Posts Tagged ‘Lois Flaherty’

I am pleased to announce that the inaugural issue of Adolescent Psychiatry in its new quarterly version will be published in January. The following is the Table of Contents.

In Memoriam

Remembering Michael Kalogerakis - Lois T. Flaherty

Michael Kalogerakis, Greek Reminiscences - Nikos Zikilis

Editorial

Adolescent Psychiatry—Past, Present, and Future – Lois T. Flaherty

Special Article

Treatment Outcome of Three Female Adolescents with Borderline Personality Disorder Max Sugar and Irving H. Berkovitz

Commentary—Borderline Personality Disorder in Adolescents Lois T. Flaherty

Perspectives

The Shame Ethic in Adolescent Psychotherapy – John E. Meeks

Keeping it Real: Overcoming Resistance in Adolescent Males Mandated into Treatment – James G. Barrett and Nancy Rappaport

“When Can I See You Again?”: The Immigration Experience, Insecure Attachment and Psychotherapy – Anjana Rajan and Nancy Rappaport

A Psychiatric Perspective on Narratives of Self-Reflection in Resilient Adolescents – Ayelet Barkai and Nancy Rappaport

Reviews and Overviews

A Selective Review of the Research on Juvenile Bipolar Disorder: Implications for Struggling Clinicians – Jennifer Harris

Conflict of Interest as a Possible Factor in the Rise of Pediatric Bipolar Disorder – Edmund C. Levin and Peter I. Parry

Cyber Cruelty: Understanding and Preventing the New Bullying – Ruth Gerson and Nancy Rappaport

Identity and Acculturation in Immigrant and Second Generation Adolescents – Eugenio M. Rothe, Andres J. Pumariega and Diana Sabagh

Albert Ellis’ Rational Emotive Behavioral Therapy – Richard Rosner

Research Article

Identity and Self-image in Turkish Adolescents -Füsun Çuhadaroglu Çetin and Halime Tuna Ulay

The inaugural issue will be free to view and download. The journal will be available both on-line and in a print version. The journal website has been launched. You can view it at www.benthamscience.com/aps

The online manuscript submission system is not ready yet but should be available shortly. In the meantime, manuscripts may be sent to me or to aps@benthamscience.com for manuscript submission

Lois Flaherty, M.D.

I am delighted to report that the inaugural issue of Adolescent Psychiatry will debut in January 2011. This issue (and only this issue) will be freely available on-line. A special reduced subscription rate will be available for ASAP members. This on-line journal replaces our biannual printed Annals which was no longer affordable or practical for our membership.

The contents of the January issue will include articles on borderline personality disorder and bipolar disorder in adolescents, cybercruelty, immigrant adolescents, research on identity and self-esteem, and several articles on psychotherapy. The journal will have a website at Bentham Science Publishers, <www.Bentham.org>, for accessing it on-line, ordering print copies and subscriptions, and submitting manuscripts. The submission, review and editing process will all be electronic. The publisher is offering 2 free journal subscriptions for anyone who requests a library subscription.

As I have previously reported, the new version of Adolescent Psychiatry will be published quarterly. The anticipated dates of publication are January, April, July and October. The deadline for receipt of articles by the publisher is 2 months prior to publication date. The usual time for peer review is 4 weeks, and it is also necessary to allow time for revision and editing, usually another 4-8 weeks. So the minimum time from receipt of articles to publication is about 4 months. So far I have plans for two special issues, one on substance abuse in adolescents and one on early manifestations of psychotic disorders. In addition, I would like to begin a tradition of having a special issue that would include the presentations at the Annual Meeting, titled, The Proceedings of the Annual Meeting of the American Society for Adolescent Psychiatry.

The journal will have a section for letters to the editor as well as commentaries on the published articles. I am hoping that the initial issue will spark some.

Prospective authors who are interested in submitting articles may contact me to discuss their submissions, or send abstracts or outlines of their articles to me directly at AnnalsEditor@aol.com.

BY Lois T. Flaherty

As Secretary of The International Society for Adolescent Psychiatry and Psychotherapy (ISAPP), I have the pleasure of announcing that ISAPP will meet September 14-18, 2011 in Berlin, Germany. Berlin is an exciting city which, since the fall of the Berlin Wall, has regained its status as one of the leading cultural capitals of the world.

President-elect Annette Streeck-Fischer, who spoke at our Annual Meeting in 2006, is hard at work organizing the program together with Fritz Resch, program co-chair. The deadline for abstract submission is February 1, 2011 and the deadline for early registration for the meeting is March 2011. The official language of the meeting is English. The following is their announcement of the meeting.

