I am a psychiatrist and the CEO of a company that trains resilience in the workplace. In the world of psychiatry, we thrive on using evidence, practicing carefully, and making changes gradually. At headversity, we thrive on making huge impacts, being innovative, and moving quickly to lead the pack.  I live at the intersection of two worlds that are dialectally, and often aggressively, opposed.

When I was in medical school I remember a professor telling us that “what we learned today will be outdated in five years”, which was the reason cited when purchasing a $200 textbook in its 11th addition. I really doubted that this was true and continue to remain skeptical. My experience in medical school was less of an exercise in coping with change and more like being adopted into an old traditional club. We learned words from an ancient language (Latin), we practiced traditional, physical exams that don’t impact decision making (the Babinski reflex) and perpetuated a work culture that the rest of the world thinks is dangerously old fashioned (30 hour call shifts).

Fast forward to my ‘modern’ psychiatric practice of today.

I talk every day to patients about psychological concepts that were introduced in 1880 (transference), where the medications I use were brought to market in 1987 (SSRI’s). In fact, I am hard pressed to think of a tool or skill that I use that has not been in psychiatric practice for at least twenty years. In short, to say the medical world hates change is an understatement. The reasons for this are partially defensible. You can’t bring a technology that could potentially kill somebody to “market quickly”, there is no “beta testing” an artificial heart valve, or a “Minimal viable product” version of a mood stabilizer.

My question, then, is, where does our world of exponential change leave medicine? Where does it leave psychiatry?

We are in the midst of a large technological revolution and an even larger interpersonal revolution. Want proof? Go to a restaurant and see how many couples are texting friends and not talking. Ever ride the train and talk to somebody? Didn’t think so. Did you post a picture of your lunch today? Yes, its ok, that is normal now. A large swath of our communication now happens on mobile devices. On average, mobile phone users in North America spend around 1,044 hours per year on their phone, that means about 12% of their existence is spent on a mobile device. This amount of time spent interacting with a piece of technology, as opposed to interacting with a human being, has dramatically changed the way we do everything.

Given my effectiveness as a psychiatrist is centered on understanding interpersonal dynamics, how could I possibly keep up with this? How could I continue to be effective in a world of exponential change, when the principles in which I was trained on are one hundred years old?

My only buttress in an earthquake of opposing worlds is the human need for connection. We are social creatures, many have argued that it is the very thing that makes us human; the need and want to connect. Connection is vital to human existence and those who don’t have it, tend to not live as long. Promoting connection, support, and healthy validation are basic principles that will never change in medicine, psychiatry, nor our world of exponential interpersonal change. Coming back to the principle of connection is the only hope I have to stay effective at my job.

Terrifying…and exciting, isn’t it?


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