Harvard Catalyst Profiles

Since 1978 I have practiced at the Brigham and Women's Hospital (BWH), at the Dana-Farber Cancer Institute (DFCI), and in an office practice. As Clinical Director or Co-Director of Psychosocial Oncology until 2008, and currently as DFCI Site Director of the Psychosomatic Medicine Fellowship, I have provided psychiatric consultation, treatment and referral for oncology patients and their family members, taught oncology staff and trainees, and helped to develop an integrated model of care. In the DFCI Department of Psychosocial Oncology and Palliative Care, I supervise palliative care fellows in their rotation through psychosocial oncology, and participate in the Department’s medical school teaching on communication in serious illness. I also teach medical students in Mind, Brain, Behavior and Development, helped to develop and continue to co-direct Psychosocial Oncology and Palliative Medicine, the most subscribed psychiatry elective.

To help young clinicians recognize and deal more effectively with the spiritual and religious dimensions of patients’ problems, I developed with Dr. Mary McCarthy a semester long course for PGY4 psychiatry residents which in 1998 received a John Templeton Foundation curriculum award. Since 2006. I have also helped develop and co-taught a Harvard Medical School elective Spirituality, Healing and Medicine, and co-edited its textbook. My approach in both of these courses has been to ascertain students’ needs and interests, to introduce them to core principles and relevant literature, and to engage them in conversation with invited presenters and patients to help them apply what they are learning to clinical practice. I aim to facilitate their understanding of the patient as a whole person in context, using a psychodynamically informed conception of the problems to identify the most important aspects of the role they play in the patient’s life.

I also supervise both psychiatry residents and psychosomatic medicine fellows - seeing patients at the bedside, searching the literature for precedents and collaborating on scholarship such as papers and book chapters that can shed new light on the challenges they present. I try to demonstrate and discuss ways to follow the patient’s lead, to help them appreciate and become comfortable with the breadth of concerns that are often ignored, to respond authentically and helpfully, and to learn from each encounter.

My scholarly interests have included the psychological aspects of oncology, the management of addiction, the interface between psychiatry and spirituality/religion, and moral and ethical aspects of practice. I began to focus on the clinician’s role in dealing with patients’ existential and moral concerns after seeing how often cancer patients expressed them and drew upon spiritual resources, and how infrequently these were acknowledged by the treatment team. At the same time I noted that psychotherapists lacked an accepted framework for approaching religious and spiritual issues. During the 1990s I collaborated with colleagues in presenting symposia and a course addressing these issues at the American Psychiatric Association (APA)’s Annual Meeting and in co-editing a 2004 book on the clinical implications of world view. I have since chaired the APA’s Corresponding Committee on Spirituality, Religion and Psychiatry, and until recently chaired the APA Caucus on Spirituality, Religion and Psychiatry. Given that clergy are the first providers for many individuals, and that cultural and religiously reinforced stigma impedes access to mental health treatment, I have worked as well with faith leaders and chaplains, most recently through the APA’s Mental Health and Faith Community Partnership, and the Section on Religion, Spirituality and Psychiatry of the World Psychiatric Association (WPA). I have twice been an invited speaker at WPA international conferences, and have co-edited a book published by Oxford University Press, Spirituality and Religion within the Culture of Medicine: From Evidence to Practice. I have also co-edited a series of books published by Springer Nature, Islamophobia and Psychiatry, Anti-Semitism and Psychiatry, and Christianity and Psychiatry, and am co-authoring with Harold Koenig and Tyler VanderWeele the Handbook of Religion and Health, 3rd edition, being published by Oxford University Press. I received the American Psychiatric Association’s Oskar Pfister Award and delivered the award lecture at the 2020 APA Annual Meeting.

My interest in the moral and spiritual aspects of practice led me to write Doing the Right Thing: An Approach to Moral Issues in Mental Health Treatment, to help revise the 2006 APA Resource Document on Religious/Spiritual Commitments and Psychiatric Practice, and to co-teach Psychiatric Ethics to PGY3 residents. I recently published on physician assisted dying, am participating in a WPA task force on the issue, and have co-edited a volume published by Oxford University Press, Ethical Considerations at the Intersection of Psychiatry and Religion. I am editing a book The Virtues in Psychiatric Practice being published by Oxford University Press.

Recognizing the importance of empirical data for understanding clinical problems and for shaping practice, I have participated with other members of the Harvard Initiative on Health, Religion and Spirituality in several studies of the religious/spiritual needs of oncology patients, conducted my own related research, and co-edited Religious and Spiritual Issues in Psychiatric Diagnosis: A Research Agenda for DSM-V. I am currently participating in an interdisciplinary project to study the virtue of accountability, funded by the Templeton Religion Foundation.