As president elect I want to invite you together with Franz Resch, chair of the scientific committee, to the conference of the International Society of Adolescent Psychiatry and Psychology (ISAPP) taking place in Berlin 2011 from September 14 to 18. September 2011.

As the topic of the conference ‘Adolescence – a second chance:  Development – Attachment – Neurobiology – Trauma – Psychodynamics – Treatment’ indicates, a broad spectrum of actual scientific findings and issues concerning the care for adolescents will be presented.

Adolescence with its specific challenges has been neglected in research as well as in diagnostics and therapy for a long time. In the lights of data that half of the psychiatric disorders of adults have their onset in youth the question if adolescence may be a second chance is not only important from a developmental perspective but has implications also for therapists, supporting systems, society and policy. The conference dealing with themes between normality and pathology shall bring together well-known experts in the field and professionals working with adolescents in health care.
We would be delighted to welcome you to discuss these important topics in Berlin, a fascinating city with its history, social tensions and cultural highlights.

Annette Streeck-Fischer

President Elect

Franz Resch
Chair of Scientific Committee

The ISAPP meetings always have a number of cultural and social events both for attendees and accompanying persons, and this one is no exception. There are several tours planned, including a walking tour, visits to museums, a tour called “Controversial Berlin” and a special tour of Jewish Berlin. ASAP members who attended the previous meetings in Province, Rome, and Montreal can testify that they are enjoyable and stimulating.

Further information about the meeting, including a list of invited speakers and topics, as well as information about the meeting venue and social program, may be found at the meeting website, www.isapp2011.org.

Perfectionism can be Deadly

Summarized by Lois T. Flaherty, M.D.

College students who experience severe shame if they fail to live up to their own and their families’ expectations for academic success, and who see depression as a sign of failure and weakness, are at particular risk for depression and suicide. In a workshop at last spring’s APA meeting, Kristine Girard, a psychiatrist at MIT, termed this syndrome “maladaptive perfectionism”.

Dr. Girard discussed the high profile case of Elizabeth Shin, who died in 2000 after a fire in her dorm room, which occurred after she took an overdose of medication. She had a history of depression with a suicide attempt, and had received mental health services from MIT.  Her parents brought suit against MIT and a number of individuals, claiming that MIT had failed to prevent her death.  MIT eventually settled the case out of court, which means that this cannot serve as a legal precedent and the details of the findings of investigations are not public. In its aftermath MIT undertook a major self study and implemented changes designed to improve the monitoring of students’ well-being on campus.

Dr. Aradhana Sood was involved in the State of Virginia’s investigation in the aftermath of the Virginia Tech case, in which Seung-Hui Cho massacred 32 students and faculty before killing himself.  Cho had a long history of psychiatric illness and was essentially untreated despite progressive deterioration that was obvious to faculty and students. That case highlighted significant gaps in mental health care to college students and the pitfalls of privacy laws.

The cases raised important questions about the limits of confidentiality and the in loco parentis role of educational institutions, which diminished as young adults were deemed progressively more independent. That both cases involved Asian-American students highlighted the pressures facing these students. Mental illness is strongly stigmatized among this group, leading to denial and reluctance to seek help.

The presenters emphasized that combating stigma, advertising mental health services and publicizing warning signs of depression and suicide are key to colleges’ efforts to prevent suicide. Supportive groups such as Asian-American societies and “Active Minds” (www.activeminds.org ) are also positioned to help. According to its website, the latter organization supports student-run mental health awareness, education, and advocacy groups on campuses throughout North America.

Jack Yen, MD. MPH, (Ohio State University) discussed his institution’s attempts at screening to identify students at high risk. Part of the prevention efforts involve educating staff at all levels – the janitor in a dorm, for example, may be the first to be aware that a student is isolating himself in his room. OSU students may take an on-line survey for assistance.  Psychotherapy including CBT and medication management are available through student health services. Ohio State, one of the largest universities in the US, has developed a federally-funded Suicide Prevention Resource Center with online resources (http://suicideprevention.osu.edu ). The emphasis is on culturally sensitive approaches, so the Center has developed and distributed brochures for each of the main ethnic groups on campus.

In another session, Doris Iarovici, MD of Duke University listed the major challenges facing universities include the high rates of students currently taking psychotropic medication, Internet addiction, and substance abuse. Students often present asking for stimulants after having taken a friend’s prescribed medication and finding it helps the study and retain information, yet have never required treatment for ADD and may be sufficiently sleep deprived to appear as though they have ADD. She advised college health services to use a harm reduction strategy, as it is unlikely most students will abstain totally from potentially harmful behaviors. The phenomenon of “effortless perfectionism,” in which mainly female students present the appearance of academic success without working, is an emerging and significant source of additional stress on college campuses.

