Mindhunting with Forensic Psychiatrist Dr Michael Schirripa

  --  Dr. O’Leary interviews forensic psychiatrist and author Dr. Michael Schirripa about his career as a forensic psychiatrist, the release of his first thriller, Mindhunt, and his podcast Mindhunting.  Dr. Shirripa explores how his love of literature influenced his decision to pursue forensic psychiatry and ultimately resulted in his creation of an international thriller with an ambitious forensic psychiatrist as the main character.  We explore topics like medical ethics, medical education, popular culture, mental health stigma, Australian football, and how people react when we tell them we are psychiatrists.  Learn more about Michael at https://michaelschirripa.com/.

Please leave feedback at https://www.psydactic.com or send any comments to feedback@psydactic.com.

References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com.  All opinions expressed in this podcast are exclusively those of the person speaking and should not be confused with the opinions of anyone else.  We reserve the right to be wrong.  Nothing in this podcast should be treated as individual medical advice.

Transcript

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SPEAKER_02 0:00

You know, I think mostly if we're guided by that principle of, well, what's the best thing I can think of for this patient? Generally it does work out pretty well. And if you can put some of the other noise to the side, other influences, and focus on that, I think that that does help. But you're right. The decision making is uh it can keep us up at night sometimes.

SPEAKER_00 0:26

Welcome to Psychactic. I'm Dr. O'Leary, and today is Monday, June 22nd, 2024. I am your host, and this is a podcast about psychiatry and neuroscience. And today I'm very happy to bring you an author and forensic psychiatrist, Dr. Michael Sharippa. Now, Michael has written a book. The book is called Mindhunt, and it's a thriller that involves a forensic psychiatrist, and I won't say a lot more, because you'll learn more soon. And also is the host of a podcast about forensic psychiatry. Today we're going to talk about uh his journey being a forensic psychiatrist and writing this uh novel that he recently released. We will also get sidetracked talking about things like medical ethics and Australian football and mental health stigma and what might go through your mind when you find out that one of the patients on your inpatient psychiatric ward is pregnant. And just like all my other episodes, I need to first warn you that this podcast is my own creative venture, and no one else is responsible for its content but me. Anything that I say or that Dr. Sharippa says on this podcast is our own opinions and does not represent the opinions of anyone else. Let me not waste any more of your time. Let's get right to the interview.

unknown 1:53

Dr.

SPEAKER_00 1:53

Sharippa, welcome to Psychactic. It's a pleasure to have you.

SPEAKER_02 1:58

Well, thanks so much, Ryan. It's wonderful to be on the show. Thank you for asking me on.

SPEAKER_00 2:03

Yeah, I I'm excited to have you on. I was contacted by, I guess you are publicist, and uh, she introduced me to your work. You have a podcast about forensic psychiatry, and you also recently published a book called Mindhunt. And then your podcast is called Mind Hunting. Is that correct?

SPEAKER_02 2:22

Yes, that's right.

SPEAKER_00 2:24

And I've enjoyed both of those immensely. Real quick, I just wanted to ask you to introduce yourself to the listeners. Uh, tell them maybe a little bit about your background and then what uh got you interested in literature and publishing a book, especially a book about forensic psychiatry.

SPEAKER_02 2:45

Oh, well, thank you. Um I'm glad you're enjoying the podcast, Roman. That's that's lovely to hear. Well, it's been a long and uh circuitous journey, I think, for me to get to this point. I mean, it really like a lot of developmental themes, I guess. Um, it all started in childhood for me. I was always a voracious reader in childhood. I had bad asthma as a child, and I spent a lot of time home from school, and you know, there's not a lot you can do. So I would always be reading, and then I started writing these little short stories just to sort of fill in the time, really. And sometimes I would literally copy other stories out of the books I was reading just to learn what it was like to try to write a proper story, that sort of thing. But then throughout high school, I loved literature and reading still, but I really didn't know what I wanted to do with my sort of career.

SPEAKER_00 3:36

Yeah, if for the listener, they can't see you, but but I can see into your room and you have piles and piles of books behind you. Yeah, yeah.

