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Cathy Seilhan: Finding Hope and Giving BackCathy Seilhan looks back on her teenage self and realizes shealways had “an extreme kind of emotion and mood. When Iwas sad, I was very sad. When I was happy, I was very happy.”Even with these mood swings, “life was kind of easy” forCathy. But adulthood — a challenging marriage, a new baby anda demanding career as an educator — created so much stress,sadness and anxiety that she found herself unable to cope.Finally, one day at school during cafeteria duty, a young boyasked how she was doing. “I broke into tears and I couldn’t stopcrying,” she recalls.The school principal whisked her out the door and into theoffice of the school’s trusted diagnostician. The two professionalssat with her for hours as it became clear that she needed morethan an office visit. Cathy was eventually admitted to a behavioralhospital, diagnosed first with major depressive disorder and thenbipolar disorder. She spent six weeks in outpatient treatmentbefore she returned to school.It was as if nothing had happened. “Back then, people didn’ttalk about mental illness,” she notes. “We kept each other in thedark. It seemed like no one would understand, and it seemed tooscary to open. The stigma was huge.”“When you are given the diagnosis, thegame isn’t over. It is just beginning.”— CATHY SEILHANGrateful to the Dauten Family CenterCathy credits her happier and healthier life to her husband, Denton,and to Andrew Nierenberg, MD and his team at the Dauten FamilyCenter for Bipolar Treatment Innovation. The grateful Seilhans aregenerous supporters of the Dauten Center. “I think [the DautenCenter team members] are going to make breakthroughs in ourlifetime,” Denton says. “We are happy to be a part of that.”With bipolar disorder, Cathy says, “practicing forms ofmeditation has great benefits. I began learning the power ofstepping back and being curious about my emotions, insteadof being a victim of them. That was a huge breakthrough.”A Supportive PartnerCathy and Denton married in June 2010. From the beginning,Cathy was honest with him about her illness and its effects. SaysDenton, “it can be really hard. When Cathy is doing well, everythingis so simple and beautiful. When she is having difficulties, it canget tense. It takes a lot of patience and understanding.”4mass general department of psychiatryDenton and Cathy SeilhanDenton also found it helpful to talk to a mental healthprofessional to gain understanding and insight. “He’s learned alot,” Cathy says. “He’s loyal. He’s not going anywhere because of it.”Effective Holistic SolutionsFinding the most effective treatment for Cathy was a “trial anderror” process. She had difficulty tolerating the side effects ofmedication.“When you are given the diagnosis, the game isn’t over,” shesays. “It is just beginning.”The breakthrough occurred when Dr. Nierenbergrecommended that Cathy try over-the-counter supplements. Thatled her to renew a focus on diet and exercise — even a 10-minutewalk would prove beneficial. She is thankful that Dr. Nierenbergalways made the case for the holistic approach. It was cognitivebehavioral therapy, not medication, that became the bedrock ofher treatment.“Over time, I was calmer and less irritable, and happier,” shesays. “I was able to regulate my emotions.”Today, she is retired, which, she contends, makes it easier tobe more open about mental illness, with no worry about stigmaand loss of livelihood.“I want everybody to feel better,” Cathy states, “and to share inmy hope. The frontier is very exciting, and I live a deeply meaningfullife with my bipolar disorder. I want others to know that they can too.”

