In this episode of Elevate Your Relationship Fitness, host Radhika Sundar sits down with Dr. Jaswant Guzder, an internationally renowned transcultural psychiatrist, professor, and celebrated visual artist. Together, they explore Dr. Guzder’s remarkable career, her innovative approach to child psychiatry, and the profound impact of her mentorship on the next generation of mental health professionals. From her pioneering work in cultural consultation to her unique integration of art and mental health, Dr. Guzder shares valuable insights on family therapy, cultural sensitivity, and navigating today’s complex mental health landscape. Don’t miss this inspiring conversation!
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Elevate Your Relationship Fitness
Unlocking Minds: Psychiatry, Art, & Mentorship with Dr. Jaswant Guzder
Send us a textIn this episode of Elevate Your Relationship Fitness, host Radhika Sundar sits down with Dr. Jaswant Guzder, an internationally renowned transcultural psychiatrist, professor, and celebrated visual artist. Together, they explore Dr. Guzder’s remarkable career, her innovative approach to child psychiatry, and the profound impact of her mentorship on the next generation of mental health professionals. From her pioneering work in cultural consultation to her unique integration of a...
- Duration:
- 33m
- Broadcast on:
- 13 Sep 2024
- Audio Format:
- mp3
(upbeat music) - We are honored to introduce Dr. Jasmine Guster, a figure whose contributions stretch across the worlds of psychiatry, academia and art. Today we'll dive into how Dr. Guster's diverse experiences and roles have shaped her unique approach to mental health, art, and mentorship. Stay with us as we explore the extraordinary world of Dr. Jasmine Guster. Hey, I'm your host, Radhika Sundar. Welcome to the second season of our podcast series, Elevate Your Relationship Fitness, where we spotlight mentors whose lives merge creativity, scholarship, and impactful work in society. I'm a registered marriage and family therapist and a clinical supervisor. As an intern member of the Cultural Consultation Service at the Jewish Hospital in Montreal, I had the opportunity to work under the mentorship of Dr. Guster. This experience taught me valuable lessons on cultural sensitivity, especially in dealing with parent-child relationship and supervisor, supervise the relationships. Dr. Guster is an internationally-renowned transcultural psychiatrist and psychoanalyst, a clinical professor at University of British Columbia, retired professor at McGill University, and she was the head of child psychiatry at Montreal's Jewish General Hospital. In addition to her clinical and academic roles, she is a supervisor guiding the next generation of mental health professionals with her deep expertise. Beyond her medical career, she is a celebrated visual artist whose work explores profound themes of identity, exile, and human resilience. Hi, Dr. Guster. We are honored to have you on our podcast today. - Thank you. - So how are you doing? - I'm looking forward to the interview with you. Thank you. - Thank you for being here. So can you just share with our audience your journey as a child psychiatrist and professor at the universities that you are teaching and also clinically representing now? And what inspired you to pursue this path? - Well, I mean, I think most people who go into healthcare have some personal incentive to serve. And I was very fortunate because I was able to come to McGill. I would say that probably being aware of my mental illness in my family tree had a lot to do with possibly at the end, my deciding on child psychiatry. So my work has been basically advocating for children, global health included and certainly locally and consolidating the department at the Jewish General on a family-based approach along with the establishment of the cultural consultation service. - Awesome. And I know that you were probably the forerunner of child psychiatry, probably in Canada. So how has your background as an artist influenced you in your approach to child psychiatry and your work with children and families? - Well, I don't think I was a forerunner. I have to always thank my mentors. It's very important to thank mentors. And I was very fortunate because when I came to the Jewish General to do my training, it was the only family-based center, I think in the country. And we had a really exciting exposure during residency and all through my life then to doing both family therapy training and psychoanalytic training and psychiatry training. So that's sort of part of it. As far as when I actually took over the child department and the day hospital, which had 56 children at a time in a family-based program with a community engagement model with school, I was, we were a training center. So for 25 years, I trained art therapists. When I went to medical school, I also went to art school. I was very divided about what I wanted to do at various times. So I just have accepted that I'm an artist and I'm also a physician. And that involves all sorts of wonderful people that I've encountered who also share an interest in how creative process is healing. - Because I have just seen you do that even in meetings, sometimes that you would be using your sketches and I am really amazed at the way that you have been able to add art into mental health. So how do you view the role of family in children's mental health? What strategies do you recommend for families to support their children effectively? - Well, that's a very broad question. Well, yeah, first of all, as a child, as a child psychiatrist, it's impossible for me to assess what a child needs without meeting their family or knowing about their family. And that's, you know, goes deep into the idea of generational impact and histories that are passed down into the parents of the child. And so at least three generations is very helpful to understand the strengths and experiences, lived experiences of that family as they, and where this child was, where this child came into that story. So family therapy for me is incredibly basic to everything. If I meet a mother who's pregnant, it's very important because that's the beginning of family therapy and so on. And in refugee care where there's a pre-migration history of exile or dislocation or loss or we lose people in our family, that's a very important part of what we work with with children. So I'm used to working with comorbidity, with great difficulties. And, but in order for us to treat you in our service, we had to have an agreement that the family would be an integral part of daily contact and weekly meetings. - That's a wonderful