In recent years the APA has increased its focus on college mental health, beginning with Michele Reba’s appointment of a task force on this topic when she was President. This year’s meeting featured several presentations on this topic. “The Deadly Years: Preventing Suicide in Asian American College Students.” was the title of a workshop presented by Aradhana Sood, Kristine A. Girard, and Jack Yen, all members of the Caucus of Asian American Psychiatrists.  Dr. Iarovici’s presentation was part of a presentation on generational issues and mental health sponsored by the Association of Women Psychiatrists

BY Lois T. Flaherty, M.D.

James F. Masterson, M.D.

James F. Masterson died at the age of 84 on April 12 in Greenwich Connecticut from complications of pneumonia. He was a psychiatrist and psychoanalyst who was one of the founders of ASAP and was Past-President of the New York SAP. He often spoke at our meetings and contributed to the Annals. He was a Schonfeld Award winner in 2001. He was well known as an expert on narcissism and borderline personality disorder, and described manifestations of these conditions throughout the life cycle, including in adolescence.  He was among the first, along with Heinz Kohut and Otto Kernberg, to apply object relations theory to the understanding and treatment of personality disorders, maintaining that these disorders had their roots in infancy and early mother-child relationships. Dr. Masterson believed that these disorders crucially involve the conflict between a person’s two “selves”: the false self, who the very young child constructs to please the mother, and the true self.

An article in Wikipedia (http://en.wikipedia.org/wiki/James_F._Masterson ) states:

In 1993 Masterson proposed two categories for pathological narcissism, exhibitionist and closet. Both fail to adequately develop an age- and phase- appropriate self because of defects in the quality of psychological nurturing provided, usually by the mother. The exhibitionist narcissist is the one described in DSM-IV and differs from the closet narcissist in several important ways.

The closet narcissist is more likely to be described as having a deflated, inadequate self perception and greater awareness of emptiness within. The exhibitionist narcissist would be described as having an inflated, grandiose self perception with little or no conscious awareness of the emptiness within. Such a person would assume that this condition was normal and that others were just like them.

The closet narcissist seeks constant approval from others and appears similar to the borderline in the need to please others. The exhibitionist narcissist seeks perfect admiration all the time from others.

In 1977 Masterson established The Masterson Institute for Psychoanalytic Psychotherapy in New York. The institute offers psychoanalytic training at its headquarters in Manhattan, its West Coast branch in San Francisco and, via the Internet, locations around the world. He was long associated with the Payne Whitney Clinic, where he headed the adolescent program, and at his death he was clinical professor emeritus of psychiatry at Weill Medical College of Cornell University.

Dr. Masterson, authored many books, including “The Psychiatric Dilemma of Adolescence” (Little, Brown, 1967).

The New York Times obituary on April 18 noted. “Dr. Masterson became so well known as an expert on narcissism that he sometimes attracted patients for whom only a high-profile therapist would do — in other words, narcissists. In the 1980s, after The New York Times cited him as an authority on the disorder, he received a dozen calls from people wanting treatment.

Too busy to accept new patients, Dr. Masterson referred the callers to his associates. As The Times reported in 1988, not a single one made an appointment.” <http://www.nytimes.com/2010/04/19/us/19masterson.html>.

Dr. Masterson is survived by his wife, Patricia, whom he married in 1949; two sons, Jim and Richard; a brother, Richard; a sister, Joan Masterson; and three grandchildren. We will miss him.

Michael G. Kalogerakis, M.D.

Lois Flaherty, M.D. and Shelley Doctors

Dr. Michael G. Kalogerakis, 83, died suddenly on March 14 while on vacation in Florida. A psychiatrist and psychoanalyst, he was Past-President of the American Society of Adolescent Psychiatry (1978-1979) and winner of the Schonfeld Award. He also served two terms as President of the International Society for Adolescent Psychiatry and Psychology. He was a beloved friend, colleague and mentor to many in both organizations.

In addition, Mike, a long-time New Yorker, was the former Associate Commissioner for Children and Youth, at the New York State Office of Mental Health.  As Clinical Professor of Psychiatry at NYU School of Medicine, and the former Director of Adolescent Services at Bellevue Psychiatric Hospital, he trained a generation of young psychiatrists, stimulating in many a passion for the study of adolescence and the pursuit of lifelong careers as adolescent psychotherapists.