The Arielle Soussan Fund for Psychedelic Research:A Young Woman’s LegacyWayne Blank won’t forget aconversation with his younggranddaughters at a diner nearhis art gallery 18 years ago. “I was puttingmoney away for them and asked, ‘what areyou going to do with your money?’ Arielle,who was then 7 years old, spoke up rightaway. I’m going to give my money to charity.”That was just like Arielle, he explained,a brilliant and sensitive young womanwho radiated kindness and cared deeplyabout the world. She was keenly aware ofits inequities and wanted to make thingsbetter. Arielle cared about her friendsand the people she loved. Whether it washelping someone overcome their shynessor standing up for someone who was beingbullied, “Arielle was always helping herfriends,” says her mother, Keren Soussan.Arielle’s LegacyA year after her death at age 24, Arielle’sfamily has fulfilled her wish with a giftto the Center for the Neuroscience ofPsychedelics at Mass General. The ArielleSoussan Memorial Fund for PsychedelicResearch supports groundbreaking work toexplore how psychedelics impact the brainand alleviate suffering in people with majordepression.Arielle herself struggled with intractabledepression. While her family was aware ofher depression and her continual search foran effective treatment, they did not realizeher life was in danger. “Her grandmotherand I are discovering now the depths of herdespair, how desperate she really was,” saysWayne Blank.But she was also funny andmischievous, with a love for poetry andmusic and cats and a passion for readingand writing in both French and English.Buoyed by her curiosity and sense ofadventure, Arielle traveled the world,living in Australia for six months andIsrael for two years. In San Francisco,she volunteered for an organizationArielle Soussanhelping undocumented immigrants withapplications for visas. In Haifa, Israel,she worked in a shelter for children ofbattered women.Arielle graduated in 2017 with abachelor’s degree in communicationsand culture from Indiana University inBloomington, a college she selected inlarge part because of its bucolic campus.At the time of her death, she was a freelancenewspaper writer in Bloomington, coveringmusic and movies.Arielle was troubled by the stigma ofmental illness, contrasting the support forcancer patients with the lack of supportgiven to people with a mental illness. “Ariellewas right. I hope that this will change in mylifetime,” says her mother.In part because of her own struggles,Arielle had expressed interest in thepotential of psychedelic compounds for thetreatment of mental illness. “She would havebeen a good candidate for psychedelics. Sheneeded something to help change themind,” her grandfather Wayne believes.The Center for the Neuroscience ofPsychedelicsJerrold Rosenbaum, MD, psychiatrist-inchief emeritus at Mass General, and oneof the world’s authorities on mood andanxiety disorders, founded the Center forthe Neuroscience of Psychedelics earlierthis year because of the promise thatpsychedelic compounds hold to transformmental health care treatment. Studiesshow that even a single dose of thesecompounds can bring previously treatmentresistant patients into remission andprovide sustained relief. “What we dohere has the potential of one day changingmillions of lives for the better,” statesDr. Rosenbaum.The mission of the center is tounderstand how psychedelics promoteneuroplasticity and enhance the brain’scapacity for change, to optimize currenttreatments, create new options for treatingmental illness, and, ultimately, make theterm “treatment resistant” obsolete.“Psychedelic compounds hold thepotential to move the dial on the capacityfor change and provide hope to those inmost need of hope, patients with treatmentresistant illness,” states Sharmin Ghaznavi,MD, PhD, associate director of the centerand director of Cognitive Neuroscience,adding, “patients like Arielle.”In addition to Drs. Rosenbaum andGhaznavi, the center’s leadership includesBruce Rosen, MD, director of the AthinoulaA. Martinos Center for Biomedical Imagingand pioneer of functional magneticresonance imaging and Stephen J. Haggarty,PhD, a leading chemical neurobiologist.Philanthropist and entrepreneur DickSimon, who aims to reduce the stigma andraise awareness of psychedelic treatmentsfor mental health issues, chairs the center’sadvisory board.“The whole team is very impressive,”says Shoshana Blank, Arielle’s grandmother.“We feel that we made a very, very gooddecision.”Arielle’s fund is supporting threeinaugural studies on the effects of psilocybinon different features of treatment resistantdepression. In Dr. Ghaznavi’s words,“Arielle’s story is a reminder of why we dothe work we do.”To contribute to the Arielle SoussanMemorial Fund visit san/.mindscapes newslet ter5

