Swimming Upstream: Reflections of a Career Educator
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《精神病学术期刊》
It is an honor to contribute a personal retrospective for this special issue of Academic Psychiatry. Currently, I am an associate professor and psychotherapy coordinator in the Department of Psychiatry and Behavioral Neurosciences at McMaster University. I have spent most of my career developing and implementing an empirically-based, competency-focused psychotherapy program (1). More importantly, I am a wife to a very supportive husband and a mother to a wonderful 10-year-old daughter. Balancing all these roles has not always been easy.
Reflecting on my career, I can identify four factors that influenced my professional development: my academic training; mentoring; my own perseverance; and the support I received from family, friends, and colleagues. Prior to entering medical school, I completed an honors B.A. in psychology at McMaster and a Masters in education at Harvard. This background significantly affected my academic development in that it underscored the importance of reading the empirical literature rather than following individual philosophies or orientations.
But it is perseverance, mentoring, and support that has had the most impact in my professional development. As a medical student, early exposure to women in academic medicine was not encouraging. These women appeared chronically exhausted in their efforts to maintain an academic and family life. They complained of difficulties obtaining senior academic roles, equal pay, and adequate mentoring. Their male counterparts, on the other hand, seemed to have less difficulty maintaining a balance, but few were involved in childcare to any significant degree. Despite these discouraging observations, I chose to pursue residency training in psychiatry, mainly because of my love for the subject area, my previous training in psychology, and my optimism that this was something I would truly enjoy. To ease the process, my partner and I delayed parenthood until after my training.
Residency training was, as expected, a truly enjoyable experience. Making a decision about an academic career was difficult, however. Having been a resident member of the Department Tenure and Promotion Committee made me acutely aware of what was required for one to succeed academically: be a successful researcher, publish prolifically, and obtain consistent grants. Although I was skeptical about reaching this standard, I was encouraged to remain at my training institution to pursue an academic career. Feeling a need to separate from the mother ship and wanting more time to make a decision, I pursued a fellowship elsewhere, at the Hinck’s Institute, University of Toronto.
During my fellowship, I explored the psychotherapy outcome and training research literature. I also became cognizant of the many psychotherapies that had been researched for patients with psychiatric disorders and specific training methods that enhanced therapist competence in empirical trials. None of these findings seemed to have influenced our educational programs. This excited me and moved me closer toward considering an academic career, specifically in broadening the psychotherapy training experience for psychiatry residents. I was passionate and determined about what I wanted to do.
Training with fellows from allied disciplines also made me realize that students from these disciplines struggled with formulating cases and reaching treatment decisions. This stimulated me to develop a model of formulation that was multiperspective in its approach and practical in that it led to treatment options. This model was later published in a book (2).
It was during this fellowship year that I met my first female role model and mentor. She was a child psychiatrist, family therapist, and the director of the Institute. She was intelligent, assertive, and a clear communicator. What struck me most about this memorable lady was her tenacity. She took risks and was not affected by the opinions of others. Instead, she followed through on what she thought was important. A true visionary, she made things happen. At some level, I believe that I internalized some aspect of her: to relentlessly pursue what you think is important, despite its unpopularity. She gave me the confidence to pursue my ideas, to be persistent, and to have courage to stand alone with a vision when others were unsupportive. This enabled me to develop and grow as an independent thinker.
But as I approached the end of my fellowship year, I struggled with the next decision: a full time academic position or further fellowship training. I sought advice from the head of the fellowship program, not because of his role but because I found him bright, direct, and yet warm and understanding. His response was "It really doesn’t matter. What you do now, may not be what you will be doing 10 years from now. So just do what you feel is most interesting to you at this moment." This simple statement had a profound effect on me. I had been so focused on making the "right" decision and less on what I truly wanted to do. His response gave me permission to pursue what felt right at the time. He also minimized the "life and death" quality I had attributed to making this decision. As a result, I pursued what was most interesting to me at the time: a full time academic position at McMaster, where I had trained, with a focus on curriculum development in psychotherapy. So, high on motivation and determination but low on wisdom and power, I returned ready to change the existing psychotherapy training program. I wanted to take an idea I had written on paper, develop it into a program, and implement it as soon as possible. There was only one problem: no one else shared this vision.