Mike served as a Board member for 25 years for the Citizen’s Committee for Children of New York, the oldest child advocacy organization in the U.S., and was President of the Kenworthy-Swift Foundation.  Michael worked tirelessly on task forces and committees of the American Psychiatric Association and the American Society for Adolescent Psychiatry, as well as on various advisory committees, in his ceaseless efforts to improve services to violent and/or delinquent adolescents who came to the attention to the juvenile justice system.  Dr. Kalogerakis wrote over thirty book chapters and articles and was the editor of The Handbook of Psychiatric Practice in the Juvenile Court, published by the American Psychiatric Press, Washington, D.C., in 1992.

His dedication to adolescents influenced countless individuals and organizations locally, nationally, and internationally.  Mike’s infectious enthusiasm won him friends wherever he went.  It didn’t take long before he was able to speak to new friends in their own language–Spanish, Portuguese, French, Greek, and others we’re certain he would have modestly asked us to omit from mention.  Dan Offer, writing in the New York Times online guestbook for Mike, expressed the feelings of many in saying, “I had the privilege of knowing Mike as a colleague and friend for at least 40 years. We shared joint interests in adolescent psychiatry and I considered him one of the wisest and most vivacious persons that I have ever known. We would always meet at the national meetings, have coffee or lunch and share experiences, opinions, and yes, of course, jokes. I will miss him.” Mike is survived by his wife Kay and his two sons, Alexi and George and their families. Alexi is a child and adolescent psychiatrist practices in New York; George is a New York Times reporter who chronicled trips with his father, including a 2007 family cruise off the coast of Turkey to celebrate Mike’s 80^th birthday in (Three Generations on One Tiny Ship < http://travel.nytimes.com/2009/09/06/travel/06personal.html>).
Everett Dulit, M.D.

Everett Dulit, M.D. a long time member of ASAP passed away on June 2, 2010.   He had been ill for some time but died at home in his bed and surrounded in his last weeks by his wife, children, extended family, and friends.

An absorbing book

In Her Wake: A Child Psychiatrist Explores the Mystery of Her Mother’s Suicide (Hardcover)

By Nancy Rappaport, MD, Basic Books, 2009, 320 pages, $25.95

Reviewed by Lois T. Flaherty

This book is an account of the unaccountable – when the author was 4 years old her mother committed suicide. The author was the youngest of 6 children in a prominent Boston family. She and her 5 siblings were raised by her father and a series of mother figures after their mother’s death. The story of her childhood has Dickensian elements but she survived to achieve success in love and in work. This book is an account of her life-long struggle to understand her mother and come to terms with her own traumatization as a result of the cascade of events the suicide set in motion.

Of particular interest to ASAP members will be her descriptions of her adolescent experiences –– she experienced, by any definition, a turmoil-filled adolescence. Psychotherapy played an important role in her overcoming many difficulties, and her descriptions of her therapy from an adolescent’s point of view are worthwhile for any adolescent psychiatrist to read.

Rappaport left no stone unturned in fact-finding – as her mother had been prominent in Boston social circles and politics there was a lot of material available. The book has elements of biography, autobiography and investigative journalism. In a way, the city of Boston is really one of the characters in the story. The parts about Boston politics and history were fascinating.

As another Amazon reviewer, D. Kulick reported, “In Her Wake is a beautiful, powerful memoir about the process of belonging to a family, coming to know oneself, making meaning from the lives of those closest to you, and, ultimately becoming established and grounded in your own identity and life’s mission. We get to know Dr. Rappaport from the inside out, from a frightened child, bewildered and sad about the tragic loss of her mother and confused by her family’s reactions, but also a child who is resilient and is able to develop strong connections with others and see a future for herself. Others who have endured tragic events in their childhood will easily identify with Dr. Rappaport’s journey. It’s more than a memoir though, it’s a tale of hope, connection, forgiveness and learning to forge ahead and make a life of meaning even though there is an emptiness at times. Dr. Rappaport shares how she became a dedicated mother and a child psychiatrist who has dedicated her life to working with children and families affected by adversity. Her book shares how she comes to honor her mother and how her search to know her mother has made her more alive and connected in every part of her life.”

I loved it and found it very absorbing and moving. It reads like a fast-paced novel. But, in addition to the compelling story, the insights are amazing. Using the perspectives of so many different people really adds a lot. I loved the way that Rappaport interweaves her own thoughts and feelings with the narratives of interactions with her family, patients and other people.

There is a beautiful sparseness in her writing and the way in which she shifts from one topic to another is suggestive of actual thought processes, the narrative of an inner life, rather than a historical account.

The book is a good illustration of resilience, a concept that is receiving increased attention, and shows the value of narrative in coming to terms with traumatic experience. This book has already received considerable critical acclaim and I definitely recommend it. An added reason to read it — the author will be speaking at our Annual Meeting in Los Angeles in March!