SPEAKER_00 0:00

We acknowledge Aboriginal and Torres Strait Islander peoples as the First Nations and the traditional owners and custodians of the lands and waters known as Australia and Maori as Tangata Fenua in Aotearoa. We honor and respect the elders past and present who weave their wisdom into all realms of life.

SPEAKER_04 0:23

Welcome to another Psych Matters podcast from the Royal Australian and New Zealand College of Psychiatrists. Psych Matters is a series of discussions on training and practice issues facing trainees and fellows of the college and other important topics in mental health.

SPEAKER_02 0:38

Hello, Richard. Welcome to the podcast for the Royal Australia New Zealand College of Psychiatrists, and it's a wonderful, wonderful opportunity to have a conversation with you. How are you today?

SPEAKER_06 0:48

Good. Good. We have boiling hot weather here because this is our summer, right?

SPEAKER_02 0:54

I know.

SPEAKER_06 0:55

But with the climate change, we we're getting hit with some big heat. But you know, Italy and France and Europe is uh boiling.

SPEAKER_02 1:02

Yeah.

SPEAKER_06 1:03

Terrible shape, yeah.

SPEAKER_02 1:04

And the part parts of the world also having floods and all in Asia. So I know you you're an avid and chronic traveler. So you're in Boston right now, is that correct? Yes, right. Fantastic. So uh yes, we are in winter, so we're in the southern hemisphere. We're in the last few weeks, or actually last few months maybe of winter. And even though, Richard, we are across two different hemispheres, but I feel really deeply and strongly connected to your work and and also inspired by the work your team and yourself have produced in clinical space, research and education for refugee trauma. So today I would like to delve a little bit deeper with some specific questioning of your work and inspire hopefully the audience of this podcast as well. So, Richard, would would you like to introduce yourself to our audience?

SPEAKER_06 1:58

I'm a professor of psychiatry at Harvard Medical School. I started with my team, the uh uh Indotrane Psychiatric Clinic in 1981, December, and then it morphed into the Harvard program in refugee trauma. So from 81 to 2026, we've been doing this work now for 45 years, and we've seen in Boston over 10,000 survivors of torture and mass violence ourselves. We've treated here and in our clinic, and um, we've also been working with our colleagues in many countries: Haiti, Peru, Bosnia, Japan, Italy, etc. You know, so we have a big project in Italy now in the Italian earthquake zone. We can go into that for eight years now, you know. So our model has never been to send an HPRT person to live in those countries or those places. We've always worked in partnership with our teams in those countries. It's always been a partnership. We met the Australians in 1988. We were invited by the people in New Zealand to, through the World Federation for Malhealth, to come on tour and introduce the refugee work to them. And that's when in 1988, in Australia in Sydney, we met uh all the people at the opening of START, their famous torture treatment. And it began a long journey for me because I was been to Australia many times and I was a Fulbright uh twice to Australia, each time working in the Aboriginal mental health, and have some very, very close friends there in Australia who are both Aboriginal, non-Aboriginal Indigenous people, including someone you know well, Judy Atkinson, who's a very close friend of mine and colleague. Yeah. So I was in Queensland visiting the remote Aboriginal sites with uh Ernst Hunter, you know, who's become quite famous for his work. And early on I met the original psychiatrist, anthropologist, who kind of uh started the Aboriginal mental health field in Australia.

SPEAKER_02 4:16

So amazing to hear just that two-minute summary of your 40 that almost five decades of work. So, Richard, the few questions already pop into my mind, but I I I'd like to perhaps go a little bit into the Harvard program, which is HPRT, which is Harvard Program for Refugee Trauma, and I was uh privileged to actually have gone through that program, the course some years back. So, what I'm interested to know from you, Richard, if you could share the model uh you mentioned that it's it's always partnership with communities, and it's not about going as experts and delivering tools and strategies and the program, but um I'm kind of keen to know from you a few key themes of the model. What are the elements for healing in the refugee space that are key?