SPEAKER_02 3:45

I think I've got some hoarding behaviors there that we won't talk about, but you know, I think that uh, you know, I find that hard to let go of books. And I I mean I do have an e-reader, Kindle, but I do love physical books, I must say. There's something magical about them. I always had thought of going to medical school and uh, you know, and be and be becoming a doctor, but I don't know that I ever had the confidence to pursue that at times, but I had this sort of epiphany where after high school I was a bit lost and wasn't sure what to do. So I enrolled in an arts degree and did an English literature major with you know within that and just absolutely loved that. But at the same time, I was still unsure in terms of in terms of a career, but I still had this idea of going to medical school, floating around in the back of my mind. So Australia moved towards a graduate medical school program, much like in the United States, which was ideal for me and where I was at in terms of the stage of my own education and training. And at the same time, I actually became really interested in psychiatry specifically from a few different sources. We had a long-term neighbor of ours who, you know, in retrospect, I realized was very unwell with schizophrenia. And I would often have these conversations with him when he was both well and unwell, and that was really just fascinating to me what was happening to him. Why was he saying these things and and what was going on in his mind? And then in my English degree, I did a lot of um literary theory. So we looked at sort of psychoanalytic themes related to literature, which again really sparked my interest really in the human mind. And then when I was in medical school, it became clear that that was really what I wanted to do. I really enjoyed working on patients, uh working with patients, sorry, rather than on patients. And so, and so, you know, I really enjoyed that element of medical school. And then it was straight into my psychic did my psychiatric residency here in Australia and then sub-specialised in forensic psychiatry. I think what drew me into forensic psychiatry specifically, you know, that intersection between mental health and the law, was that it had that analytic component to it. I really found that it was such a deep dive into people's minds, what brought them to this point, you know, these mentally ill offenders, you know, how did they what happened to them?

SPEAKER_00 6:24

They each have their own story, right? And stories, yeah.

SPEAKER_02 6:28

Yeah, it is. You're right, Ryan. That's exactly what it's like. It's it's all about people's stories. And um, and I think forensic psychiatry afforded you the time and space to be able to really look into these things a lot more deeply than other areas of of psychiatry to try to piece it all together to understand how and why these patients ended up in the predicament they were in. It was it was a it was a long journey, but you know, a very fulfilling one. And um, it also allowed me to, I think, keep my reading interests up. As you know, and listeners would know, you know, there's a lot of reading in psychiatry in terms of uh people's lives, past histories, you know, a lot of the collateral information we we receive about patients. So all of those elements I think came together for me to sort of shape the career that I have.

SPEAKER_00 7:28

Yeah, and and as a forensic psychiatrist, you have a different relationship with patients some, or actually, you probably don't call them patients a lot of the times, the people who you're interviewing at the time and trying to learn about. Can you describe a little bit of the differences between like the relationship a forensic psychiatrist might have with the person in front of them as opposed to like someone who's treating them?

SPEAKER_02 7:51

Yeah, look, that's such a great point, Ryan. And there is there are some significant differences because when someone's coming to see you for a forensic psychiatric assessment, it's it's first and foremost not for treatment. It is for really for an assessment, is is what it's all about. You know, traditionally, if someone comes along to see a psychiatrist, of course, they're coming for symptomatic relief and you know direct treatment. But in the forensic setting, you are often referred to people not from their general practitioner or their family physician, but normally from a lawyer, an attorney, uh, maybe an insurance case manager, or some other layperson who wants you to specifically answer questions about, you know, really what we are, what is this person's diagnosis? And in the case of criminal offending, you know, has a mental illness had a role to play in this person's offending? And what are the risks that this person is going to re-offend in the future? You know, those sorts of questions. Do they have a mental impairment defense available to them, for example? So the focus is very much on trying to elicit as much clinical information from the person you're assessing. Um, because what you want to get to is as much as you can the clinical truth as to what has happened to this person, what their symptoms really are, what their psychiatric history is, rather than focusing on treatment. And it's a it's it's different because you really don't want to be putting words into their mouths, you you know, you don't want to lead them in any particular direction. Your duties are very much to the courtroom rather than specifically to the patient, which is another big difference as well, because you're there to provide an independent, unbiased opinion to the courtroom at the end of the day about this person rather than being on anyone's side or being biased, say, towards the uh the person that you're assessing.

