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One Day I'll Start a Book Club

Good morning!

 

I’ve been trying to figure out how (and if!) I want to get back into blogging. It’s a lot to keep up with. I’ve decided that I will start with revamping a couple of older things I’ve written in the past. Maybe that will get the juices percolating. The first few will definitely reflect my goals for creating a book club for health professionals and/or parents. We would read not just boring old non-fiction, but also use fiction to reflect and explore tough themes. I just need three more hours in the week and then I'm gonna do it!

 

Two years ago, some folks at work were thinking of facilitating a department wide book club. I was asked to consider what book I would recommend the entire Department of Psychiatry should read. This was a bit tricky for me, because I also work in Pediatrics, and had to really turn off a little part of my brain to focus on the folks who would be more interested in mental health than body health.

 

There were two books that I thought would be strong contenders so I read them both to make a solid recommendation.

 

The review part of this post is an updated version of a portion of the email I sent, in 2022, about one of those books: What Happened to You, written by Bruce Perry and Oprah Winfrey. You’ll have to check back to see what the other book was.

 

"What happened to you" is the driving questions underlying Trauma- Informed Care. It represents a move away from the question "What is wrong with you," which drips of judgement and ignores the influence of our environments. A year after the book was published, an "unofficial, third party workbook" was published with worksheets and interactive actvities... I don't know anything about that! LOL.

 

I think both books have something to offer and are basically about the same things (Social Determinants of Health (SDOH), Adverse Childhood Events (ACEs), the artificial separations between mental, physicals, and behavioral health), told from different perspectives. It would be impossible to find a book that everyone would agree on all the time and the goal should, instead, be to find a book that would lead to rich discussion and reflection. One thought I had while thinking about these choices is that both books highlight the fact that early experiences matter for later (mental) health and are told from the POV of people who work with children; so, much of the data and examples are about childhood adversity and referral. I don't know if it would be better to find something with more adult focus... I personally would be less interested in that. LOL. But I don't know what the department ratio of child to adult work is. Of course, if biopsychosocial approaches is the theme, ACEs and SDoH are a great choice. I don't know how those things are talked about comprehensively in the adult literature.

 

My recommendation would be for What Happened to You. When I read it, I thought of all the mental health clinicians, parents, and teachers I wanted to give it to. The examples/ vignettes are more applicable to psychiatry [than to pediatrics] because they are focused on work and referrals for disruptive behavior and mental illness. The tasks that Perry is asked to do are more similar to tasks we are asked to as behavioral health folks. Also, because WHTY references the pandemic, George Floyd, more recent events, and the term "Anti-racist work," it will feel more relevant and timely. There are also specific barriers that Perry brings up (e.g., working with families in systems designed for singly identified patients) that are common things we talk about in Psychiatry that pediatric primary care folks don't think about as much.  I also think that both Winfrey and Perry include more reference to long term impacts related to the kinds of problems we as a department are interested in (e.g., thoughts, feelings, behaviors, relationships) versus medical diagnoses​. ​Bruce Perry has been doing this work for decades and his research sits in the cornerstone of what we know about trauma and healing. He references all systems of care, implicit biases, and system -isms. He talks about providers' need to do their own self- work to be good clinicians. And finally, I think the conversational style of the book and the real-world examples from both authors are going to be more engaging and powerful. There were two moments in the audiobook where I actually got chills.


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