SPEAKER_06 5:08

You know, we've been talking about this journey, 45-year journey, and of course the team has been together for 45 years, most of the team. And so I I think talking about 45 years of work is I compare it to talking about a planet, not an island. In other words, there's so many things that went on in the past 45 years that you're really holding in your hands a planet. What's interesting about this journey is that it began in December of 1981. And at that time, myself, James Lavella Sol Showker, and six Indochinese people who had just suffered the tragedy of Vietnam and Pol Pot, Cat Cambodian Josai, which we didn't know much about. We started seeing one day a week refugees in my new clinic that I was running for veterans in primary health care. So we were seeing these newly arrived people from Southeast Asia that were coming to the country by the tens of thousands, millions of them arrived, and they had to go through public health service hospitals. And I was the chief of psychiatry in one of those public health service hospitals, Bright Marine Public Health Service, and we began the experiment seeing refugees in the primary health care clinic, the six of us, and the model has always been the same. Listening deeply to the trauma story, I introduced that term trauma story in 1988 in Frank Achberg's book on violence and PTSD. So we've always had the same model. It was a new idea. One was listening to trauma story, took us seven years to arrive at that point. Two, creating a clinic of tremendous beauty, mostly with art from the Indochinese people themselves. Three, working with bicultural workers who were not interpreters, but were team members who were equal to the psychiatric and psychology and social work staff and were trained in mental health with Swan Torr, my colleague. We've been together working 38 years with Cambodian patients. And so we also used the phenomenological men because at Yale Mini School I was trained in phenomenological philosophy for five years while uh studying psychiatry. And our model was called Epoche from Husserl, where we bracketed everything that conventional psychiatry at that time said about trauma and refugees, saying could be true, could not be true. We didn't buy the conventionalism. And we discovered in our 45 years of work, way back when, that almost everything that conventional psychiatry said in 1981 was wrong. Everything. So we had to create a new field. And UNHCR, with all its 40 years of work working with refugees, never had a mental health component. We were able to add after the site to Cambodian refugee camp work, first study of a refugee camp we did, we published in JAMA. You can look that up in 1993. We introduced the first mental health focal point into UNHCR. And then that focal point became the refugee focal point in WHO. So up and through the 90s, there was nothing in UNHCR and WHO on refugee mental health.

SPEAKER_02 8:32

Which is so impressive and also astonishing to recognize, Richard, as you're saying, that it took a few key people, which which are your colleagues and yourselves, to actually experience firsthand the refugees who just arrived from a very recent war. And then recognizing the limits of uh, as you say, psychiatry and the practices at the time, something kept on inspiring you. And I'm really keen to see if we could highlight some of that. But something did not stop the the intentions that you all had to do to be good and to be of service, and then incorporating you said that uh you know excellent elements of beauty in the in the state space, and then incorporating bic bicultural conditions who are part of the team members. So that that in itself is visionary, absolutely visionary to think about in in the time that you're working. So if you were able to tap into the richer that was you in 1980, what what do you think kept you looking forward?

