Off The Couch #1 Introduction

In our first episode of our series “Off the Couch”, we find out how Dan came to be the psychologist that he is today. What did he study in school? How did he become interested in Buddhism as a molecular biologist? Who were Dr. Brown’s mentors? Where was his first clinical placement?

Read the Full Transcript:
Caroline Baltzer: So, Dan, I’m very interested in how you got to be the psychologist that you are. I’m thinking about what you were like as a kid and how you started to become interested in psychology. And I want to know, since you have so many different areas of expertise, how did you find yourself going from one to the next. How did it all weave together?

Dan Brown: Well, I grew up in the 1950s, and science was the religion of the 1950s. So, when I went to college, I went to the state school because that’s all I could afford to go to, the University of Massachusetts. I had to work three jobs to get my way through school because my parents didn’t have the money to help me go through college. Education was my ticket. And when I went to undergraduate school, I did all the science courses, and I saved the Humanities and Social Sciences for the last year. But I had to take certain requirements in order to graduate, and I didn’t want to take all that stuff, because it was soft. So, there was a course on Eastern religions. I said, “Well, that’s a joke.” That was the softest thing I could possibly imagine. And there was a textbook in that course. They had a book of Tibetan meditations called Tibetan Yoga and Secret Doctrines – a translation of a Padmasambhava text and a Pema Karpo Mahamudra text from 1927.

Caroline Baltzer: Oh my gosh.

Dan Brown: I read the text, and it stunned me. And it was all very familiar to me. And I said, “This is what I want to do with my life. I want to work with training the mind.”

Caroline Baltzer: What do you mean, “it stunned you?”

Dan Brown: It was all very familiar to me. And at the time, I was a molecular biologist, and I was growing invisible bugs all day in the laboratory. It seemed more and more irrelevant to the Vietnam era and all of the things that were going on in the world around me, the idea of growing invisible bugs all day. It seemed increasingly irrelevant. And training the mind and being more involved in social phenomena around us seemed more relevant. But I knew I couldn’t make a living by translating Eastern meditation texts, so I thought I would retool as a psychologist and do the translations on the side, which is what I ended up doing. 

Caroline Baltzer: Not psychiatry, with your molecular biology background.

Dan Brown: I couldn’t afford medical school. And I happened to get a Danforth, which was a fellowship that they gave, I think 12 a year, to people around the country. They paid full tuition and full living expenses at the University of Chicago, which was a very expensive school in those days. That was my ticket. It was a scholarship for young promising teachers. I applied for that, and I also applied for the Rhodes. I was the backup candidate for the Rhodes.

Caroline Baltzer: Oh my gosh. 

Dan Brown: And that got me started. That gave me a ticket. So, I’ve always tried to give back, in appreciation for what I got out of my education. This was in 1970-‘71. And at the time, one of the jobs that I had was working in a walk-in drug clinic. That was my first exposure to mental health. I was working with people who were addicts of various sorts, and being a product of the 60s, I was one of the people who went around the country and set up medical tents at all the big rock festivals. Our biggest rock festival was May Day, in Washington, and they marched, a million people in Washington. There was a Heart concert all night, and in the middle of the night, they tear-gassed the concert and arrested everybody. Chaos broke out, and I was trying to protect my staff in the total chaos of the environment. We were betrayed by our own government.

But then I went to Chicago, and the summer before I went to Chicago, I was at Maimonides Memorial Medical Center, working with Stan Krippner. And he wrote a letter of introduction to my mentor at Chicago, who was Erika Fromm. I wouldn’t have got to work with her without that letter of introduction. But she was my main clinical mentor for 35 years. When she was in her late 80s, we traveled around the world together, teaching three-day hypnosis courses. I was in my 20s, and I would tease her and say, “I’m too old to keep up with you.” She was in her 80s, and she was not just the clinical mentor, but a real mentor. 

Caroline Baltzer: How did she mentor you? 

Dan Brown: She was like a good parent. So, I worked with her for 35 years. That’s a long time. 

Caroline Baltzer: What kind of mentoring advice did she give you? 

Dan Brown: Well, I remember one time I was really sick, and I was out of school for about two weeks, in graduate school. I had gotten endemic hepatitis from eating in an Indian restaurant. Poor food. Knock on the door. She walks in with all these bags of groceries and food that she had cooked. She says, “It is two weeks’ worth of food and groceries.” There was that kind of nurturance that was very special. She took care of me. 

Caroline Baltzer: She took you under her wing. 

Dan Brown: And I took care of her. So, it was a special relationship. Then, at the University of Chicago, I had other mentors. One was Gene Genlin, from the Rogerian, Carl Rogers group. 

Caroline Baltzer: I didn’t realize that. 

Dan Brown: He was my next-door neighbor and friend. I learned experiential focusing from him.

Caroline Baltzer: Focusing.

Dan Brown: Yeah, I learned that well. And then, I did my first clinical placement in the mid-1970s, at Michael Reese Hospital in Chicago. Those were the days that Analysis of Self came out, the beginning of the self-psychological movement with Heinz Kohut. He was one of my supervisors. 

Caroline Baltzer: At Chicago or at the hospital? 

Dan Brown: He was at the Analytic Institute, and he was at Michael Reese.

