what is Psychosomatic Medicine? Interview with Dr. Mary Alice O’Dowd

I had the pleasure of a brief Q&A with Dr. Mary Alice O’Dowd, Director of the Psychosomatic Medicine Consultation Service at Montefiore Medical Center in New York. Dr. O’Dowd is also Professor of Clinical Psychiatry at Albert Einstein College of Medicine, author or co-author of almost one hundred peer reviewed articles, chapters, editorials, abstracts and book reviews, among her many accolades.

Integrating psychological care with the medical care for those facing serious illness or end-of-life seems like an obvious necessity. But the nuances are great — a team of skilled and dedicated individuals has to come together to manage the right care for each patient. A lot of communication is required between patients, doctors, psychologists, and social workers to ensure that a quality of life for a patient in any condition.

I asked Dr. O’Dowd about how she works to achieve this balance through psychosomatic medicine.

Dana: How does your work in psychosomatic medicine interface the end-of-life?

Mary: For myself and my team in Psychosomatic Medicine, we are psychiatrists seeing patients in a medical setting, mostly hospitalized patients, but some outpatients.  Whether dealing with end of life issues or not, our goal is to take the time to sit down and try to get to know the patient as an individual, to understand the patient’s experience of his or her illness in the context of their life experience.

Dana: Can you give a basic overview of how Montefiore is incorporating psychological and spiritual healing into medical practice?

Mary: Often we are called in when there is conflict between the patient and the team about treatment options. Our job is to ask “Why?”  “What’s going on?”  “What happened?”

So often the conflict grows out of misunderstanding on both sides, so clarifying, reaching consensus can be so helpful to caregivers and patients alike.

Dana: How else can caregivers help patients facing serious illness?

Mary: I’d say another important area for caregivers  is always being aware of barriers to patient understanding, whether these be language, poor literacy skills, or cognitive impairments due to dementia or delirium.  Sometimes something as simple as the patient’s inability to draw a clock on the page of a chart, putting in the numbers and the hands, can bring home to the caregivers why the patient isn’t taking their medications or missing appointments — it’s because they can’t remember, they’ve lost the ability to tell time.

So, bottom line at any stage of illness is getting to know the patient, eliciting his or her agenda, identifying barrers to care, talking to people, marveling at the uniqueness of every person’s story — whatever the problem, that’s always part of the solution.

Dana: Finally, is there anything I haven’t mentioned that you’d like SevenPonds readers to know?

Mary: Montefiore also has a strong Palliative Care team for patients facing end-of-life and also an outreach program for caregivers.

Dana: Thank you so much for taking the time to share in the SevenPonds community!