This writing describes my experience during 2001-2003 working as a post-doctoral fellow at the Massachusetts Mental Health Center in Boston, Massachusetts and my views as a brain researcher on mental illness, wellbeing, and the importance of mentorship. David T. Chau, Ph.D.

1. My
Experience
at
the
Massachusetts
Mental
Health
Center
and
My
Views
on
Mentorship,
Mental
Illness
and
Wellbeing
My
research
within
the
Clinical
Research
Training
Program
at
Harvard
during
2001-­‐2003
was
conducted
at
the
Massachusetts
Mental
Health
Center
(MMHC).
Well-­‐known
for
its
pioneering
research
in
schizophrenia,
the
MMHC
has
produced
a
number
of
clinical
leaders
in
psychiatry.
It
may
come
as
a
surprise
to
many
that
the
MMHC
(previously
known
as
the
"Boston
Psychopathic
Hospital")
was
the
most
influential
sites
for
psychiatric
training
at
Harvard
for
over
90
years
until
it
was
it
closed
in
2003.
A
special
tribute
was
made
at
the
center’s
closing
ceremony
in
honor
of
the
men
and
women
who,
at
various
points
in
their
lives,
have
dedicated
their
efforts
to
provide
long-­‐term
care
for
severely
ill
patients.
Those
who
have
crossed
path
here
reminisced
on
an
era
of
progress
in
which
Psychoanalysis
transitioned
to
Biological
Psychiatry.
The
MMHC
is
rather
a
small
institute,
largely
unknown
to
many
new
students
in
the
field,
but
it
was
an
important
driving
force
behind
this
shift
in
psychiatry.
The
links
below
contain
articles
on
a
heart-­‐warming
tribute
to
this
very
special
place
on
its
closing
day
in
2003.
http://www.1856.org/bloom/main.html
or
http://www.thisiscolossal.com/2012/03/bloom-­‐28000-­‐potted-­‐flowers-­‐
installed-­‐at-­‐the-­‐massachusetts-­‐mental-­‐health-­‐center/
Potted
flowers
(28,000
of
them)
were
installed
throughout
the
MMHC.
A
picture
of
an
old
office
at
MMHC
that
resembles
my
old
office
(upper
left)
and
pictures
of
other
parts
of
the
building
for
the
closing
ceremony

2. At
the
MMHC,
I
had
a
rare
opportunity
to
interact
with
unique
individuals
who
made
significant
impact
on
the
way
“mental
illness”
is
viewed.
These
individuals
also
gave
me
a
glimpse
into
the
inner
world
of
the
human
mind.
I
had
the
pleasure
to
meet
Dr.
Allan
Hobson,
a
pioneer
in
quantifying
conscious
and
unconscious
mental
events
during
sleep
associated
with
brain
states.
Through
conversing
with
him
and
studies
of
his
work,
I
saw
that
he
had
a
profound
insight
into
the
processes
of
the
mind
well
ahead
of
his
time.
I
also
had
the
honor
to
be
mentored
by
and
worked
with
Dr.
Joseph
Schildkraut,
who
many
consider
"the
father
of
psychopharmacology".
He
first
proposed
a
neurochemical
basis
of
psychopathology
through
his
treatise
on
the
norepinephrine
theory
of
depression.
I
saw
the
genius
in
Dr.
Schildkraut
and
gained
valuable
insight
into
the
neurochemical
basis
of
depression
through
working
with
him.
My
research
mentor
within
the
CRTP
was
Dr.
Alan
I.
Green,
who
then
was
a
Harvard
Professor
of
Psychiatry.
He
was
also
a
former
mentoree
and
a
long-­‐time
colleague
of
Dr.
Schildraut
at
the
MMHC.
Currently,
Dr.
Green
is
Department
Chair
and
Professor
of
Psychiatry,
Professor
of
Pharmacology
&
Toxicology
and
Director
of
SYNERGY
–
The
Dartmouth
Center
for
clinical
and
Translational
Science.
My
initial
meeting
with
Dr.
Green
came
about
almost
by
coincidence.
Before
I
arrived
at
the
MMHC,
I
had
daylong
interview
with
PIs
across
different
institutes
affiliated
with
Harvard.
Toward
the
end
of
the
day,
I
received
a
last-­‐minute
notice
that
Dr.
Green
wanted
to
talk
to
me.
A
national
leader
in
the
treatment
of
schizophrenia
and
co-­‐occurring
substance
use
disorder,
Dr.