Caroline Baltzer: Oh my gosh. 

Dan Brown: So, I got to study with the first generation of self-psychologists, and then when I came to Boston for my internship, I had a female analyst who was a self-psychologist. I spent nine years on the couch, four times a week, with self-psychological analysis, so I learned self-psychology very well. 

Caroline Baltzer: Who was that?

Dan Brown: Judy Kantrowitz. But I had worked with Erika, and it was short-term hypnosis work. So, I had to synthesize short-term hypnosis work in visualizations with long-term self-psychological development. 

Caroline Baltzer: Because you were learning both at the same time. 

Dan Brown: Yeah. So, the blend of that developed a series of short-term visualizations that corrected self-development and self-esteem. And that’s where that came from. So, in the 1980s, we developed a series of protocols for self and self-esteem development that were very effective in treating people with severe self-esteem problems, otherwise known as people with narcissism.

Caroline Baltzer: Some of that we use in our attachment model. 

Dan Brown: Some of that we use in our attachment model. Then, when I came to Boston for an internship at McLean, which is where you also did your internship, I spent the first 10 years of my professional life doing intensive psychotherapy with psychotic individuals. Because that’s what we did in those days. And I spent sometimes four or five times a week, half hour session and sometimes hour sessions, working intensively with psychotics and trying to get them better. I had a supervisor at McLean, and we had a good track record with getting psychotic people better. 

Caroline Baltzer: Who was that? 

Dan Brown: Dr. Jalna Perry. 

Caroline Baltzer: I remember hearing about her. 

Dan Brown: She was a great mentor to me. No one ever heard of her, but she knew how to get people better. And then, later at the Menninger Foundation, it was Milton Wexler who had a self-psychological model. Dr. Perry’s model was that psychotics are deficient in the capacity to experience emotional states. There’s a whole protocol for how to get them to experience genuine emotional states, locate them in the body. 

Caroline Baltzer: Is that still being used today?

Dan Brown: Well, we stopped doing psychotherapy on schizophrenics when antipsychotic medications came out. Milton Wexler had a model, where psychotics were deficient in self-development, and he focused on developing a sense of self. So, if you focus on affect development and sense of self, then the likelihood is that, by developing those positive structures of mind, which are normal developmental lines, then the psychotic symptoms go away without any change in the medication; and they get better. And we found, before the years of great outcome studies, that like what we did in the generation of outcome studies, that there was a third- third-third split. About a third of psychotics got better, a third showed some improvement, and a third didn’t respond at all to treatment. But I found, over the years, that psychotherapy with psychotics became on the endangered species list, because no one was doing it anymore since the antipsychotic medications came out. It sort of co-opted the profession. 

But when I was at Cambridge Hospital, in the 1980s, and I worked first at Central Hospital, and then at Cambridge Hospital. Those were the years when all the NIDA money went into substance and alcohol use work and treating people for affect dysregulation problems, which were the heart of addictions. So, I trained in that generation with people like Ed Khantzian, Howard Wishnie, and George Valliant. And we learned a lot about the whole generation of how most addictions, whether they’d be alcohol, or drug addictions, or eating disorders, or self-mutilation, they’re all addictive behaviors, start with problems of affect regulation and then become overlearned responses. Then, Cambridge Hospital brought in Alan Marlatt from Oregon for a year, and he taught all the behavioral stuff on how you work with relapse risk-prevention. So, I got a good model for how to treat addictive behaviors from my years at Cambridge and eventually began to apply that more to it looking at things that weren’t considered addictions in those days, like self-mutilatory behavior and Internet addictions. 

So, before I was at Cambridge, after my internship, I first worked on the dual diagnosis unit at the State Hospital, with patients who had psychosis and alcohol and drug addictions. 

Caroline Baltzer: Where was that? 

Dan Brown: Westborough State Hospital. I did that for a year. And then, the Director of Training position opened up at Cambridge Hospital, and after I finished my postdoc, I stepped right into that and ran the psychology internship program for nine years at Cambridge. While I was there, I started the Behavioral Medicine Program because the 1980s was when behavioral medicine was developing. So, we ran groups and did individual treatment for people with irritable bowel syndrome, chronic pain, and insomnia; and we had hypertension groups and asthma groups. We sat in the wrap-up meetings for medical patients with the primary care doctors teams, senior teachers in internal medicine from Harvard Medical School, and we gave behavioral commentary on their cases. We found that two-thirds of primary care cases were about psychological issues and issues that were not purely medical. So, we had a central role in the treatment and developed a major Behavior Medicine clinic at Cambridge Hospital. 

Caroline Baltzer: I wonder if that’s still there.

Dan Brown: It isn’t. It has all been dismantled.

Watch the full “Off the Couch” clinical interview series

1. Off the Couch Intro: Meet Dr. Daniel P. Brown 
2. Overview of Trauma Treatment
3. Attachment Disturbances 
4. CCRT (Core Conflictual Relationship Themes)
5. Three Pillars Approach (Treatment for Attachment)
6. Teaching Psychology
7. Conversion Disorders 
8. Factitious & Dissociative Disorder
9. Psychological Assessments
10. Bipolar Disorder Treatment
11. Trauma Bonding Maps
12. Conclusion 

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