Over the next 5 years, I struggled to implement an educational idea in an unsupportive climate. The energy required to implement and maintain this program was considerable. There were no guarantees that it would succeed or that it would lead to tenure and promotion. After many failed attempts, I gave up. Then an acting-Chair, who supported the proposal’s implementation, insisted that I present the proposal again at an important meeting. The subsequent Chair insisted on the program’s implementation and made it mandatory. This was an unusual directive, given that we were the only department mandating that residents receive broad-based psychotherapy training in an evidence-based manner with a focus on competency assessment. But this particular Chair did more for me than any other, encouraging me to publish the program, even directing me to a specific journal (1), and, more importantly, recommending that I pursue the career educator track. He directly stated:
This is what you should do. It is your career path. It is not that you can’t do research, but your passion is in education, and this is what’s important. I wouldn’t recommend getting distracted by any research project unless it is tied to education.
This statement has had the most powerful impact on my academic career. It gave me permission to be a career educator, and, more importantly, I believed that it was valued. This Chair was a true mentor. He was honest and direct, and, most of all, he had integrity. His mentoring gave me the courage to push the program forward, to deal with problems of implementation, and to successfully work with a team of people to produce a successful program.
Support from the subsequent Chair and postgraduate director enabled the program to develop and grow. Financial support and secretarial assistance came slowly, improving only when external recognition of the program was received through awards and invitations to present at other academic institutions.
I have learned, however, that support must be actively sought. You need to seek out good mentors, regardless of gender, age, or interests. I have found that the best mentors have focused on my interest and my potential. Honest feedback has always been appreciated, although not always easy to hear. There have been times when the best advice that I’ve received has come from administrative assistants who worked with Chairs, especially since they truly understood the tenure and promotion process. I have also had an excellent program assistant who has been with me from the beginning of my academic career.
Other academic departments and organizations have provided encouragement when internal support has been low. I have been amazed by the mentoring I have received from organizations such as the Association for Academic Psychiatry and AADPRT. Both women and men from these organizations have been instrumental in helping me with my academic career. On one occasion, a member of one of these groups wrote to my Chair to help me obtain financial assistance to present at a conference. It worked!
And of course, I have always counted on family and friends. I have been most fortunate to have a partner who has been there since the beginning of my academic career. His guidance and never ending support have enabled me to get through the most difficult times. He knows me like no other and is able to tell me the truth, which is always appreciated. Having a daughter has also opened my eyes, making priorities clear. A career is rewarding, but family always comes first. This is not negotiable.
But balancing is difficult. Having a spouse who shares equally in childcare and household activities has helped enormously. However, I still fall prey to the same issues that I think most working women do: the frequent guilt that I am not always there all the time as mother. But as I get older, I realize no parent is able to be there all the time. A "good-enough mother" is a reasonable standard. I don’t have to be perfect.
Coincidentally, while writing this paper I pursued the position of Vice Chair of Education in my department because I wanted to take on an active role in mentoring career educators to develop innovative educational programs that were department-wide. I was unsuccessful in obtaining this position, and very disappointed. But this experience has, once again, reaffirmed for me the importance of mentors and support figures in one’s academic and personal life as well as the need to persevere. It has also reminded me that no matter how unlikely the chances, pursuing what you truly want is always worth it.
The last 13 years as an academic has been rewarding. It has given me the opportunity to be creative, to face challenges, and to grow. It is not an easy road, but directions are always obtainable with the proper guidance from the right people.
ACKNOWLEDGMENTS
The author would like to thank Bruce Linder, Freda Martin, David Goldbloom, Russell Joffee, Nick Kates, Claire Kostyshyn, Wendy Mattingly, Jeff Goldbloom, Laura Roberts, Michele Pato, David Goldberg, and Geoff Norman.