The Advantage of Talk TherapyRobert Waldinger, MD, says many emotional problems can be solved by psychodynamic (talk) therapy.More than 20 million Americans seekhelp each year for emotional problems.The Endowment for the Advancement ofPsychotherapy at Massachusetts GeneralHospital ensures that highly effectivepsychodynamic or insight-oriented therapyis available for patients in need througheducation, research and professional training.Robert Waldinger, MD, is a psychiatristand psychoanalyst at Mass General; professorof Psychiatry at Harvard Medical School;and a Zen priest. Dr. Waldinger serves as codirector of the endowment with Carl Marci,MD, a Mass General psychiatrist, scientist andentrepreneur.What is psychodynamic therapy?It’s the kind of therapy that encouragespeople to talk in depth about their lives —not just about what’s troubling them, butwhat they care about the most. It helpspeople connect their previous experienceswith what’s happening now, so they can seepatterns in their lives.A classic example is the person whofights with every boss they work for. Intherapy, the patient may begin to recallmemories of a difficult father who constantlydemanded blind obedience. The patientmay come to realize a pattern of castingevery new boss in the role of a ‘dictator’ andin this way accidentally undermining workrelationships. Seeing this kind of pattern canbe enormously liberating, freeing people tomake wiser choices.You are a Zen priest. How does that informyour work as a psychotherapist?Both psychotherapy and meditation areways of studying the mind. Zen helps ussee the difference between the stories ourminds create about the world and what theworld is really like. The analogy often usedis the difference between reading a menuand tasting the food. Our descriptions ofthe world — for example, a description ofthe taste of chocolate — cannot begin to dojustice to experiencing the real thing.6mass general department of psychiatryMany people who are hurtingemotionally end up in a primary caredoctor’s office, and some people getmedication they don’t need, or surgeriesthey don’t need. We know that at least halfof these doctors’ visits for physical ailmentsare emotionally based. Many of theseproblems can be better helped bytalk therapy.What are the challenges involved in thepractice of this type of therapy?Robert J. Waldinger, MDRecognizing that stories about ourlives are not the whole truth is one way thatpsychotherapy can relieve suffering. BothZen and psychotherapy help us see thateverything constantly changes, that yourcurrent low mood or difficult situation is notgoing to stay that way — a much-neededperspective when people feel stuck. Thetruth of impermanence has been especiallyhelpful for me during this pandemic.What is the Endowment’s mission?We train mental health professionalsin psychodynamic perspectives andtechniques that can inform every area ofmental health care. The Department ofPsychiatry does not want this approach tomental illness to go away. In 2010, I wasrecruited to Mass General with the expresspurpose of ensuring that psychodynamicthinking is always taught to our trainees.“So that tomorrow, there will be someone totalk to,” is the Endowment’s motto.Could you describe the training?It starts with illustrating very basic premisesabout how the mind works. Instead of justteaching theory, we use vivid case examplesto show students how psychodynamicprinciples operate both in their ownlives and in their patients’ lives. Researchdemonstrates that psychodynamic therapyis very effective — as powerful or morepowerful than medication for anxiety anddepression.Insurance companies are worried thatpeople will linger in psychotherapy forever.But in fact, when people are offered apsychotherapy benefit in their health plan,they do not overuse it, and it reduces othermedical costs.The vast majority of people who comefor psychotherapy want to get the workdone, feel better and get on with their lives.There is a more limited role for long-termpsychotherapy, and it can be cost effectivein keeping people out of the hospital. Apsychiatric hospitalization can cost tensof thousands of dollars. Seeing a therapistonce a week or once a month doesn’t costmuch at all by comparison.How can philanthropy make a difference?Expensive medical procedures are muchbetter reimbursed than primary carevisits and psychotherapy. The lack ofparity in insurance reimbursement isone of the reasons why philanthropy isso important.We need support for trainingprograms and for professional developmentopportunities such as conferences andfellowships in advanced psychotherapy sotrainees can take a much deeper dive intothese therapeutic techniques. We especiallyneed support for endowed positionsto ensure the long-term stability andsustainability of this teaching program.For more information, pleasevisit ment

