Dr. Ashok J. Bharucha was born in India, and moved to the US at the age of ten. He completed his undergraduate degree in Chemistry and German at Bucknell University in Pennsylvania before pursuing his medical schooling at the Penn State College of Medicine. Dr. Bharucha completed his residency in adult psychiatry at Harvard Medical School’s McLean Hospital, and his fellowship in geriatric psychiatry at the University of Washington School of Medicine. He has received multiple nominations and awards for his clinical teaching, and has been involved in projects funded by the National Institute on Aging and the National Science Foundation. Dr. Bharucha now operates a private practice, Transformations: Adult and Geriatric Psychiatry, PC, which can be found at www.transformationspsychiatry.com.
Why did you decide to create your own business?
After nearly twenty years of involvement in rigorous academic research and education, I decided to pursue a private clinical practice. As much as I enjoyed the intellectual intensity of academia, I was struck by the fact that the most pressing issue for those with mental illness is access to high-quality care, especially outside of the larger metropolitan areas where most of the world-class academic institutions are based. The opportunity to care for a highly underserved population, combined with the flexibility of running one’s own practice, consistent with one’s own values, motivated me to start my own business.
What do you love most about the industry you are in?
Individuals often present in a crisis to a mental health specialist. As a psychiatrist, I operate in one of the few fields in medicine where one needs to attempt to understand the person as a whole, rather than simply focusing on the disease process alone. The opportunity to navigate them through the crisis involves a deep understanding of their personal, developmental, as well as family history; their medical and psychiatric conditions; and a comprehensive picture of the environmental, social, and interpersonal stressors that are impinging on their well-being. The profession truly involves a great deal of detective work and creativity in designing personalized approaches and solutions that fit best for the individual.
What keeps you motivated?
The ability to powerfully and positively impact the lives of others keeps me motivated. The privilege of partaking in highly intimate accounts of others’ inner lives is one that comes with great responsibility and many competing intellectual and emotional tensions which one must balance. No two individuals with the same condition are ever alike, and the challenge of competently addressing the distress depends to a very considerable extent on grasping the unique features of the presentation. I enjoy this challenge.
Every day is different, as is every patient. Nobody ever fits the textbook definitions of what depression, bipolar disorder, or schizophrenia might look like.
Who has been a role model to you and why?
Harvard psychiatrist and psychotherapist Leston Havens, MD has been a major role model in my life. His capacious mind, quick wit, and unparalleled empathy for his clients has touched me deeply. Dr. Havens’ command of language and the nuances of verbal and nonverbal communication have taught me a great deal about how to access the dark recesses of the human heart and sit side-by-side with the patient’s pain, neither falsely reassuring nor fearfully retreating from it.
For a time, Dr. Havens was actually my own therapist, and I learned a great deal from him through my experience as a patient in his care and from observations of how he reacted to my challenges and my crises. I observed the verbal and nonverbal approaches that he would utilize during treatment sessions, the kind of consistency and reliability that he offered, and his unique empathy. He also had a tremendous grasp of literature, so he would often quote great writers, and I think he emphasized that because he knew that I also had a background in literature. He taught me a lot about how to personalize and individualize treatment simply by the way he was able to incorporate these unique aspects into my treatment. Essentially, he taught me the importance of speaking the patient’s language.
What suggestions do you have for someone starting in your industry?
My industry presents a vast array of opportunities, but also some serious pitfalls for young psychiatrists. The obvious dilemmas revolve around whether one should remain in academia or work privately, whether one should remain in major metropolitan areas or venture into underserved communities, and so on. But, the most difficult decision, it seems to me, relates to the extent to which a position offers the level of freedom, flexibility, and creativity necessary for one’s continual growth, and respects one’s deepest values.
One should also consider carefully and choose a specific path. Psychiatry is such a vast field, with so many different approaches, that one really should find an approach that they will stick with, whether it’s cognitive behavior orientation, or psychoanalytic orientation, or whatever else moves them. But having a clear approach, I think, is important.
What is one piece of advice that you have never forgotten?
A beloved mentor of mine once shared with me advice he commonly offered to all of his trainees: “When in doubt, be more human, not less.”
I think, any time you’re in a difficult situation with a client where there are no good options, you certainly want to do the humanly right thing. For example, there may be times when there are billing conflicts where the patient thinks that they don’t owe you anything when, in fact, they do. It may be better to write off the bill to resolve the problem, rather than arguing with them or sending them to collections.
What is your biggest accomplishment?
I have been incredibly fortunate to have had stellar training, clinical, and research opportunities throughout my career. But, my biggest accomplishment has been to help others live fuller lives, driven by their own inner voice and vision rather than external motivators.
Fuller lives might mean that they are no longer repeating maladaptive patterns of behavior from their past. For many people, that’s a huge accomplishment.
What’s one piece of advice you would give to others?
Remain true to your own vision of life, regardless of the adversities and external pressures you may face. Conformity and consistency, beyond a certain point, stunt personal growth.
What is the biggest life lesson you have learned?
Human beings are complex and chameleon-like. Never assume that you truly know another human being. Their souls are like crystals; what you see simply depends on the angle at which the light refracts.
What trends in your industry excite you?
For at least the last couple of decades, there has been a move towards holistic approaches to mental health, not merely as adjuncts or desperate measures, but rather as critical ingredients of comprehensive treatment. The incorporation of mindfulness meditation, yoga, acupuncture, and other forms of healing arts is truly exciting. Recent investigations of psychedelic-assisted psychotherapy also promise important tools in our treatment arsenal.
These holistic kinds of interventions are highly effective for anxiety disorders, panic disorders, and so forth. I think they are important, and there is a growing database to support their use, at least as adjunctive therapy. In the old days, they used to view anything that didn’t involve medication as a desperate measure – when all else fails, you do whatever you can. But I don’t think that’s how holistic approaches are being viewed today. I think the fact that Hopkins and Harvard both have open Centers for Integrative Medicine speaks to this.