REFERENCES
Weerasekera P: Postgraduate psychotherapy training: incorporating findings from the empirical literature into curriculum development. Acad Psychiatry 1997; 21:122–132
Weerasekera P: Multiperspective Case Formulation: A Step Towards Treatment Integration. Melbourne, Fla, Kreiger Publishing, 1996(Priyanthy Weerasekera, M.)
Reflecting on my career, I can identify four factors that influenced my professional development: my academic training; mentoring; my own perseverance; and the support I received from family, friends, and colleagues. Prior to entering medical school, I completed an honors B.A. in psychology at McMaster and a Masters in education at Harvard. This background significantly affected my academic development in that it underscored the importance of reading the empirical literature rather than following individual philosophies or orientations.
But it is perseverance, mentoring, and support that has had the most impact in my professional development. As a medical student, early exposure to women in academic medicine was not encouraging. These women appeared chronically exhausted in their efforts to maintain an academic and family life. They complained of difficulties obtaining senior academic roles, equal pay, and adequate mentoring. Their male counterparts, on the other hand, seemed to have less difficulty maintaining a balance, but few were involved in childcare to any significant degree. Despite these discouraging observations, I chose to pursue residency training in psychiatry, mainly because of my love for the subject area, my previous training in psychology, and my optimism that this was something I would truly enjoy. To ease the process, my partner and I delayed parenthood until after my training.
Residency training was, as expected, a truly enjoyable experience. Making a decision about an academic career was difficult, however. Having been a resident member of the Department Tenure and Promotion Committee made me acutely aware of what was required for one to succeed academically: be a successful researcher, publish prolifically, and obtain consistent grants. Although I was skeptical about reaching this standard, I was encouraged to remain at my training institution to pursue an academic career. Feeling a need to separate from the mother ship and wanting more time to make a decision, I pursued a fellowship elsewhere, at the Hinck’s Institute, University of Toronto.
During my fellowship, I explored the psychotherapy outcome and training research literature. I also became cognizant of the many psychotherapies that had been researched for patients with psychiatric disorders and specific training methods that enhanced therapist competence in empirical trials. None of these findings seemed to have influenced our educational programs. This excited me and moved me closer toward considering an academic career, specifically in broadening the psychotherapy training experience for psychiatry residents. I was passionate and determined about what I wanted to do.
Training with fellows from allied disciplines also made me realize that students from these disciplines struggled with formulating cases and reaching treatment decisions. This stimulated me to develop a model of formulation that was multiperspective in its approach and practical in that it led to treatment options. This model was later published in a book (2).
It was during this fellowship year that I met my first female role model and mentor. She was a child psychiatrist, family therapist, and the director of the Institute. She was intelligent, assertive, and a clear communicator. What struck me most about this memorable lady was her tenacity. She took risks and was not affected by the opinions of others. Instead, she followed through on what she thought was important. A true visionary, she made things happen. At some level, I believe that I internalized some aspect of her: to relentlessly pursue what you think is important, despite its unpopularity. She gave me the confidence to pursue my ideas, to be persistent, and to have courage to stand alone with a vision when others were unsupportive. This enabled me to develop and grow as an independent thinker.
But as I approached the end of my fellowship year, I struggled with the next decision: a full time academic position or further fellowship training. I sought advice from the head of the fellowship program, not because of his role but because I found him bright, direct, and yet warm and understanding. His response was "It really doesn’t matter. What you do now, may not be what you will be doing 10 years from now. So just do what you feel is most interesting to you at this moment." This simple statement had a profound effect on me. I had been so focused on making the "right" decision and less on what I truly wanted to do. His response gave me permission to pursue what felt right at the time. He also minimized the "life and death" quality I had attributed to making this decision. As a result, I pursued what was most interesting to me at the time: a full time academic position at McMaster, where I had trained, with a focus on curriculum development in psychotherapy. So, high on motivation and determination but low on wisdom and power, I returned ready to change the existing psychotherapy training program. I wanted to take an idea I had written on paper, develop it into a program, and implement it as soon as possible. There was only one problem: no one else shared this vision.
