russia, and is intended to portray positive sentiments toward Jewish people. Variations on Jewish folk tunes were used. This concern came at the same time that Russia was under siege from the Nazis. Ultimately, it deals with loss and justice and, as such, generalizes to all oppressed individuals. That would include those with mental illness in our hot-off-the press federal Executive Order “Ending Crime and Disorder on America’s Streets” by forcibly taking homeless individuals with mental illnesses off American streets into long-term institutions.²

Interesting and mistakenly, the musical program notes said that Shostakovich was Jewish. He was not, but he increasingly voiced his concern for Jews at the time as he heard of their murders in the concentration camps.

Unfortunately, we still see other examples of the concerns of the piece currently in society and psychiatry. Though most Jews have left Russia, Russia has turned to invading and destroying Ukraine. The world cooperation goal after World War II remains an aspiration. In America, it is increasingly risky to speak out directly criticizing the federal government.

Clinically in psychiatry, especially dynamic psychotherapy, we see a parallel process to Shostakovich’s music in our patients, who often convey hidden meanings in their presentations. Painful memories and conflicts must be gradually opened up, interpreted, and reframed with the patient.

Understanding and processing meanings is one of the special skills of the art of psychiatry. As Freud admonished against wild analysis, we must carefully and accurately apply these skills clinically and societally.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. Shostakovich D. Testimony: The Memoirs of Dmitri Shostakovich. Volkov; 1979.

2. Ending crime and disorder on America’s streets. Executive order. July 24, 2025. Accessed July 25, 2025. https://www.whitehouse.gov/presidential-actions/2025/07/ending-crime-and-disorder-on-americas-streets/