SPEAKER_06 9:40

I quit medical school because I was racist and I quit. I won't go into details. Then I went to New Mexico to a brand new medical school. New Mexico is 60% indigenous people, 30 tribes. You probably know them, Zuni, Navajo, etc. Right. And I did a year of uh pathology, and then I I was invited, luckily, because they wanted to send me to Vietnam, and I was invited to join a class of 23. This was the third year of medical school class. I worked in Zuni Pueblo, I worked in the Nes Perse Indian Reservation, and I worked in uh Navajo Reservation. And I joined the Indian Health Service. Then I ended up going to Toronto in neurology, and then I went to Yale, where I met the famous Fritz Redlick, who was my mentor the whole rest of my life. Fritz was a German Austrian, didn't know he was Jewish until the end of his life. He had married a famous opera star, hurt the glass, and he came over with other German psychiatrists and founded the Yale Department of Psychiatry, which became one of the greatest departments in the country. I would say he was next to Freud. He was at not at the Freud level politically or fame, but he created American psychiatry. And his famous study, social class in Meloma's, with Hollingshead, a famous sociologist at Yale, had a huge impact on community mental health. And Fritz work with John F. Kennedy, the president, to start the community mental health centers. And I was fortunate enough, because I was at Yale Divinity School for five years part-time while doing my training in psychiatry to be asked by Fritz to take over and eventually run a follow-up to social class and mental illness. And so I did that challenging epidemiological work as a young resident. And also Fritz asked me to write with him first article ever written in ethics called an overview. You could look at Fritz Redlick and Rich Malika, Overview of Psychiatric Ethics. And it was a summary of psychiatric ethics for the first time in the American Journal Psychiatry. So Fritz gave me great opportunity. He was a mentor to me for 30 years. And then I went to England as a Fulbright, ended up in Italy, and also ended up with Douglas Bennett in the Maudsley Hospital. And Douglas Bennett helped shut down Bedlam, the Mental Hospital. He helped shut down the Mental Hospital. And he invented having severely mentally ill psychiatric patients leave the metal hospital, live independent lives, and work. He created factories with them where they owned the factory and made money from the factory. And he taught me what they call upside-down psychiatry. Professor Douglas Bennett's philosophy was take everything psychiatry believed in and do the opposite. Then I came to Harvard and started the refugee clinic.

SPEAKER_02 12:38

Brilliant, brilliant. It seems like I'm getting the vision of a young, extremely courageous, independent thinking, maybe spiritually driven Richard who went places and and followed his inner drives and instincts and also learning from great masters in psychiatry globally. One of the things he we mentioned, and I really appreciate and and thank you for that. You're quoting someone that everything in psychiatry you learn and take it upside down. And I'm wondering if you if you if you want to comment on what you are seeing in psychiatry at this time. And there there are many ways to to be considering how we are practicing, how we are diagnosing as a first. You know, got different classification systems, and then how we provide the services, and it's also dependent on the financial status, where you live, what opportunities you have, and then what outcomes we actually can achieve. I'm wondering if there are some thoughts about how psychiatrists are practiced.

SPEAKER_06 13:38

Well, you know, I'm not an anti-psychiatrist, and I I'm a phenomenologist. And the phenomenologists like our greatest psychologist at Harvard, everyone knows in Australia as well, William James, said, you have to put your hands in the dirt of the human experience. And you have to find a human being behind the facts, the scientific facts. There's a human being behind hemoglobin A1C and uh all these lab tests, etc. There's a human being there, you know. And that's the whole life world analysis of phenomenology, going back to Husserl and Lillian Bilti and others, you know. So I think we're in a very exciting phase because let me put it honestly, in my new book I'm calling New Medicine for a Violent World, we'll talk about that in a minute, is I think biomedical medicine, which is based on non-reductionistic, reductionistic physicalism, materialism philosophically, is fantastic. Let me be frank about this. If I had a brain tumor, I wouldn't go to a yoga master or herbalist to treat my brain tumor. And I've seen, for instance, my wife, who was the head of women's health, a pioneer of women's health for 30, 40 years, I learned a lot from her. Women today don't die anymore of breast cancer. They did 20 years ago. And neither do they have both breasts removed to treat the cancer. They're not deformed either. So the physical is that you know that everything is related to the body, everything is brain-body-based, is a little extreme. And I'm trying to temper that with a different humanistic approach. But the bottom line is that biomedical medicine is fantastic, and all of us know this. And it's hard to compete with the biomedical model, which is based on the fact that everything is brain-body-based. There is no spirituality, there's no conscious consciousness is brain-based. Spirituality is brain-based. Everything is brain-based. Well, I don't tend to agree with that. I I think there is room for a more humanistic. I think if we can combine humanistic medicine with biomedicine, wow, what an unbelievable treatment platform we're going to have. And I know many, many, many surgeons and biomedical people who do that. They'll spend an hour with the patient, not 10 minutes, and talk to them about how the cancer is affecting their life or the treatment. I've had this experience many times. And so I think a couple things we have to own in psychiatry. One is that the decade of the brain was too much. Nobody in my department wanted to hear about anything we were doing because it wasn't about psychotropic drugs. Most clinics in America today are run by corporations, and most doctors spend 10, 15 minutes with the patient. And most primary care doctors interrupt the patient after 11 seconds. This has been well researched. So we we know the biomedical model is in danger. In other words, someone who's been raped comes in, has hemoglobin high hemoglobin 1-A, they skip the rape and they go right to the hemoglobin A1C. You know, they don't want to hear about the human site, you know. I think the other thing, and to be frank about this, is the biopsychosocial approach has been a huge failure because it tried to humanize biomedicine, the biomedical approach, but it never came up with strong indicators metaphysically about what is the social things that are really making people sick. What's the resiliency? What is the vulnerability? The spirituality was left out. Now we had spirituality, legal was left out. We need a different humanistic model than the biopsychosocial approach. I think the approach by Engler 40 years ago was a great attempt to humanize biomedicine, but it's too vague.