Over the next 5 years, I struggled to implement an educational idea in an unsupportive climate. The energy required to implement and maintain this program was considerable. There were no guarantees that it would succeed or that it would lead to tenure and promotion. After many failed attempts, I gave up. Then an acting-Chair, who supported the proposal’s implementation, insisted that I present the proposal again at an important meeting. The subsequent Chair insisted on the program’s implementation and made it mandatory. This was an unusual directive, given that we were the only department mandating that residents receive broad-based psychotherapy training in an evidence-based manner with a focus on competency assessment. But this particular Chair did more for me than any other, encouraging me to publish the program, even directing me to a specific journal (1), and, more importantly, recommending that I pursue the career educator track. He directly stated:
This is what you should do. It is your career path. It is not that you can’t do research, but your passion is in education, and this is what’s important. I wouldn’t recommend getting distracted by any research project unless it is tied to education.
This statement has had the most powerful impact on my academic career. It gave me permission to be a career educator, and, more importantly, I believed that it was valued. This Chair was a true mentor. He was honest and direct, and, most of all, he had integrity. His mentoring gave me the courage to push the program forward, to deal with problems of implementation, and to successfully work with a team of people to produce a successful program.
Support from the subsequent Chair and postgraduate director enabled the program to develop and grow. Financial support and secretarial assistance came slowly, improving only when external recognition of the program was received through awards and invitations to present at other academic institutions.
I have learned, however, that support must be actively sought. You need to seek out good mentors, regardless of gender, age, or interests. I have found that the best mentors have focused on my interest and my potential. Honest feedback has always been appreciated, although not always easy to hear. There have been times when the best advice that I’ve received has come from administrative assistants who worked with Chairs, especially since they truly understood the tenure and promotion process. I have also had an excellent program assistant who has been with me from the beginning of my academic career.
Other academic departments and organizations have provided encouragement when internal support has been low. I have been amazed by the mentoring I have received from organizations such as the Association for Academic Psychiatry and AADPRT. Both women and men from these organizations have been instrumental in helping me with my academic career. On one occasion, a member of one of these groups wrote to my Chair to help me obtain financial assistance to present at a conference. It worked!
And of course, I have always counted on family and friends. I have been most fortunate to have a partner who has been there since the beginning of my academic career. His guidance and never ending support have enabled me to get through the most difficult times. He knows me like no other and is able to tell me the truth, which is always appreciated. Having a daughter has also opened my eyes, making priorities clear. A career is rewarding, but family always comes first. This is not negotiable.
But balancing is difficult. Having a spouse who shares equally in childcare and household activities has helped enormously. However, I still fall prey to the same issues that I think most working women do: the frequent guilt that I am not always there all the time as mother. But as I get older, I realize no parent is able to be there all the time. A "good-enough mother" is a reasonable standard. I don’t have to be perfect.
Coincidentally, while writing this paper I pursued the position of Vice Chair of Education in my department because I wanted to take on an active role in mentoring career educators to develop innovative educational programs that were department-wide. I was unsuccessful in obtaining this position, and very disappointed. But this experience has, once again, reaffirmed for me the importance of mentors and support figures in one’s academic and personal life as well as the need to persevere. It has also reminded me that no matter how unlikely the chances, pursuing what you truly want is always worth it.
The last 13 years as an academic has been rewarding. It has given me the opportunity to be creative, to face challenges, and to grow. It is not an easy road, but directions are always obtainable with the proper guidance from the right people.
ACKNOWLEDGMENTS
The author would like to thank Bruce Linder, Freda Martin, David Goldbloom, Russell Joffee, Nick Kates, Claire Kostyshyn, Wendy Mattingly, Jeff Goldbloom, Laura Roberts, Michele Pato, David Goldberg, and Geoff Norman.
REFERENCES
Weerasekera P: Postgraduate psychotherapy training: incorporating findings from the empirical literature into curriculum development. Acad Psychiatry 1997; 21:122–132
Weerasekera P: Multiperspective Case Formulation: A Step Towards Treatment Integration. Melbourne, Fla, Kreiger Publishing, 1996(Priyanthy Weerasekera, M.)