Paul Genova's finely crafted essays, which proffer a humanistic and humanizing vision of psychiatry in the face of his profession's preoccupation with target symptoms, "correct" thinking, and medication, have won him a wide and appreciative readership in the pages of Psychiatric Times. This expanded edition of The Thaw, the first collection of his writings, adds seven of Genova's recent pieces, along with one older one, his elegiac "Is American Psychiatry Terminally Ill?" of 1993, to the original collection. An eloquent defender of psychodynamic psychotherapy in an era of generic "trauma stories," drug-driven treatment, and managed care, Genova joins deep erudition, lightly worn, to a pragmatic sensibility that is respectful of the real-world options - behavioral, symptomatic, interpersonal, and otherwise - available to patients from different walks of life.
Whether he is reflecting critically on the therapeutic claims of the latest treatment modalities, grappling with the meaning of boundary violations, paying homage to the transformative potential of suffering, or recounting episodes from his own personal and professional odyssey, Genova is a luminous guide, elegant and down to earth, unfailingly thoughtful and thought-provoking, to the trials, tribulations, and healing promise of day-to-day psychotherapeutic work. With vivid immediacy, The Thaw celebrates the renascent healing potential of a contemporary, person-centered psychiatry that is analytically, neuroscientifically, and politically informed. All mental health professionals and many interested lay readers will find much here to illumine their daily struggles.
Table of Contents
I. Seven VisitationsIntroductio to Part I.Case 1: Dream Rebuts TherapistCase 2: Catfish on the BottomCase 3: The Permanent TripCase 4: Lacan at Bonus BagelsCase 5: Living with DoubtCase 6: "I'm Not Your Urban Renewal ProjectCase 7: The New CovenantII. Supervision and Self-DisclosureIntroduction to Part IIThe ThawHere Are the ScalesSnow WhiteRaffaela's Hug"I Just Keep Playing the Same Note"Getting Two (2.0) People into the RoomThe Endless Walk of the FoolRockabye Baby: Winnicott's HatredOur Trainees' Calling, Our Job DescriptionIII. The Psychiatric PersuasionIntroduction to Part IIIWhy I Love LewistonTake Care of HimGod or Vending Machine?Requiem for PsychoanalysisThe Shifting Metaphors of Biological PsychiatryThe Coming Polarization fo PsychotherapyPsychiatric WisdomGetting Macie off the MountainIV. Still Carving, Day and NightIntroduction to Part IVIs American Psychistry Permanently Ill?Boundary Violations and the Fall from EdenThere Are Really Only Three Kinds of PsychotherapyRabbi Among the MechanicsWhat Does Suffering Do?Psychotherapy after Mohammed AttaThe Domestication of the TruthThe Owl Stick
Paul Genova, M.D., is a graduate of Harvard College and Dartmouth Medical School. He briefly practiced general medicine in East Kentucky before returning to Portland, ME for psychiatric training. There he has practiced general psychiatry and psychotherapy since 1982, both in private practice and in a variety of public settings. A Clinical Associate Professor of Psychiatry at the University of Vermont College of Medicine, Dr. Genova writes a well-known column for his profession's most widely circulated publication, Psychiatric Times and is a Contributing Editor of Voices: Journal of the American Academy of Psychotherapists.
"In this era of managed care and the latest DSM as Bible, and the emphasis on quick and measurable symptom relief by appropriate medication and short manualized psychotherapies, one welcomes an experiences clinician's insistence on the persistent benefits of open-ended psychotherapy...Being in the trenches with such a colleague makes this reading enjoyable."
- Kathleen M. Mogul, M.D., American Journal of Psychiatry
"Genova's book...helps the reader locate the deep well of humane values underlying our profession...[He] aims at extracting the best essence from both psychodynamic and biological approaches and using them pragmatically and judiciously to help the patient...The Thaw reveals a clinician whose goal is always to free the frozen psyche, allowing it to rejoin the larger, warmer world."
- Ron Pies, M.D., Psychiatric Times
"[Genova] gives us insight, creativity, intuition balanced with erudition, and all wrapped in a parchment of caring...The Thaw is well worth your time and attention, and that of anyone with an interest in pragmatic and compassionate psychotherapy. One final reward consists of the sheer pleasure of being guided through complex and meaningful issues by a mind that examines them with such clarity and humanity."
- Stephen Howard, M.D., JAAP
"The Thaw brings to mind Holden Caufield's observation that sometimes when you finish a book you with the author were a friend of yours, so you could spend more time with him. Genova's writing is insightful and self-effacing. He's an intellectual, but not a pedant, and he's got a nice, cerebral sense of humor...[H]e's willing to talk about experiences that therapists don't address in the books that they hope will get them on Oprah."
- Jim Naughton, Ph.D., Psychotherapy Networker
"In this well-written and timely book, a series of essays by the author is collected in which he passionately argues for the reclaiming of the individual, the person, from the orientation of biological psychiatry, which is viewed as being more interested in neurotransmitters and their physiological effects. Genova is to be commended for trying to reconsider the individual, the person, in psychiatry and psychotherapy, taking great pains to emphasize how important it is for psychotherapists not to lost track of the actual lives, rather than biology, that are there to be treated."
- Herbert Bennett, Psy.D., in Psychotherapy Review, 18.1, 2006