SPEAKER_02 17:46

Yeah, I think this alignment or alchemy of biomedicine with a humanistic practice of medicine feels like the next frontier.

SPEAKER_06 17:55

It is, yeah. And I'm excited by it. I I think the surgeons I know are great humanists. They do great work humanistically as well. And we'll talk about the current crisis in the world and they're concerned with that. You know, so I I love biomedicine. I love evidence-based medicine. But that's where you start. You start by being an expert in psychiatry and biomedicine, and then you expand your toolkit to include empathy, reflection, meditation, you know, trauma story, etc. In other words, there's a whole place to go that maximizes. And then, of course, our wonderful colleagues in holistic medicine, we got a tip I had to them uh herbalists, massage therapists, yoga masters. They do fantastic work with patients. Fantastic. And so I I don't want to see biomedicine, alternative approaches to medicine. I love acupuncture, for instance. I go to acupuncture myself because I got dengue fever when I was in the refugee camps and still have some nerve disease from 40 years later, you know, and the acupuncture treats it. But I I think isn't it great to be in a field where you can do evidence-based biomedicine apathy and acupuncture and yoga? I mean, what what a that's unbelievable. What kind of field is that? It's something fantastic.

SPEAKER_02 19:23

Yeah, absolutely. Totally with you on this, and and 100% in agreement. And in fact, I do mention this and bring this in discussion with you know registrars and training doctors and students that holding multiple constructs of understanding human suffering, human illnesses, and learn and grow ourselves as we learn and understand the patients. Become the become the centerpiece. That's wonderful.

SPEAKER_01 19:50

Yeah. I hope that you're enjoying this podcast. If you have a topic suggestion or would like to participate in a future episode of Psych Matters, we'd love to hear from you. Please contact us by email at psychmatters.vback at ranzcp.org.

SPEAKER_02 20:09

Because often the expertise and the uh, as you mentioned, the drive to really nail the problem and get to the bottom of it absolutely is required. But then if it comes at the at the cost of being a human being, aware of what's happening for the patient, the invisible aspects of the of the therapeutic space, which is empathy, compassion, non-judgment, then it becomes most likely these are unsuccessful treatment uh ventures. Right. And then we ponder what was missing and why why the success wasn't there. So I think it's it's brilliant that through work through here, uh, you have worked in mainstream but with populations who are from different backgrounds and have, you know, documented that element through the trauma programs. So, Richard, I would like to know about the healing spaces. You know, in the education platform HBRT, you often talk about the healing space, art, spiritualities, and humanistic practices. So who could say a few things about that for next generation of doctors?