Caring for Women, Building Communitycontinued from p. 1and their families emotionally well by providing high-qualitycare informed by groundbreaking research. Finding the rightbalance between treating psychiatric illness and choosing theright treatment is a major dilemma for patients and clinicians,who must grapple with the question, what are the risks and whatare the benefits? Center clinicians are experts at tailoring effectivetreatments to women before, during and after pregnancy whileminimizing the risk to the fetus of potentially harmful exposure tomedications.Optimizing wellness before pregnancy is a main tenet of thecenter. “Our focus is on helping a woman to pause, and to reallyget psychologically well in anticipation of a pregnancy,” Dr. Cohennotes. If a woman is pregnant or postpartum, the goals are tomaintain or even achieve remission from psychiatric disorders.He added, “The pandemic has broadened that focus.”Providing Resources During a PandemicPregnant and postpartum patients were deeply affected byCOVID-19 in the early days of the surge. The pregnancy and deliveryexperience they hoped for suddenly was no longer possible.Without having in-person, new mother support groups availableafter delivery and direct support from family members outside thehome, many patients reported a sense of isolation and sadness.Telemedicine, however, made it possible to continuecomprehensive initial consultations as well as ongoing careto monitor the effects of prescribed medications, observethe emotional status of patients and modify treatment plansaccordingly. “These virtual visits allow us to keep women welland out of the hospital for psychiatric care as much as possible,”Dr. Cohen said.The center, with its long-standing role in the deliveryof comprehensive women’s mental health resources, waswell-positioned to transition to virtual care, education, andconsultation when COVID-19 hit. The center’s website,www.womensmentalhealth.org, offers the latest resources,articles on scientific advances and other educational materialsfor patients, providers and the public. During the pandemic,visits to the website are up 38 percent.Research is Essential to the MissionStemming from the pandemic, the center is researching theimpact of the coronavirus on maternal and infant health andwellbeing during pregnancy and the postpartum period. Inaddition, the center is currently conducting several new clinicaland translational research studies. One is the MGH PostpartumPsychosis Project (MGHP3.org), which aims to identify potentialunderlying genetic risk factors associated with this severe illness.“This is an important undertaking as very little is knownabout the factors which contribute to postpartum psychosis, theLee S. Cohen, MDMarlene P. Freeman, MDmost severe and potentially life-threatening form of postpartumdepression,” said Dr. Cohen.The center recently enrolled their 2,000th patient as part of theNational Pregnancy Registry for Psychiatric Medications. The goalof this registry is to gather information on the safety of psychiatricmedications such as antidepressants during pregnancy that willhelp to inform evidence-based treatment decisions and will guidefuture studies. The center is also seeking support for clinicalresearch on women of reproductive age diagnosed and treatedfor ADHD, as there is a lack of data to inform and guide medicalchoices for women when it comes to treatment during pregnancy.The research initiatives, as well as the focus on education andclinical care, speak to the center’s patient-focused mission. “Whenwe take care of patients with serious psychiatric disorders, onething we can provide is hope, that there is something we can do tomitigate suffering, that any improvement can be meaningful, thatwe are going to stay in the game,” Dr. Cohen notes.Persistence and Determination are KeyThat philosophy was in evidence during the recent virtualrounds, when Dr. Freeman described three years of persistent,determined, treatment trials to help a seriously ill patient — themother of young children who experienced severe and disablingobsessive compulsive disorder after delivery of her son. Aftermany medication trials, she was still suffering greatly, as was herfamily. Finally, deep brain stimulation provided relief. The patient’shusband reported that it was as if “a switch had flipped.”“We encourage patients to partner with us until we cancollaboratively find a treatment solution that leaves them in abetter place,” Dr. Cohen said.“It had taken a really long time,” Dr. Freeman said of herpatient’s successful outcome, repeating a favorite inspirationalquote: You never say never, you never say always, and always saythere is one more thing to try.mindscapes newslet ter7

Nonprofit Org.U.S. PostagePAID125 Nashua Street, Suite 540Boston, Massachusetts 02114-2548N. Reading, MAPermit No. 211If you do not wish to receive certain or all fundraising communications from Mass General, please call 877-644-7733, or visit giving.massgeneral.org/com-pref.Dr. Uchida is doing just that. As a childpsychiatrist and director of Mass General’sChild Depression Program, she is working withcolleagues at Biederman Lab and the GabrieliLab at MIT to understand how biological factorscontribute to underlying vulnerability in teens.“Just as high cholesterol and hypertensionare warning signs for heart attack, mooddisorders

Psychiatry 10th Annual Visiting Day June 7, 2021 Distinguished Department of Psychiatry faculty will present the latest updates in clinical care and research and share the impact of philanthropy on their work. COVID-19 and Mental Health Information The Mass General Psychiatry Guide to Mental Health Resources for COVID-19 is updated regularly.