work. You know, I think, you know, you are just sharing that with our audience. So what do you think are the most pressing mental health issues that you see in children today? And how have these issues evolved over the times? So especially with the back to school and everybody's looking for tools to help, what would you share with our audience about that? - Well, I think since COVID, we know that there's been an incredible escalation in anxiety and depressive disorders and drug addiction problems in youth and young people. So if you start at the very beginning, having good daycare is really important. Adverse effects in childhood from the very beginning are crucial to the long-term health of any child. So every effort that a parent makes to have support in bringing up a child is very, very important and where that child goes to daycare and what kind of care they get and what kind of care the parents get for their health. That's all part of being healthy and being connected with your community and your school. That's also part of it once children start school. The rougher times, I think, are youth and adolescents. It's a very fragile time for a lot of children. Minority children in particular, I think have certain kinds of issues which are often not addressed or invisible in schools. So it's a complex question actually and I don't like to give advice. I rather that the person understands what they think is gonna help support them and be in parents because that's an imprint we have for life on somebody's formation. - Yeah. And then also we are looking at a new generation of children who are growing up with social media and their world is just around that. So that is going to be really difficult. There's another layer of concern here how to navigate around those issues too. - Yes, I think the school boards who have decided that during school you shouldn't have a cell phone with you, that's an intelligent move. - I think it's, you know, ever since we, you know, children have also been exposed to TV for a very long time. And one of the issues again is about cell phones and TV and media is the attention span and the lack of opportunities to be in nature and to use your body and to work in teams and how solo it is, that activity and how attention span goes very, very quickly that people are bored very easily. They don't know how to have a conversation. It's really not something that people in our generation understand that that's a very huge world out there and false information is another huge issue. So we have a time of ideological instability in the world of climate change impact in the world, of kind of finding a path that is really going to be very challenging for young people. So it's not easy again for us as parents to anticipate how we could help children. But certainly the indigenous people are very strong on this. The land is very important and being out in nature can be very healing. And so what do we give our children that is healing? Like sports teams and team experiences or however that child is talented to support that and validate that, that's very, very important. - Yeah, awesome. So how important is cultural sensitivity in child psychiatry especially when working with the South Asian families because here in the GTA area, it's 52% of the population is from South Asia. - Well, let's just focus on the South Asian community then because I think it's important for every family. It doesn't matter what family, every family has a culture. And I think minorities as you know, particularly black and indigenous children are the highest risk for mental health challenges. Unless they find themselves in a very healthy cohesive community with a lot of support. But thinking about South Asian families is very heterogeneous. India itself is very heterogeneous. South Asia is very heterogeneous. What happened in Sri Lanka is very different from what's happened in India. There's a huge breakdown in Bangladesh and in Pakistan. So people from the subcontinent have their own complexities. And then there's a generational issue. So I'm from a generation that started in 1906. So it's a very different history from a lot of the waves of immigration started in the 1970s where the professionals came. And then there was before that when my grandfather's generation came, it was laborers. And I think that's another issue is the, is the tremendous heterogeneity of educated migrants versus those who have come as laborers, et cetera. So I don't think we should ever treat the South Asian community as a homogenous entity. We should always be very careful to understand that every patient you meet has got to be taught, they are your teacher. And you have to say, I've come into this not knowing. So I consider cultural sensitivity to be number one. I don't know anything. - At number two, I'm prepared to learn from you what you eat and who you are. And until you teach me that, I can't make assumptions. - That's an excellent way of looking at the perspective that we are in this particular society. I think that's an excellent explanation that you just gave. So I just would like to move from here to the clinical supervision. So before I just move on to that part, I just want you to, you know, wrap up that section where we are talking to children and families. And what would be your one advice, you know, for especially going with the cultural sensitivity? Like you said, it's a homogeneous group. But then what would be a good advice for them as they go back to school now? - Again, I would find that very difficult to answer because I wouldn't know if your family was very sophisticated and stayed in the same community their whole life and knew the school and the children had a stable peer group as opposed to a child who just moved or whose parents are ill or, you know, so there's so many complexities for every family in launching somebody into the school year. And including your community and your community school and what you feel is your connection to it as a parent or not or not. How many jobs you have, how busy you are as a parent, a present you are in the child's life. So all I can say is we all do our best. - Okay, and I just hope for all these children that are getting the support they need that they thrive in a community that cares about them. - But thank you for that. So let's just now move on to, you know, your role as a clinical supervisor and your experience with that. So how would you describe your approach to clinical supervision, especially what key principles guide you when mentoring young professionals? - Well, I've had a long role as a supervisor. One of the issues is it's very different to do individual