Green
discussed
with
me
about
the
prevalence
of
substance
use
disorder
in
patients
with
schizophrenia
and
his
effort
trying
to
understand
whether
certain
abnormality
in
the
brain
reward
circuitry
of
these
patients
that
was
responsible
for
this
comorbidity,
known
among
clinicians
as
a
condition
that
was
“notoriously
difficult
to
treat”.
Coincidentally,
I
had
been
curious
for
some
time
about
a
possible
link
between
depression
and
schizophrenia,
because
my
Ph.D.
research
found
that
depression
involves
elevated
tonic
release
of
the
neurotransmitter
acetylcholine
in
the
nucleus
accumbens
(a
central
component
of
the
brain
reward
circuitry),
while
the
opposite
seems
to
occur
in
schizophrenia
–
patients
with
schizophrenia
are
known
to
have
a
deficiency
in
the
number
of
cholinergic
neurons
in
the
same
region.
As
fate
has
its
way,
I
subsequently
joined
Dr.
Green’s
group.
As
a
recent
Ph.D.
graduate
previously
engaged
in
laboratory
research,
coming
to
the
MMHC
has
broadened
my
view
of
the
complexity
of
psychiatric
practice
in
the
real
world.
I
found
that
many
of
the
patients
being
treated
had
multiple
psychiatric
disorders
that
compounded
their
problems
and
greatly
complicated
treatment.
But
there
was
one
thing
I
learned
that
stood
out
from
the
rest.
Through
my
conversations
with
Dr.
Green
I
gained
a
rare
insight
into
the
minds
of
patients
with
schizophrenia
whose
lives
were
transformed
in
an
amazing
way
after
receiving
clozapine
treatment.
Many
of
these
patients
transformed
from
being
withdrawn
and
incommunicable
to
being
delightfully
sociable,
as
well
as
having
a
great
sense
of
humor.
Interestingly,
these
patients
also
ceased
to
use
alcohol
and
substances.
On
the
other
hand,
I
could
feel
the
sense
of
hopelessness
in
those
who
did
not
get
well
despite
receiving
multiple
different
kinds
of
treatment.
I
could
also
imagine
the
confusion
and
despair
in
individuals
afflicted
by
similar
or
other
psychiatric
disorders,
many
of
whom
do
not
have
access
to
care
or
might
not
seek
care
for
a
variety
of
reasons,
including
lack
of
insight
into
their
own
conditions.
During
my
journey
trying
to
understand
the
body,
brain
and
mind,
I
met
individuals
whose
extraordinary
visions
and
life
philosophies
have
made
lasting
impression
on
me.
Among
them
was
Prof.
Stuart
T.
Hauser,
M.D.,
Ph.D.
former
President
of
Judge
Baker
Children
Center.
He
was
known
for
his
work
in
adolescent
development
and
his
focus
on
resilience
to
adversity.
An
excerpt
from
Harvard
Gazette
commented
on
his
work
that
highlighted
the
humanity
aspect
of
clinical
care
and
research
noted:
http://news.harvard.edu/gazette/story/2011/03/stuart-­‐t-­‐hauser/
“His
passion
was
to
understand
the
construct
of
self-­‐identity
development—the
growing
capacity
of
the
individual
to
integrate
diverse
sources
of
information
(internal,
social
and
environmental),
balancing
the
needs
of
self
and
other,
to
move
forward
in
the
world.
As
much
as
Stuart
was
committed
to
understanding
the
development
of
the
individual
human
organism,
he
also
recognized
at
a
deep
level
the
profound
ways
in
which
family
interactions
shaped
this
development.
Not
content
with
the
paper
and
pencil
measures
available
at
the
time
to
assess
these
interactions,
Stuart
developed
methods
for
observing
family
interactions
in
vivo,
so
that
key
qualities
of
family

3. relationships
could
be
better
understood
by
researchers.
Not
surprisingly,
a
favorite
adjective
of
his
applied
to
human
development
was
‘complex’,
and
he
continually
sought
a
deeper
understanding
rather
than
simple,
facile
explanations.”
Another
pioneering
clinician
and
researcher
I
met
was
Prof.
Joseph
J.
Schildkraut.
