The Art of Healing: Dr. Daniela Discusses Psychiatry, Vulnerability, and Growth

In the world of psychiatry, where vulnerability meets healing, Dr. Daniela brings a wealth of experience and insight that transcends the clinical. In her book, Practice, Practice, Practice, she candidly shares her journey through decades of patient encounters, illustrating both the triumphs and challenges of her profession.

Interview with Daniela

In this interview, we asked Daniela about her motivations for writing, the lessons learned along the way, and her unique perspective on the transformative power of therapy. Read along as we explore Daniela's remarkable path, uncovering the stories that shaped her career and the wisdom she hopes to impart to both readers and aspiring clinicians alike.

Q: What first inspired you to write Practice, Practice, Practice—was it a particular patient encounter, a career milestone, or simply the desire to capture decades of stories before they slipped away?

This book began as a series of stand-alone essays that I wrote over a period of more than ten years. But none of them captured the wonder that incited me to write them, so I filed them away, dissatisfied.

Q: Your book is full of candor and honesty about the challenges of psychiatry. What made you decide to share not just the successes, but also the mistakes and "pratfalls" of your career?

In 2016, I saw a short video of novelist Kurt Vonnegut giving a lecture about a plot curve he called Man in Hole. Man digs hole, he said, man falls in hole, man digs himself out. People LOVE that story. In reviewing the essay that became the chapter titled “There’s No Place Like Gnome” it hit me— I had glossed over the only interesting thing in the piece: what I had done wrong with the patient and how I made reparations. Shrink digs hole, falls in hole, digs herself out. I had found my way in.

Q: Was there any part of this book that was especially difficult to write or share publicly?

I found myself crying writing the chapter about my teen years but that was much easier than working through the confidentiality issues. I consulted a lawyer and revised the book at least four times to protect patient identities.

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Q: Which was more challenging—decades of psychiatric practice, or writing a book about it?

They are more alike than different.  Both require a focus on the patient/reader; continuous practice; clarity, skill, and a willingness to be vulnerable. Both require I pay attention and notice what I notice.

Q: The title Practice, Practice, Practice suggests continuous learning. What are some of the most valuable lessons you’re still learning even after decades in psychiatry?

Embrace the unexpected as an opportunity to learn something new. Ask questions that go beneath the obvious. Look for the funny.

Q: You describe therapy as sometimes messy and unpredictable. How do you personally stay grounded when sessions don’t go as planned?

I am continuously amazed, grateful, and honored that my patients trust me to help. It is immensely grounding to cultivate and stay in that state of wonder.

Q: How do you balance being both a clinician and a storyteller, while still respecting the vulnerability of the people you’ve worked with?

Respecting my patients’ vulnerability is a given, always there, guiding anything I say or do. In writing about insights that I want share publicly in writing—whether about the patient, myself, our relationship, or the craft of therapy work—the same operating premise applies.

Q: What was the most surprising reaction you’ve received so far from a reader—either a patient, colleague, or general audience member—about your book?

I love when readers love the book! From an Amazon reader review: Have you ever read … [a] book so good that you have to read it twice?... [She] teaches you how to be a problem solver. She shows her thought process, which is fascinating… There’s more, but you get the gist. I love that she read it twice! That’s what I do when I love a book.

Q: If readers walk away with just one message from Practice, Practice, Practice, what do you hope it will be—and was that your most intentional message when writing?

I wanted this book to dispel the many misconceptions and unrealistic expectations people have of what we psychiatrists and therapists do; how we do it; and what it’s like to be in therapy. Mission accomplished!

Q: What do you hope readers—whether clinicians, students, or simply curious people—gain from reading your story?

Readers, you do not have to be “crazy” to see a psychiatrist. Therapists, flawless performance is not required to be genuinely helpful. What matters in a therapy relationship—any relationship—is that both people make a thoughtful effort to put Unfortunate Interaction X in perspective so as to understand it as part of a larger interpersonal pattern. Understanding an old behavior in a new way gives you the option to behave differently when Unfortunate Interaction X crops up again. Because, trust me, it will.