SPEAKER_06 21:12

I don't know what the next generation of doctors are being taught. When I was a young doctor, you could tell the social class and the race and the background of the patient. We didn't use the term people of color then, and we we didn't have any awareness of indigenous people then. And it would smell a pea, it would be dirty, it wasn't clean, and you could tell the social class of the patient by the ugliness of the clinic. So having myself grown up in the worst ghetto in the United States, the South Bronx, knowing what that's all about, we made the clinic the most beautiful clinic in Boston.

SPEAKER_05 21:49

And people would come in and go, This is a refugee clinic? There's a smell of pea. And I said, Well, what do you expect? Because I don't expect this clinic To be more beautiful than the clinic for rich people. Huh, why is that? Just i i it goes against what I've been taught, what I've expect.

SPEAKER_06 22:12

So we've carried this to the extreme, and we have a saying, we work with the new bishop now in Haiti, bishop was McPope Francis, who I knew, made him bishop, and we have a saying, there's no healing without beauty. That's our saying. Now we know that beauty takes place at every level. Like in the biomedicine, the beauty of the clinical approach that's so precise and so scientific is beautiful. We know the beauty of the patient, no matter how deformed they are, if they've been burned or injured or have cancer, whatever. The humanity of the person is beautiful. We know that every clinic, if you don't have it, run out and get it. Every clinic needs plants because there's been a massive amount of research on the role of nature in healing and the importance of plants. My office is a jungle and the patients go crazy over it, and our clinic is a jungle of plants. We'd have people come to our courses and go back to their expensive clinics and fill the clinic with plants because they didn't have a single plant. So anyone's listening to this podcast, if you don't have a plant in your office, you're in trouble. It's a message here. Get a plant. Now, a plant, we know, has a personality, communicates, and we know from the mirror neurons that we're all connected as animals and plants through the mirror neurons. So we we know that we don't have to postulate anymore whether or not we can read a dog's mind or read another person's mind, because they have hundreds of thousands of mirror neurons that we have. It's already in their mind, in our mind, you know. And there are a huge amount of books about how plants, trees feed each other when they're sick, and that's a beautiful world to be networking in. And then we know also that in every patient, no matter how poor they are, that their culture is full of beauty. Every clinic we've been in, every country, we get involved with local puppets. You know, puppetry is amazing and it tells you a lot about the people. So the beauty of the work helps prevent you from having burnout. Moral beauty is where someone helps someone else in a morally altruistic way, and that's beautiful, and that inspires us, the clinician. And so in our clinic, we ask every patient, and we write prescriptions like medications prescriptions for altruistic behavior. We promote altruistic behavior in every patient. Because moral beauty is inspires the family, the children, inspires everybody. We built a beautiful clinic in Haiti that's absolutely gorgeous based on integrating a bird sanctuary with uh gardens and a place for children to play. And in Lebanon, we did the same thing. The kids themselves who were traumatized in Syria, the Syrian refugee kids built a gorgeous school themselves. Now in America we can't do that, in Italy we can't do this. Against the law of kids build their own clinic. But in in Lebanon, we could do it.

SPEAKER_02 25:26

You you worked with the possibilities and opportunities in in those places and remained creative along the way. The field of refugee trauma and working with refugees, so laden with pressures, challenges, systemic issues, not to mention geopolitical situations and crises. I'm wondering how has your team steered itself and navigated through that? And how did you keep keep the hope alive?

SPEAKER_06 25:56

See, the bottom line is the clinical work is a partnership based on teamwork. The patient is a partner in the teamwork. We have to get away from charity, this concept of charity of giving people things that they really don't want, or they in other words, people need to be a partnership in their own development. And so in our work, we have a saying, what is clinical work? Two people, usually a team, working together in a shared empathic partnership to create a new worldview. That's therapy. Now, if you break this down, the patient and the family has partnership towards you, you have empathy towards the patient, and you share that. We hardly think about clinically the empathy coming from the patient. I'll give you an example. My mother died a couple years ago in a Cambodian clinic. Cambodian women, they don't like people touching them. They came in, a Cambodian woman came in, grabbed my hand, held my hand, and said, I'm so sorry your mother died, and she started to cry. I started to cry. The next 30 women that came in did the same thing. They had shared in the community that my mother had died and Richie Malika, Dr. Malika, needed some support. They reached out and gave it to me. I didn't ask for it. They were surprised. Most of my patients I've seen 35, 40 years, through having a child, the adolescents, etc. The adolescents of their kids, etc. And so we're close. What did they like about coming to the clinic? An Australian colleague of yours asked me to do this, you know.