SPEAKER_00 9:58

Is it sometimes difficult given that you know, as a psychiatrist, you're trained to treat people? And then in this case, what you're doing might, or what you say in a courtroom, especially, um, might result in what the person would feel is unfavorable action for them. I'm sure it takes a lot of practice to kind of separate those two things in your mind. Can you explain how you, you know, the process you go through to do that a little bit?

SPEAKER_02 10:26

Yes, I mean that that's another great, another great question because you're right. You're you're in a situation where you you may be, as you say, saying things or reporting things about a person you've seen that that they're not happy with, that uh that that that sometimes they can even take you know great offense to, or at the same time, you know, on the other side of the ledger, so people often it's in their interest sometimes in these particular settings to be like, you know, who's with a particular psychiatric disorder, because it may lead to them, you know, for example, in a criminal sense being found not guilty by mental impairment, or for in a in a civil sense, allow them to receive financial compensation. So you you do have to be very careful about sticking to the actual clinical medicine, I think, that you're you're being presented with, especially in cases where, say, your your diagnosis of a person may be a personality disorder, which again some people can take sort of great offense to at times and not not be very happy with at times.

SPEAKER_00 11:40

Yeah, well, that will happen even if you're not a forensic psychiatrist.

SPEAKER_02 11:43

Yeah, well sometimes that's right. I think we're all in the same we're all in the same situation there. But it is, I think the important thing is reminding yourself that you know the brief you have here and the goal that you have here is really is to to make as accurate a diagnostic assessment as you can. And also, as we were saying, that that really you your responsibilities lie to the courtroom at the end of the day. And by that I mean you're giving it your opinion to an independent arbiter of the facts at the end of the day, and so that's what's important. And I I do make that very clear to every person that I do assess, you know, from the get-go as part of that process when we get going with an assessment and part of their consent process, is that I explain that role very, very clearly. So that does help as well because you know, a lot of people who come to see me for a forensic evaluation, they do believe that they're coming for treatment, even though they may have been told otherwise, say by their attorney or by someone else. It's still very important to clarify that. And I think that does help a lot. And also, you know, remembering as well, a lot of times as psychiatrists, if we're referred to someone for treatment, for example, it's by another doctor, of course, usually, say, a family physician. So when we write back to the family physician, we're writing to a medical colleague. So of course we can use particular terminology in a way of writing. But again, in forensic psychiatry, you're often writing back to lay people, certainly to non-medical, non-psychiatric people who are reading your reports. So again, it's really important in terms of, and this is where the writing kind of comes into it for me and is quite appealing. It's about trying to communicate your opinion and why you've reached your diagnostic opinion in a writing style that can be understood and makes sense to a non-clinician. So trying to avoid jargon or explaining terminology, explaining what medications are or symptoms are or whatnot. Because I do, like yourself, probably I've seen a lot of reports written where the psychiatrist has not explained these things and the lawyer or the social worker or the judge reading these reports may not be able to make head or tail of them because they're still in jargon terms. So that's an important part, the actual report writing element as well.

SPEAKER_00 14:20

That's important even just when you're talking back to a patient in a regular practice to try to remove all the jargon, not assume that they understand uh any of the medical terms or what the medications are, or like if I were to say an SSRI, like how is yeah, to me that's like second nature, but to most people that it's like what what what exactly, exactly.

SPEAKER_02 14:44

So all of those things do help, um, I think in that context of a forensic assessment versus a normal sort of clinical psychiatric assessment.

SPEAKER_00 14:57

I've been reading your book, Mindhunt, and the main character, Dr. Jack, is it Giorgio? Is that how you have Jack? Yeah, and he's working in a forensic unit and actually treating patients, which is a little different than being uh a forensic evaluator at and writing a report.