Q: If a young psychiatrist or therapist picked up your book today, what’s the number one lesson you’d want them to carry into their own practice?

Think of the work as an adventure. Of course things will go wrong. Travel with an experienced mentor to guide you.

Q: Many people think about starting therapy but feel hesitant, uncertain, or even afraid. Based on your decades of experience, what advice would you give to someone contemplating therapy for the first time?

Those feelings are natural because who wants to reveal their most tender self to a stranger? Know this: we are here to help. No one can make you say anything or do anything, including taking medicine. You can quit anytime and seek help elsewhere. That said, give your clinician a chance. It can take a few sessions to figure out if this is the person you want to work with. You should feel listened to and understood. You should feel they care. They should be asking you questions which make you consider yourself in a new way.

Q: Looking back on your career, if you could give advice to your younger self on her first day in psychiatry, what would you say?

Instead of berating yourself when you make a mistake, Daniela, figure out what went wrong, and then move on to make a new mistake.

Q: What’s next for you as an author, are there new stories or projects you’re working on that readers can look forward to?

Actually, I’ve already had a second book published by W.W. Norton. Doorknob Bombshells in Therapy: The Brain, the Deadline, and Why It Is Important to End on Time is about a perennially difficult phenomenon we clinicians must manage: the doorknob bombshell. That’s when a patient drops distressing and important new information when the session is technically over, with their hand on the doorknob.

While I wrote the book for clinicians, creatives will find my solution useful too. Duke Ellington famously said, “I don’t need time. I need a deadline.” He didn’t know the brain science driving this brilliant insight. But we do.

Our brain has two hemispheres, the right and the left. The right creates, the left criticizes and revises. The right deals with and creates anything new. The left rejects what it hasn’t seen before. A deadline helps an artist’s right hemisphere overcome their left’s nay-saying (it sucks, it’s not ready, etc.) to deliver new work despite the fear of negative judgment by the public.

In the treatment relationship, imagine the patient functions as the right hemisphere and the therapist as the left. The patient delivers new material. The therapist analyzes it and helps the patient process it. Understandably, the patient is afraid to reveal information that leaves them vulnerable. In the same way a novelist’s right hemisphere must overcome the left’s inhibitions to deliver the book to the publisher, the impending end of the session—the deadline—allows the patient to deliver information they need us to receive. While it is stressful to end on time in the face of a patient’s tears, I now take heart doing so because I’m confident the patient would not have released this new information if they didn’t trust me to end on time. I prepare patients to expect this will happen occasionally.

Creatives, it’s true that a deadline carries anxiety and stress, but if honored, it allows you to get a creative project started in the face of procrastination, and to complete it when caught in perfectionistic tweaking. Using a timer set for twenty-five minutes, I drafted thirteen chapters of Practice, Practice, Practice in thirteen days. (The revisions took several years.) I wrote without stopping, one word at a time, no reviewing, second guessing, or deleting. When the timer dinged, I reset it for another twenty-five minutes and kept going until, somehow, I knew I was done. (The right hemisphere “speaks” in feelings and images; the left with words.) I put that draft away for a while, to bypass my left’s rejection of what it hadn’t seen before. I returned to it when I could read it objectively, as if someone else had written it.

What am I working on right now? More about the brain and the creative process. Stay tuned.

As we close, is there a misconception—about your journey, your field, or even your book—that you’d like readers to better understand?

Novelist Octavia Butler said, “Persistence is the great talent.” Obstacles and problems can’t be avoided. So don’t let adversity stop you. Persist. Whether you are working on a project or yourself, how you deal with difficulties shapes who you become. - Daniela Gitlin, MD

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 Thank you, Dr. Daniela, for sharing your profound insights and experiences with us today. Your honesty about the challenges and rewards of psychiatry not only illuminates the field but also inspires readers to embrace their own journeys of growth and understanding. We encourage everyone to delve deeper into your wisdom by checking out your book, Practice, Practice, Practice. It’s a powerful exploration of the human experience that everyone can learn from. Wishing you continued success in your writing and your impactful work!