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Saturday, 06.03.2021

Martin Kassell: One af a Kind of Psychiatrist by Barry Blackwell

Barry Blackwell’s Reply to William Dubin’s and Jay Amsterdam’s comment’s

 

            Both Jay Amsterdam and “Billy” Dubin, now distinguished late career psychopharmacologists, first met Martin Kassell as medical students and then in more intimate circumstances as psychiatric residents at Thomas Jefferson University Hospital in Philadelphia during the mid-1970s on the cusp between psychoanalytic hegemony and newborn psychopharmacology.

            It was Jay who alerted me to Martin’s skills as a psychotherapy supervisor, his lifelong career contributions and his continuing accomplishments and practice post retirement at the age of 100. Jay suggested I offer to pen a biography and Martin responded enthusiastically.

            I was piqued because this coincided with my own experience touching on the evolving relationship between therapy and medication management in that time period (Blackwell 2012).

            Jay and Billy concur in the components of their experience. Embedded in a training program in which the Chairman and faculty were almost all psychoanalytically oriented, imbued in a rigid orthodox interpretation of behavior they were also in the midst of the modern psychopharmacology revolution still inclined toward an ambivalent view of combined therapy and medication.

            As residents Jay and Billy worked together on Dr. Kassell’s interventional psychotherapy clinic mostly with patients recently discharged from the back-wards of a rapidly redundant local asylum, many with co-morbid medical conditions. Also mostly taking psychotropic drugs with side effects, including tardive dyskinesia; they privately renamed it “The Prolixin Clinic.”

            Three components of Martin’s supervisory skills are evident.

            First, he “Took the analytic concepts, stripped away the jargon and presented them in a practical way” (Billy). Martin was “a role model to me as a young academic psychiatrist. Your invaluable no nonsense approach to psychotherapy also provided me with the ability to survive in the vortex of the academic jungle” (Jay).

            Second were the skill and virtues derived from Martin’s two decades as a competent, independent, primary care physician. “He also taught me to be systematic in my thinking and how to categorize problems” (Billy). “Taking a one credit writing course as a medical student and submitting an eight-page medical history he criticized me for not being pithy enough in communicating medical facts and impressions.” (Jay was awarded an “F” grade he never forgot).

            Third was the manner and demeanor with which Martin supervised his trainees. “He was demanding but never demeaning. Within 5 minutes I realized I was going to have an excellent training experience. Dr. Kassell greeted me warmly and wanted to know about my background and interests. He treated me like a friend and colleague and had warmth that was the foundation of a lifelong relationship” (Billy). He was a no nonsense kind of guy “…a valued mentor and friend … your teaching has far surpassed that of many (often not so effective) psychiatry mentors” (Jay).

            My own brief memoir of Martin Kassell and the lifelong impression his teaching made on two former trainees is of considerable value and relevance at this particular time in the history of psychiatry. The bottom line of Martin Kassell’s therapeutic style was his integrity. After two decades of unsatisfactory experience in primary care he discovered how to understand and help patients deal effectively with their predicaments using principles he distilled from psychoanalysis and applied with conviction in a no nonsense manner. The results gratified his own needs, those of who he mentored as well as the patients he treated.

            In a revelatory review of his personal experience striving to combine psychological understanding with medication. Daniel Carlat analyses a similar contemporary predicament confronting our profession with a stringent analysis of the causes and possible solutions in his memoir Unhinged (Carlat 2010). I will review this book for posting on INHN in the upcoming weeks.

 

References:

Blackwell B. Bits and Pieces of a Psychiatrist’s Life. XLibris; 2012.

Carlat DJ. Unhinged; The Trouble with Psychiatry. Free Press. A Division of Simon & Schuster, Inc. New York. 2010.

 

May 16, 2019