An
article
commented
on
his
research
philosophy
(independent
thought,
rationality
and
objectivity)
that
reflects
current
approaches
in
contemporary
research:
http://news.harvard.edu/gazette/story/2008/10/joseph-­‐j-­‐schildkraut/
“[In
1959],
having
selected
the
Massachusetts
Mental
Health
Center
because
of
its
reputation
as
a
program
offering
a
psychoanalytic
approach,
he
found
himself
as
a
trainee
intrigued
by
the
dramatic
response
of
depressed
patients
to
the
administration
of
electroconvulsive
therapy,
and
imipramine
and
phenelzine,
then
being
used
clinically
for
the
first
time.
Although
Joe
continued
to
be
respectful
of
psychoanalytic
treatments,
that
revelation
altered
his
academic
trajectory,
and
stoked
a
career
that
soon
played
a
major
role
in
launching
research
into
the
biological
mechanisms
of
depression.
The
result
of
this
work
[measuring
metabolites
of
norepinephrine]
was
a
paper,
“The
Catecholamine
Hypothesis
of
Affective
Disorders:
A
Review
of
Supporting
Evidence”
(1965).
This
paper
…
launched
25
years
of
global
research
on
the
relationship
between
neurotransmitter
function
and
affective
disorders
…
he
elaborated
the
concept
presented
in
his
seminal
review
article
by
defining
subtypes
of
depression
that
could
be
identified
by
their
biochemical
“signature”.
In
retrospect,
this
work
was
a
pioneering
precursor
of
current
research
that
seeks
to
replace
diagnoses
based
on
clinical
signs
and
symptoms
with
a
classification
scheme
grounded
in
biological
markers
that
are
much
closer
to
actual
disease
processes.
It
also
anticipated
current
efforts
toward
personalized
medicine,
to
identify
treatments
that
are
tailored
to
attack
disease
subtypes
defined
by
biological
markers,
including,
now,
allelic
variants
of
DNA.”
A
pioneer
in
behavioral
neuroscience
dear
to
my
heart
was
my
former
Ph.D.
advisor
Prof.
Bartley
G.
Hoebel
from
Princeton
University.
Bart
was
a
visionary
researcher
who
set
out
to
discover
the
brain
reward
circuitry.
His
enthusiasm
for
this
important
line
of
research
is
reflected
by
the
fact
that
he
truly
cared
for
the
wellbeing
of
his
students
and
the
society.
He
was
a
mentor
who
taught
cooperation
and
how
to
live
a
healthy
balanced
life.
His
friends
and
colleagues
commented:
http://www.princeton.edu/main/news/archive/S30/80/58G73/index.xml
http://www.examiner.com/article/food-­‐addiction-­‐expert-­‐bart-­‐hoebel-­‐leaves-­‐widely-­‐recognized-­‐legacy-­‐for-­‐future
“His
interest
in
the
brain
mechanisms
that
control
appetite
and
body
weight
went
back
to
his
Harvard
days,
when
he
studied
under
renowned
behaviorist
B.F.
Skinner.
A
member
of
the
Princeton
faculty
since
1963,
[Bart’s]
interest
in
understanding
how
the
brain
rewards
behavior
encompassed
a
breadth
of
research
and
led
to
discoveries
in
the
areas
of
eating
disorders
and
obesity,
addiction,
alcohol
consumption
and
depression.
Some
of
his
earlier
research
included
examinations
of
how
animals
regulate
their
body
weight
and
the
neural
pathways
and
neurochemicals
involved
with
motivation.
A
1999
study
involved
examining
the
brain
chemistry
of
motivation
and
depression,
looking
at
how
dopamine
[and
acetylcholine]
reinforces
connections
between
cognitive
inputs
and
behavioral
output,
so
that
successful
behaviors
are
repeated.
“Bart’s
research
on
sugar
addiction
in
rats
generated
worldwide
attention
for
its
possible
public
health
applications.
His
work
allowed
scientists
to
examine
more
deeply
the
connections
between
food
cravings
and
brain
physiology,
with
the
hope
that
the
research
could
one
day
influence
work
related
to
humans
with
eating
disorders.
‘[Bart]
was
a
pioneer
who
was
never
afraid
to
put
forth
a
new
idea
and
run
with
it
when
others
might
not
agree.
He
wanted
to
come
out
with
something
that
paved
the
way
for
new
areas
of
research.
Bart
was
very
creative
and
always
tried
to
come
up
with
original
ideas.
His
most
significant
research
unlocked
mysteries
about
how
neurotransmitters
send
messages
between
the
brain
and
the
body
to
turn
on
and

4. shut
off
behaviors.