SPEAKER_02 15:17

So, yeah, so we do have forensic psychiatric facilities out there, which are uh there's sort of a hybrid, of course, between a jail and a psychiatric hospital. So there is sort of say a maximum security psychiatric hospital where you can have two types of patients admitted there. You can have, say, the regular prison population, say, where prisoners are say sentenced for a particular crime. So if they need inpatient psychiatric treatment outside of the jail, they can be sent to a forensic psychiatric unit for treatment and then they're discharged back to the jail. And then you also have the group who are those who have been found not guilty by mental impairment or have the insanity defense who still need secure psychiatric treatment, but they can't be held in a prison as such. Um, so we have these facilities sort of out there that can that can treat uh psychiatrically, psychiatrically treats this sort of pop prison population.

SPEAKER_00 16:20

Yeah, and I think some people, you mentioned earlier that maybe some people could benefit from a determination uh of having a mental disorder that you know kind of resulted in their actions, but some people might seek that out as a way to kind of not uh you I guess the word we would use is malingering, although we don't really like to use that term a lot, but definitely happens uh sometimes. And I was l listening to another forensic psychiatrist who told me that often if they do get a diagnosis, it could end up worse for them because then they go to a unit where uh they if if you're given a sentence by a judge, you spend this much time and then you're eligible for parole and then you get out. But if you are sent to a psychiatric facility, then it the time you spend there in a lot of ways is determined by like the treatment you have to receive, and you could end up being in a place a lot longer or have worse outcomes if you do malinger. Uh that's right.

SPEAKER_02 17:26

Yeah, yeah, you're absolutely right. That's a very good point, Ryan. And and not only that as well, once you are released, see if you're a regular prisoner, of course, you either do your complete sentence or you're paroled, you know. But once your sentence is up, it's up. Then you're out. Out in the community, say, for example, you're you know, you're free. Whereas if you go down the mental impairment line, even once your sentence may be up and you're out in the community, you still will very likely be tightly followed up and have to continue with treatment, even once your sentence has expired as well. Because again, you're right, then it becomes very much a clinical decision. And if the clinical team looking after you still believe, oh, maybe you do need more, you know, you just have to comply with that, and not so it can go. So uh, so it's a very, you're right, it's a very vexed issue if people want to go down that line, they often don't think through all of those consequences.

SPEAKER_00 18:31

Yeah, and I think sometimes the public sees it as an out when it's not necessarily an out, it has consequences itself, yeah.

SPEAKER_02 18:39

Yeah, yeah, that's right, that's exactly right. It it can lead to um even a greater level of supervision and scrutiny being placed on the person than if they were actually just found regular guilty of their crime.

SPEAKER_00 18:54

Um, so Michael, let me uh pivot a little bit toward your book. It's gotten into so many different themes, and I'm really impressed with how much you're kind of packing in there. Why don't you just like give the listener an idea as to what is the book about? Um and then uh I'll uh we can go. Yeah. Oh, wonderful.

SPEAKER_02 19:15

Yeah. So the the book really uh is about uh this young, he's he's he's quite green, but he's he's a very um astute and ambitious, successful young forensic psychiatrist, who Dr. Jack Giorgio, as you said, who lands a this dream job at this brand new purpose-built forensic psychiatric facility in London. And one of the the um lures for him to get this job is he is working with Professor Nathaniel Mortimer, who is this global guru almost of forensic psychiatry, who's who's been around for decades and is sort of one of the most eminent physicians in the world and certainly one of the most eminent psychiatrists in the world. So he's thrilled to get this this job at this brand new facility. However, once he starts working there, he starts to question what may be going on around him. He starts to realize that perhaps the professor is not who he thought he might be. And the professor tries to lure him into a different kind of world, which of course, Jack being ambitious and wanting to sort of please this sort of authority figure, wants to sort of go along with. And he has a particular type of mental state and a particular type of presentation that's very confusing for all the staff. So no one knows what's what's going on there. And and Jack is trying to look into this to see what's going on because he's sort of never seen anything quite like it. I don't want to give away too much. There's some elements there. So yeah. So so yeah, so I try to set the scene as to what it may be like in some of these forensic psychiatric facilities and you know, some of the dynamics that can happen in medicine as well between professors and junior staff. Staff and medical students and how some of those hierarchies can influence people, which I believe they can, and all of those dynamics.

