Columns E-interview

e-interview columns Sidney Bloch knowing full well that they are entitled to complete privacy. I frequently wonder what Sidney Bloch is Professor of Psychiatry at they are up to and have to restrain myself the University of Melbourne. He trained in from trying to satisfy my curiosity. the Universities of Cape Town, Melbourne What is the role of the and Stanford. His special interests include in countries emerging from conflict? the psychotherapies, psycho-oncology Participating as decent, ethically minded and psychiatric ethics. citizens. I have always been wary of If you were not a psychiatrist, what as social visionaries, a concept would you do? I first encountered in Raymond Waggoner’s An impresario in the musical world. I have 1970 presidential address to theAmerican sung in choirs since I was a teenager and Psychiatric Association. Since we are much continually wonder at the creativity of too ignorant about the‘bigger picture’, we bringing a chorus, soloists and orchestra should confine ourselves to humble clinical together to perform great classics. and research roles. If someone desperately wants to change the world, he or she should What has been the greatest impact stand for public office. of your profession on you personally? The realisation that everyone has a story to What is the most important advice tell. My encounters with people from all you could offer to a new trainee? walks of life and from diverse cultural back- in which they function. Erikson’s classic Get to know your patients as human beings grounds have taught me that humans are succeeds admirably in this regard. no matter how difficult this may be in some unceasingly fascinating.The uniqueness of cases and then recruit them explicitly to each individual with which I become What part of your work gives serve as your foremost teachers and guides. you the most satisfaction? intimately acquainted never ceases to Getting to know people. Earning patients’ What are the main ethical problems amaze me. trust sufficiently so that they feel com- that psychiatrists will face in the Do you feel stigmatised by your fortable to share their inner lives is most future? profession? gratifying. In effect, I am referring to So-called cosmetic psychopharmacology! On the contrary. I feel privileged to have individual psychodynamically oriented We are poised to enter an era in which chemical agents that have the potential to contributed to the well-being of my psychotherapy, as well as to the form of enhance various psychological functions patients and of many of their families.When family therapy I was trained in byJohn will become readily available.What will be they have expressed any concerns about Byng-Hall at theTavistock and Helm Stierlin, our role in prescribing, if any, and how will the shame they feel about having a mental formerly Professor of and we determine what agents can be of illness, I have encouraged them to join FamilyTherapy at . forces with me to help change the attitudes benefit are ethical questions that cause me of members of society.The vast majority What do you least enjoy? to shudder! Administration, especially budgets. My respond positively to the invitation. Do you think psychiatry is brainless older brother trained as an accountant, my or mindless? What are your interests outside younger one as an economist.They are Neither in recent years, I hope! My symbol of work? welcome to the world of finance. Music is my passion - choral singing and for psychiatry is a modest piece of furniture opera in particular. Also literature, bush- What is the most promising - a three-legged stool.The psychiatrist walking ( is a great country for this opportunity facing the profession? respects the brain and mind (and the inter- pastime) and Jewish Studies (I belong to Achieving genuine complementarity personal realm) when sitting comfortably, two groups in which we read the Old between the sciences and humanities, in supported by three legs of equal length and Testament and Rabbinical commentaries). juxtaposition with the impressive advances strength: science, thehumanities andethics. we are making in neurobiology, the social What single area of psychiatric prac- Who was your most influential trainer, sciences as they pertain to the mentally ill, tice is most in need of development? and why? and the refinement of the psychotherapies. Genuine community psychiatry: that is, A tricky one. I have benefited from a few The caveat is that we remain open-minded achieving the integration into society of our mentors. IrvinYalomhas probably influ- and flexible. enced the way I work: he taught me how to patients, no matter their diagnosis and level engage with individuals who are vulnerable What is the greatest threat? of impairment. Merely keeping someone and in need, and, above all, of empathic Rigidthinkingandbeingderailedbyideology. out of hospital seems an inappropriately understanding. I also learned from him that What single change would limited goal to strive for. Instead, we should we should respect many pathways to substantially improve quality of care? devise the means to promote a satisfying acquiring knowledge about the mind and Someone would have given us the answer if quality of life that enables even the most none trump the others; science, literature it were that simple. Alas, there has never severely ill person to obtain basic satisfac- tions that we tend to take for granted. and clinical observation are but a few. been a panacea available to doctors and How would you like to be Which publication has influenced there are certainly none on the horizon that remembered? you most? I can spot. Community psychiatry, a I wouldbe acting arrogantly if I were to even ’s Childhood and Society. I have wonderful concept and one many of us think in such terms.The greatJewish medi- always required a framework to facilitate an would want to see implemented optimally, eval Maimonides highlighted the understanding of how people at different continues to be elusive. attribute of humility as paramount for the stages of their lives deal with the‘slings and What conflict of interest do you doctor. I could not agree more. arrows of outrageous fortune’and how encounter most often? their inner psychological experiences Wanting to know how my patients are Dominic Fannon interdigitate with the human environment faring following their ‘graduation’ but doi: 10.1192/pb.bp.108.023655

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