He
showed
that
sugar
addiction
causes
changes
in
the
brain
seen
with
drug
abuse
and
the
use
of
cocaine,
morphine,
and
nicotine.’
Dr.
Sarah
Leibowitz
from
Rockefeller
University,
a
colleague
and
longtime
collaborator
with
Bart.
‘Bart
always
loved
to
contribute.
His
science
on
diet
and
food
disorders
seemed
to
be
motivated
mainly
by
an
enthusiasm
for
helping
people,’
Michael
Graziano,
associate
professor
of
psychology
at
Princeton.
“Beyond
his
research,
Hoebel
was
a
gracious
mentor
to
colleagues
and
students,
his
peers
said.
[Bart’s]
accomplishments
led
many
to
call
him
a
Rennaissance
man,
and
he
was
much
loved
for
his
sense
of
adventure
and
fun,
and
for
generously
sharing
his
time
and
knowledge.
He
followed
the
same
advice
he
gave
everyone:
'Do
what
you
love.'
'Lead
by
example.'
You
do
a
lot
more
by
doing
than
talking.’
‘He
loved
teaching
and
was
dedicated
to
teaching
undergraduates
–
not
just
getting
up
there
and
lecturing
in
class,
but
training
young
people
to
be
scientists
and
really
caring
about
the
outcomes
of
their
lives.’
Barry
Jacobs,
professor
of
psychology
and
the
Princeton
Neuroscience
Institute.
‘Bart
was
the
very
best
example
of
a
friend,
professor
and
mentor.
He
was
always
the
most
generous
with
his
time,
ideas
and
support.
He
helped
many
of
his
students
achieve
great
things
but
also
to
find
a
balance
in
their
lives.’
Mark
Gold,
chair
of
the
department
of
psychiatry
at
the
University
of
Florida.
Sadly,
Drs.
Hauser,
Schildkraut,
and
Hoebel
all
have
recently
passed
away.
They’ve
reminded
me
that
my
current
work
and
understanding
have
benefited
from
the
collective
efforts
of
early
pioneers
and
the
wisdom
that
they
passed
down
to
generations
of
students.
At
times,
I’ve
wondered
whether
my
encounters
with
these
three
individuals
came
from
my
desire
to
understand
the
brain
and
mind
from
their
points
of
view.
At
other
times,
I’ve
also
wondered
whether
I
was
placed
in
places
where
I
could
meet
these
individuals
to
learn
from
them.
In
either
case,
they
taught
me
three
fundamental
principles
that
I
needed
to
know
in
order
to
make
a
difference
in
someone’s
life.
Over
the
years,
I
became
more
aware
that
my
quest
to
understand
the
human
body,
brain
and
mind
was
really
about
discovering
what
it
is
to
be
a
human
being.
From
the
onset
of
my
career,
I
have
always
been
focused
on
applying
my
research
to
help
better
people’s
wellbeing
and
to
lessen
their
suffering
and
pain.
Over
time,
I
became
more
keenly
aware
that
“individual
wellbeing”
is
intimately
tied
to
“collective
wellbeing”
within
and
across
communities.
When
view
this
way,
I
clearly
see
that
working
toward
bettering
“collective
wellbeing”
is
an
important
endeavor.
Such
effort
requires
cooperation,
which
often
does
not
come
easily.
Nevertheless,
history
tells
us
that
successful
cooperation
is
not
totally
outside
the
realm
of
possibility,
even
during
difficulty
times.
In
the
spirit
of
an
ideal
from
one
very
special
person,
Dr.
John
Nash,
cooperation
can
occur
even
when
there
are
differences
in
goals
and
opinions.
Many
societal
issues,
such
as
joblessness,
poverty
and
improper
diet,
can
adversely
affect
brain-­‐body-­‐mind
health.
These
root
causes
can
be
resolved
if
individuals
and
communities
recognize
that
it
is
in
the
best
of
their
interests
to
focus
on
finding
solutions
for
improving
collective
wellbeing
as
well
as
the
wellbeing
of
individuals.
In
my
view,
Dr.
John
Nash’s
life
is
an
embodiment
of
this
ideal.
While
he
himself
faced
enormous
difficulties,
through
the
support
from
his
family,
friends
and
colleagues,
he
in
turn
was
able
to
make
a
difference
in
so
many
other
lives.
-­‐
David.
T.
Chau
June
19,
2015