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The Psychology of Depression, Sex, Movies and Brains

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I was in Los Angeles for a speaking engagement and had an extra day to enjoy so I wandered out of my hotel thinking I would go to a Thai restaurant and then a movie.

Two minutes later, after making a left turn, I found myself surrounded by enemy motorists, the ones who are on cell phones, box you in and cut you off. I had heard about LA road rage, now I was in it--I needed a hurt locker. My anxiety was mounting, my hands drenching the steering wheel, and I had lost my bearing. I was in the fast lane and I surly thought I was going to lose my mind, so it can only be a miracle that I ended up in Dr. Ron Podell's office.

Dr.Ronald Podell: an "A Plus list " Los Angeles Psychiatrist, recognized innovator in the treatments of mood disorders, sexual dysfunctions, psychiatric applications of neuroscience and author of Contagious Emotions: Staying Well When Your Loved One is Depressed, the first and best book to address the needs of those whose partners are depressed and anxiety ridden.

Dr. Hank: What did you learn from your parents that helps you as a psychiatrist?

Dr. Podell: I have always said that I learned more about psychotherapy from working in my father's pharmacy than from my residency. People would come from near and far to sit in the comfortable chair in the back of the store and talk about their struggles. I overheard many of these "sessions."

I learned about the power of healing through dialogue early in my life. My father was an intuitive therapist. He was non judgmental, extraordinarily encouraging and always found relevant pearls of wisdom. Failures/setbacks were simply part of the game.

When people come to my office they are distressed and fearful. Healers understand the importance of sustaining hope and building courage. This wisdom was passed down from my parents.

Dr. Hank: It is a well documented fact that emotions are contagious, but you were the first psychiatrist to make the clinical insight that emotional contagion plays a huge role in marital and relationship distress. What was your flash of genius?

Dr. Podell: After founding the Center for Mood Disorders I saw many depressed and anxious patients and intuitively began to invite loved ones to joint sessions. I found that communication was characteristically disturbed. Debates focused on convincing the other person that his/her behavior was "the problem." Essentially, they were arguing about whose perception of reality was accurate--creating circular, unending accusations.

Each person hopes the therapist will agree with him. The leap was to understand that assigning blame was the problem. "What if both are right and both are wrong?" By looking at the communication differently, I realized that re-circulating emotions explained the unending hostility and impasses. I called the communication "fusion" because it destroyed boundaries and, like radiation, affected everyone nearby.

Dr. Hank: Besides an expertise in treating mood disorders, you have achieved a national reputation for treating sexual dysfunctions. What got you interested in human sexuality?

Dr. Podell: I was a teenager in the 60's! Masters' and Johnson's research explained the physiology of sex and offered behavioral treatments for dysfunctions. Early in my career, I founded the Center for Sexual Science with an urologist and vascular physiologist. I studied the medical aspects of male sexuality and developed a theory for understanding ED by integrating psychological and biological factors.

I chaired a Sexuality conference at UCLA, invited Masters to speak, and made a personal connection. We exchanged clinical views. Later, we delivered keynote speeches at the International Society for Impotence Research. I discussed rifts among professionals in the sexuality field and urged cooperation between disciplines. Masters apologized for inadvertently alienating physicians with treatments that overstated psychology--the torch was passed.

Dr. Hank: You are quite a movie buff and there have been many films in which a psychiatric disorder is acted out. Tell us two performances that would win your Best Psychiatric Performance Award?

Dr. Podell: I've treated scores of acclaimed actors, writers and directors and have their insights. The stereotyping of psychiatry is troubling. The evil, idiotic, or unethical psychiatrist is the norm. Lecter was more appealing than Dr. Shelton in Silence of the Lambs. Barbara Streisand's affair with her patient in Prince of Tides evoked no ethical crisis.

Dangerfield's rendition of parental molestation in Natural Born Killers was vivid and believable. It validated the daughter's deviant behavior.

Rod Steiger and I taught a UCLA class. I analyzed The Pawnbroker. His portrayal of a severe chronic, post traumatic stress disorder was perfect--every gesture and expression communicated the character's terrifying reliving of the holocaust. Contagious emotions cost him the Oscar--viewers were overwhelmed by concentration camp flashbacks.

Dr. Hank: If your office is a microcosm of America, what is our diagnosis and what paths do we need to take over the next few years to optimize our mental health?

Dr. Podell: One of the boons of economic calamity was Congress attaching to the bailout an amendment mandating insurances to reimburse psychiatry equally with medical services. We must stop looking at emotional disorders as weaknesses or humiliations. They are no more shameful than heart disease, cancer or hypertension.

Psychiatry is catching up with neuroscience. I founded the Center for Bio-Behavioral Science (www.cbbsla.com) and assembled neuropsychologists to quantify memory, attention disorders and learning problems. Get tested annually if you are 65 -- free with Medicare.

I am associated with medical group (www.smartbrainandhealth.com) where sophisticated neuro-imaging identifies brain areas causing depression. Magnetic stimulation adjusts brain function and treats depression.

CBBS anticipates research with Fisher-Wallace's electric brain stimulator for ADHD. Medication will become less important to psychiatry.

I left Dr. Podell's office confident and calm. I took advantage of the bumper-bumper traffic by using my blackberry to amazon myself a copy of Contagious Emotions. Next, I called my sister and had her schedule a magnetic brain stimulation for my 85 year old mother who lives in an assisted living home. Then, as planed I found my Thai resturant but instead of going to a movie, I stopped at a local Blockbuster, and picked up a few of Dr. Podell's recommendations to watch on my computer in the comforts of my hotel California.

As I drove into the sunset, my only thoughts were, "Thank you, Dr. Podell."

You may contact Dr. Podell at www.cbbsla.com

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