SPEAKER_05 27:44

And I asked them, and they go, What? You're trying to get rid of me? I said, What are you talking about? I'm trying to get rid of you. I'm just asking you, what do you like about the clinic?

SPEAKER_06 27:53

Why do you keep coming? And they they got really upset and they thought I was trying to fire them. Everyone said the same thing. They said, We're family. You're part of our family. After 40 years, you've been to the temple, you've been to the marriages, you've been to the funerals. We don't want to quit the clinic. We love coming. I said, okay. So not one person was uh transferred out of the clinic.

SPEAKER_02 28:20

So it was not about the patient is healed from their psychiatric conditions and you could pull out. It was that your staying available meant they could continue healing and growing. And then trauma healing, as we know, it's not a two-year journey. So so that sort of highlights the the humanistic connections you held with the patient and they also developed empathy towards you in your times of grief and loss. Which is so beautiful. Yeah, thank you for sharing that, Richard. So my mind now goes to learning from you and and especially for our audience. You know, we're talking about the hope, and and today's uh top title of the session is The Refugee Trauma, the wounds the the the people experienced through displacements, uh persecution often, isolation, woundedness, complete shattering of identity or soul of the refugee human being. And I I'm just wondering through that wounding as you witness that, how do you keep the sense of hope for the patient and for yourself as a clinician?

SPEAKER_06 29:25

Wonderful question. In my book, Healing Invisible Wounds, I talked about humiliation. See, humiliation is the atomic bomb of emotion. The woman working in the Middle East came up with this. But I like that. You use you the tools of humiliation and attack humiliation to create the state of humiliation and to annihilate the person, the family, the town, and the culture and the society. Yeah, so unfortunately, none of us have the emotional intelligence and the skills to identify in ourselves deep humiliation. I've never had one patient out of the tens of thousands that I've seen, I've never had one patient say, I've been humiliated. They'll describe deep humiliation, but they don't use that word. Moving someone out of the state of humiliation is a long journey. It's a very hard journey to repair the damage done by humiliation. And I think clinicians need to know that. They need to try to understand the humiliation the person went through. The first step is listening to the trauma story. But the trauma story might have to be told over a five-year period. It may trigger too much in the first year to tell the trauma story, or they may hide it. So you have to really wait patiently to listen to the trauma story. You have to hear the patient's story. It's crucial. But it's not buried treasure. You can't say, You're a new patient. I heard you were experienced uh terrible violence in the Congo. Tell me your story. The patient will clam up and not say anything, you know. So you you need time. You may spend 10 minutes every session on a trauma story, and that's it. Maybe that's all the patient can handle. I've listened to patients for years, just five minutes at a time. You don't need to rush into it, you know. But then finally, once they tell the story, they feel a tremendous relief, you know. Empathy is very important because most of our clinicians have poor supervision and experience empathic distress from these stories and a burnout. Every clinician who works with highly traumatized people need a good supervisor. See, all the people listening are fantastic empathically. That's dangerous. Too much empathy will fry your amygdala, your nervous system. So we we have to learn how to titrate our empathy. And that's hard to say to people because they they want to be caring and empathic and loving and affectionate, and so they they don't have ways of controlling empathic distress. We know scientifically the patient will transfer all of their distress to the therapist, to the doctor. But the doctor also comes in upset and will transfer all of their stress to the patient. Work goes both ways. Yeah. We have to deal with empathic distress, and my crusade now is better supervision. Maybe in Australia you don't have that problem, but but in America we do now, especially now with the collapse of the community health centers, et cetera.

