Owen Lewis, M.D., is the senior vice president for Mental Health Initiatives, Turnaround for Children, and a clinical professor of psychiatry at Columbia University in New York, NY. Dr. Lewis provided valued mentorship to me dur- ing my general psychiatry training and CAP fellowship. I had the opportunity to interview Dr. Lewis during the AACAP Annual Meeting in New York City.
Karimi: What is the most important thing about a mentorship relationship?
Dr. Lewis: There has to be a meeting of the minds. The choice of the mentor and mentee is a spontaneous one at first. They are drawn to each other for reasons that neither of them understands. It has to do with their view of the work they are doing together and their priori- ties about the work. For the mentor, it is exciting to work with young doctors who are starting out, looking to realize their goals, even though they have not fully articulated them. A trainee is drawn to a mentor because she or he has a hunch that the mentor knows something that the trainee wants to master. For the mentor, there is also a lot of learning. When you teach an idea, the way it's understood and processed by the trainee adds to the idea and develops it further. There is always an overlap of interests, and both mentor and mentee benefit and grow.
Karimi: I grew to know you best as your psychotherapy supervisee in my 3rd year of general residency training when I treated a 17-year-old boy as my weekly outpatient child psychotherapy case. You taught me how to think about the development stage of my adolescent patient and how he relates to the world. We also spent a lot of time in supervision, discussing how to under- stand him in light of his educational strengths, his cultural background, and his struggle to negotiate his relationship with peers and with his mother. Then we started working together with him in an additional weekly family treatment, a valuable period of clinical mentor- ship in action. As the year progressed, my mentorship relationship with you expanded, to include conversations about career options.
Dr. Lewis: I think there is an evolution, which commonly occurs, from being a teacher to being a supervisor to being a mentor. It's finding that spark of commonality and interests. No mentor/mentee relationship is ever the same. These relationships change you and stay with you, throughout your entire life. That's what is so wonderful about AACAP Annual Meetings. You see people who trained with you, and the different, exciting trajectories their lives have taken.
Karimi: Who were your mentors?
Dr. Lewis: Three of them stand out. My director of training, Ted Shapiro, at the Cornell University Child and Adolescent Psychiatry training program. I have always thought he was the single individual who knew the most about psychiatry of anyone I have ever met! My other mentor was Peter Blos, who is now deceased. He was an analyst from Vienna, who did the definitive work on a psychoanalytic approach to adolescent development and psychotherapy. He taught me new ways on how to think about and work with adolescents. I called Peter Blos without introduction while I was working at the Jewish Board because I wanted to begin to conceptualize my patients in a different way. Also, Clarice Kestenbaum. I worked with her when I was a young attending. My time spent under her mentorship helped me shape a career. She helped me expand my path to broadly integrate teaching, academic work, and clinical practice.
Karimi: It seems like you found different mentors to match your training and career needs at each stage. That seems like an important thing for young clinicians to do. The early time in a career is such a critical one. You can take so many different paths, but it's also a time to start differentiating and narrow down the options. How did you decide?
Dr. Lewis: What you know in the early years are the broader strokes, not the specifics of exactly what you want to do. I think one of those first points of decision is "What kind of relationship to patients do I want?" I started off in medical school with a 19th century romantic ideal about being a practitioner. I wanted to treat people across the lifespan. I wanted to have a special relationship with families, while keeping an eye on communities and how families negotiate the challenges of daily life. It was clear to me in medical school that the type of relationship I wanted to have with patients could be found in psychiatry, and child psychiatry was a natural extension of that. I knew I wanted the type of relationship and clinical practice where I could treat children, adults, and families; and I had an interest in communities. The second thing was that I knew I wanted to do something else besides practice. The knowledge one invests in becoming a child psychiatrist ought to move beyond one's office.
Karimi: It seems like integrating com- munity work into one's career can be rewarding. I was glad that as my mentor, you encouraged me to think about this. It's helpful when mentors encourage trainees to consider adding different facets to their skill set, particularly when it interests the trainee.
Dr. Lewis: I was totally delighted when you expressed an interest in learning more about community and school- based applications of child psychiatry and working with me in one of the Turnaround schools. What I know you got from this experience was the opportunity to see how children with psychosocial difficulties function in schools, the interactions between child and school, and how those schools function in the community, and the various interactions on that level. In a medical-center clinic, it is impossible to understand how schools can contribute to a student's psychopathology, and also impossible to envision how schools can exert an ameliorating effect on the outcomes of psychopathology. Ultimately, I would like to move more psychiatric training into community settings so that trainees can wrangle with these real problems right from the start.
Karimi: Your career has taken an amazing path, through so many areas of clinical, educational, and community work! Do you have any final thoughts on mentorship and teaching?
Dr. Lewis: Teaching has been a big part of my professional life, both to psychiatric trainees and to mental health professionals in a variety of community settings. Our current work in schools allows me to extend professional knowledge in school systems as a whole, and really expand the impact of what we know as child psychiatrists. Teaching and mentoring, like parenting, has a central place in my life.
Dr. Mailutha is a 2nd year child and adolescent psychiatry resident at New York Presbyterian Hospital at Cornell and Columbia Universities. She completed medical school at Harvard University, her Master's in Public Health at Johns Hopkins University and her adult psychiatry training at Columbia University in New York City. Her interests include community psychiatry, mental health concerns of asylum seekers, and school-based mental health.