supervision and very different to do group supervision and team supervision. So I do a lot of team supervision because very often I'm the only psychiatrist and there are many different professions in the room and also very uneven amounts of experience. So in a group supervision and you're building a team it's very helpful that you have unevenness and that you have respect for each voice in the team. And I think that that, so that's that starting. And then I think the experience that I have is really modified according to that team and according to that person. So I have to meet that experience like we all do with some respect for each of my team members because my job is to validate and build strengths, to build critical thinking, to expand understanding of the literature if that's helpful, to understand the nuances of diagnosis and the complexities of not jumping to conclusions and building how to build alliances with people who you're supervising with and also to help them build alliances with whoever they're treating. And I always, it's very important to recognize that the person in the room with the patient is the expert on that session. So I'm very, I'm very careful about respecting that whoever is in that room with that family is probably seeing and experiencing lots of things which are very difficult to integrate all at once. So one of the things I like to suggest sometimes to a young person is having a co-supervisor experience with different people so that they can develop a critical thinking about developing their own style of approach. And in South Asian families, you're dealing with collectivists of families. So you must also be very careful to understand who has power in that family and the power to silence and the importance of silence and not putting a child on the hot seat. And when there is a lot of pressure on that child for cultural reasons, not to betray anything about their family. So again, this is about navigating culture, navigating where the power is, finding out who really is the person with distress even though the identified patient may be a child, very often they're the symptom bearer for a family system problem. That's one of the first things you have to figure out. That's an excellent look at how we are looking at the collectivistic families that's often found here in the GTA area. So as supervises and as a clinical supervisor, I often get referrals from students who are of the South Asian background and also about from students who are not from that background but they want to know more about the South Asian culture. So when they first come into my clinic, the first question they say, what should I do before I start supervision? Is there something I have to learn about the South Asian culture before I work with a family? Now I just heard you talk about identifying that power and identifying the silence in the family or in the room. Can you just talk to us more about or just give us some examples about how we can just look for this in the therapy room? - Well, you've already introduced another quandary which is someone who is South Asian being a therapist as opposed to someone who is not acquainted even. So that would be like a black therapist or a black family being treated by someone who has no concept of what is like to be black in North America or has any even legacy. So I think that is not something you get in a book, okay? Which is why supervision is really helpful. So that's why the Cultural Consultation Service, we always included the therapist in the meeting with the family because a lot of the learning took place during the interview about your question about how does one listen and navigate the complexities of a family? And there should be a follow-up, a time when you're not with that family when you can discuss what that person felt and experience and what you can add to it. And so again, because of the tremendous heterogeneity intermarriage, people who have a range marriage, people who married somebody, their parents didn't want, a million, you know, improvisations of what, who is in the room. And then even more complicated is people who are on, you know, have been unaccompanied minors or have had to migrate during war, people who have been in exile and so on. So there are many fragilities that one has to learn case by case. And that means you need to talk to people and you need to elaborate and continue your conversations rather than saying there's a particular way I should approach a Jewish family or a particular way I should approach an Italian family. I really do not believe in recipe books. I mean, I'm very opposed to reading a book that says, okay, this is how you deal with such and such a family. I would prefer that you deal with intersectionality, the gender and identity and all kinds of other issues, structural issues have a lot to do with what's going on in your room and how they perceive you. So a lot of this is about identifying what you might be representing in that meeting and who you might unconsciously be identifying with or over identifying with or disliking and using those feelings within yourself to figure out why you're going there in that meeting. So I find a lot of my work in Quebec, there was a kind of sense that we're saving a child from a traditional family because they want people to a culture quickly. But you see, it's much more complicated than that 'cause if I love my family, I'm navigating two worlds and some of it's got to be private for a while. So what you're doing in a family session could be quite different from what you can do in an individual session. And you don't tell people to get their kids to a culture aid. You come to a family where they are and you try and get them to tell you, okay, what it is that they think they need and what it is that they're finding difficult. And you go with them, you don't decide for people. - I don't know if that's helpful, but. - Yeah, that is because it's like we just look at the client and I just remember my experience working with a case when I was at the Jewish as an intern. And this is like you place yourself where the child is situated, not from where you are situated, was what you would always say to us. So I just remember that. And I think it just applies to every therapist or intern or a supervisor I see with whatever culture it is, it is where they are situated and how they look at it from their own perspective. So thank you for that perspective. I think our supervisors will really like to listen more about it. And I also really appreciate the fact that you say, "There is not one book that is just going to teach us "about what we really want to know about a culture, "because