SPEAKER_02 32:25

Exactly. And burnout in this field, particularly in refugee trauma and and and any trauma field really, the burnout and empathy fatigue are real problems. And I think supervision, self-care, titrating, empathy, even developing ways of looking after your own self, physically, mentally, emotionally become very critical. I'm pleased to hear that you have recognized that over the years. Richard, we're coming to the to the end of this wonderful conversation and a masterclass in ethics, philosophy, and trauma healing in psychiatry. So really, really grateful for for your uh presence and wisdom and knowledge. What do you think is is the next venture for people who are interested to enter the field, want to work in this field, and also contribute in research and education?

SPEAKER_06 33:17

Well, this is a great question because in our country, we we run a technical assistance center for 35 programs funded by the government that treat survivors of torture, all the clinicians are quitting. And the young people are quitting because they see no future in this field. So if you say to a young person, hey, you want to hear horrible stories every day and not have lunch and get no supervision and get low pay, why don't you come into our field?

SPEAKER_05 33:46

You get what I'm saying? It's ludicrous. I say the opposite.

SPEAKER_06 33:51

I say, come into the field. You don't have to destroy yourself being in this field. You can have a balance. With good supervision and good support, you could work with people from other societies, other cultures, have the honor of learning about their life and their society. And through listening to the storytelling of their culture and your culture, you can have a beautiful career. Now let's talk about hope. You know, Pandora's box, after she opened it up, she found at the bottom hope, right? I've been thinking about this a long time. Hope is not wishful thinking. Oh, I hope for more money, I hope for a better car, I hope for a better relationship. A according to Gabriel Marcel, M-A-R-C-E-L, Gabriel Marcel, one of my great idols, a phenomenologist in France during the Nazi occupation, said, Hope is a community of hope, not an isolated, oh, I wish to say you're you're part of a community that hopes. And also, this gets into the biomedical difference than biomedical. You allow for the fact that something mysterious and wonderful is possible to come out of nowhere to change your life and to make you into a more loving, affectionate, and better doctor, clinician, and person. So you are open to the mystery of life because we never know what's coming our way that's gonna make a better world for ourselves and our patients. We gotta be open to that.

SPEAKER_02 35:30

What an amazing, amazing way to end this episode to think about hope, hope in medicine, and hope in psychiatry and hope in clinical work across the divides of fragmentations, trauma, torture, complexities, divisions, silos we see across all spheres of our lives.

SPEAKER_06 35:51

I love medicine. I mean, how how can you imagine a poor little Italian kid from the worst getter in the United States could have the opportunity and the honor of becoming a doctor? Every single medical person believes that all life is sacred. Can you imagine that working in a world where every one of your colleagues believe that life is sacred? You know, this is a beautiful thing, isn't it? To have this job.

SPEAKER_05 36:24

I mean, how how can you beat a job like this?

SPEAKER_02 36:29

We might have many, many recruits to to join psychology and psychology after this podcast. Richard, so amazing, and I am so deeply grateful and honored to see you. It's been a number of years since we last connected, and I'm also privileged to have shared uh your knowledge, skills, expertise through this platform to our audience. And I look forward to many, many years of your good work. Your new book is coming, which we will uh put in the show notes, and also uh staying connected to hear what's next, and also learning from you and your teeth.

SPEAKER_06 37:05

And you're a great role model, so don't forget, Linda, you're a wonderful role model, and it's wonderful you're doing this because you have a lot to teach people, and I'm honored that you asked me to do this, and I admire your work tremendously.

SPEAKER_02 37:20

Yeah, likewise we'll show thank you so much.

SPEAKER_03 37:24

We hope you enjoyed this episode of Psych Matters. Feel free to share it with others and keep an eye out for future episodes. Psych Matters is produced by the Royal Australian and New Zealand College of Psychiatrists.