I had a really great day today. I am currently at the American Psychiatric Association meeting in Hawaii. I feel like a lot of my professional life has been a critique of the mainstream of psychiatry, whether it has been studying psychotherapy (which according to a lecture today has “always been subversive,” because it challenges people’s understanding of themselves, their relationships, and it challenges the status quo), learning about trauma and bearing witness, or moving outside the confines of psychiatry into holistic medicine. The thing about living a critique is that it can start to get lonely, because I seem to continually question the fitness of the different treatment/personal growth philosophical systems that I put myself in. It is kind of like the dilemma of trying to find a group of people who don’t fit in and who form a community of “misfits.” Looking around at the conference today, I felt that old desire to be part of the group while also finding fault in the limitations of the dominant, evidence-based paradigm. I was slightly envious of the people who seemed to have built something in their lives over time as I compared myself to them. The thing with continually being open to new ideas and practices is that there is a risk of ending up intellectually homeless and unrecognized, another way of saying that I felt outside of the circle. With my recent move to New Zealand, I have faced this dilemma of wanting to fit in, but also wanting to follow my own passion and my own ethics and idealism.

Yesterday, I had this realization. I won’t bother putting it into words, it would sound incredibly simplistic, anyway, but it was just this felt sense of connection and meaning, even if I wasn’t feeling a clear sense of purpose. That is when I thought about blogging on the topic of coming full circle, which can mean so many things at so many different levels. On this trip, I brought along Maugham’s, The Razor’s Edge, a book I read a lot when I was in college and medical school. In some ways, the book is important and in some ways it is not, what is more important is re-connecting to things that I was interested in the past, and more important than intellectual things I was interested in, it was about connecting to the feeling of who I was when I was younger and what was important to me, including questioning, searching, and idealism. I had this sense of meeting an old friend, only the old friend was my younger self.

So, that is what I was going to write about, how I had so much growth in my life through saying “yes,” but that it was time to start reining all that in a bit and to start being more discerning in what I put my energy into and making sure that I am not just doing what needs doing, or jumping into an opportunity, but really practicing discernment and making sure my heart was in whatever I take on in the future. That said, today I had two really cool synchronicities that happened only because I said a few chance words. It was like the old accidental networking (which is what I used to call it) kicked in again. Things started to make sense, I felt more connection, more trust in myself and the universe. I think I won’t write about the actual events, the process is more important anyway. I will talk some about coming full circle, though.

I imagine that as a person goes through life, they have various circles that they go through. For one thing there is the grand circle of birth and death, that is really the foundation of life, I suppose, it is the most basic and incontrovertible fact. There are other circles, too, though.  For me, I just went through a training so that I can supervise psychiatry trainees in New Zealand (registrars, or what we would call residents in the US). In looking over the supervision pathways, I mentioned that I had done a lot of psychotherapy training, enough so as to be considered to have done a sub-specialty in it in New Zealand. So I mentioned it, and now I am also a psychotherapy supervisor and I already have been assigned my first registrar. Being at this conference also helped me to get excited about the role of psychotherapy in psychiatry. It is tending to get less and less attention and some training programs are even questioning whether it should be taught, but to me, it provides the humanitarian and ethical counter-point to guideline-driven medication management. I have also started doing some psychotherapy at my new job, whereas at the community mental health centre, it really wasn’t part of the work (at least not in a formal and in-depth way) and there were always so many patients that needed to be seen.

Getting back to Hawaii, the little bit I have seen so far is beautiful. I have met some really friendly birds and I’ll post a few pictures of them. I am trying to go swimming in the ocean every day, so I better circle back to hotel and the beach and go for a swim.