it is situated within the family "and every family is different." So, and I think it is a very important conversation, not many guides or books are really out there. So it has to be really experienced. And coming from an experienced person like you, I think it is going to be really helpful for the supervisors to take these guidelines and apply them into their field of work. So now I just want us to wrap up our session with some personal reflections from your career. So how have you balanced your role, Dr. Guster, as a psychiatrist, as a professor, as an artist and supervisor throughout your career? How did you do that? I don't know. How are you doing that? I don't know. I don't have an answer for that. I've always, you know, you have to do things that you love and that you find meaningful. And that would be the guide for me. If I need my art in order to say saying, I'm making art. And if I believe in certain things, I have to change in order for other generations to do better. I'll try and advocate. I mean, those are really important values that I got from my family. I also think that what you said about books, I mean, the fact is that when I started out in psychiatry, there was tremendous prejudice against treating the untreatable patient. And untreatable patients included indigenous people and they often included South Asians or anybody, a black, because the white therapy approach didn't fit what they saw. And there was not a sense of safety for people in that community. Generally speaking, children, they came because of youth protection or because somebody decided that a family was a parent. And so it was very traumatic, the whole. So again, you have to think that what it was like then and what it's like now. I think now we have more South Asian therapists, we have black therapists speaking up, we have tooth and reconciliation movement beginning, the acknowledgement of the genocide, the acknowledgement of slavery. Now, but it still hasn't permeated into general thinking and I had to go out and meet people and read medical anthropology was very important to me, OBS Kerry's work, Sudhir Kakkar's work, Daya Somosundaram's work on the subcontinent, because these people were investigating the mythic basis of a lot of the feelings and cohesiveness and collective ideas of the subcontinent. And that you can't get from one book, but from many conversations. And also finding people who have had lived experience in different cultural spaces and movement, even migration. So even you'll see in research now, we don't just look at quantitative methods. Thank God, we are also understanding, we have to understand lived experience and we have to do qualitative methods. Now that means really looking at now, is it gonna be just CBT and AI that are gonna give a therapy? Or are real people like you and me going to actually learn from a family? That's also something that's pretty fragile at the moment. So I think things are really changing and I think you believe in family and couple work and so on. But I've not met a lot of people who are choosing that path. So congratulations on your work. Thank you. So what would be your advice to young professionals, especially those from the South Asian backgrounds who are entering the fields of mental health and psychiatry? Well, first of all, it's not like when I first started, there's a lot of South Asians in medicine and in nursing and in social work. So it's a completely different genre of experience. Now there are people that you can identify with, there are role models or, you know, the person who's running for the United States presidency has a mother who's South Asian, et cetera, et cetera. So, you know, so I would say that we're in a different place as South Asian educated or even generations allowed to have an education. My mother and my grandmother didn't have access to an education because of poverty and all sorts of other things, a partition of India, whatever. So I think if I was a South Asian young person now, I don't think culture would decide what I was gonna do. I think you're really free, fortunately, really free in this country to choose. Not everybody in your family will maybe, you know, say rah, rah, rah, but, you know, if you're used to being, if you're used to the fact that it isn't a popularity contest and you're following your joy and you're really committed to what you're doing, you're gonna probably do well. Yeah. - That's very motivating and it's good to hear from someone, you know, who has been a pioneer for us, you know, with a South Asian background, you know, you have been really a big inspiration to some of us. So I think it's an exciting future and we are just waiting to see how things are going to pan out with the AI and also with the family work and the couple work. So I would just like to wrap up our interview with this and just to start with one last question about, how do you continue to find inspiration and motivation, you know, with your own personal aspect with your career. So we will just wrap up with that. - Oh, you know, I'm 77 now and I love what I did. And I feel so grateful that I was allowed to have the career I did, but I believe in change and in being where you are. And these are very difficult times coming now in my institutionally, in terms of mental health access in terms of division between people who have financial assets and those who do not. So in so many ways, we have a great opportunity to put input into institutions and help communities. But on the other hand, there's a lot of tensions, you know, pulling the other way, like privatizing all care and disbanding Medicare and losing very many young people who are shying away from actual medical careers. And so I just hope that if there are bright young people out there, that they will consider medical care and that they will consider any level of medical care is going to be so needed. And whether they're a researcher or whether they're a clinician or whatever they decide to do, because we're going to need them. And we're getting, I'm hearing a lot of young people telling me, no, I don't want to do nursing now. No, I don't want to do medicine. I don't want to do family medicine. I don't, and it's because these are challenging times. So I hope they follow their joy and do things which they feel are deeply meaningful. - Well, thank you, thank you for being with us today. I really appreciate your time. And I just look forward to the comments from you, audience, about and your feedback. You can just share it with me by email or you can just go on to the website at www.omfamilytherp.com. www.omfamilytherp.com. Thank you. Thank you. (upbeat music) [BLANK_AUDIO]