SPEAKER_00 22:11

I've noticed that you use those interactions between the senior staff, psychiatrists, and the medical students to actually discuss psychiatry, forensics, and different uh principles and put them into more plain words. Um, because the staff has to have to explain to the medical students what's happening. And they can't just use the technical language, they have to do it in a more um uh kind of a layway so that they can guide them into an understanding. And by doing that, the reader uh who in most cases is not going to be a medical student, I imagine, is also learning about these things. And so I thought that you do a great job of having these fascinating discussions happen in the book that can be edifying to whoever's reading it too. So they'll understand a little bit more about psychiatry in general because of that.

SPEAKER_02 23:05

Oh, well, thank you for that. That was that was certainly my intention to do that because when I was writing the book, um I was reflecting, uh, you know, again, I think this is where hopefully some of that authenticity comes through. Because as a medical, I remember, you know, I like you, Ryan. I remember my medical school days where you know you're just starting out and you sort of know nothing. And um, you know, and and you're you're greatly influenced, I think, by some of the the clinical teaching that you get from some of the senior staff, both in terms of how they are they are able to communicate technical information to the junior staff. And as we all know, some are better than others, but also the the attitude that senior staff can take to junior staff in terms of well, are they very encouraging and understanding and take the time to explore, or are they very dismissive and of course, you know, even bullying, hostile. And we see some of those elements in the book as well. There's there's there are certain staff in the facility who are who are far more down the old school bullying line who just uh you know, right. Whereas uh so I tried to draw on my own memories and experiences of that as to well, what was it like for me when I was learning about psychiatric terminology and illnesses and treatments, and and tried to relay that through the book.

SPEAKER_00 24:29

Yeah, there's a huge cultural change that's been uh pushed through or trying to be pushed through, like medical education, to be less of that um what we call it pimping, where they just ask you questions to see what you know instead of teaching, where they you know they they they find the limits of your uh of your knowledge and and then you know help you to get further instead of just embarrassing you in front of everyone. Yeah, exactly. Exactly right. You also talk a lot about stigma in the in the book, and you have some of your characters are very complicated, like Professor Mortimer, uh, and out of one side of his mouth, he's talking about like the stigma again uh against patients and the the way the media portrays them, and then and then he's also doing other things that I'm not going to talk about on the podcast. But yeah, can you talk a little bit about that stigma and how you see it in society and how and why you address that in the book?

SPEAKER_02 25:27

Yeah, oh thanks for bringing that up because I think that is an important general theme out there, still in mental health, and something again, yeah, I've tried to incorporate that into the into the plot of the book because I think, yes, we've come a long way in the last, particularly the last 10 or more years, I think, in terms of generally in society, reducing stigma, and in particular having people feel able to come forward with their mental health problems and seek help rather than hiding away in the shadows, like had been the case for so many decades. So I think that that side of things has certainly improved, but I still think there's a lot of there is still a lot of language out there that gets used in a derogatory way or in a punitive way about mental health and mental illness, and a lot of terminology still gets thrown around, even casually out there.

SPEAKER_00 26:23

That really is an example. I know you're really good at pulling up like actual pop culture um uh references. In your podcast, you do it all the time, and it's fantastic. Like right now, can you think of anything in particular you've heard maybe recently that uh is an example of that?

SPEAKER_02 26:37

Well, yeah, well, you know, in in the media recently, um there there have been a big sport in Australia is Australian football, of course, which some of your listeners may have heard of. It's it's it's a bit hard to describe efficiently, but probably like with the NFL or the NBA or other professional sports, there's a small percentage of athletes who have drug problems, of course, like in any part of society. And increasingly um athletes are coming forward with mental health problems as well, you know. Um, certainly, and you know, the concussion issue is becoming a big thing here as well. Like I know in the NFL that's been a big thing, but but when people come forward with mental health concerns, it still gets reported as, oh, you know, such and such is battling their demons or fighting their demons. And and you know, there's still there is still that sort of almost that kind of uh mystical, good versus evil, religious type of terminology that can be used, just as one example like that that comes into my head, where where people are coming forward with mental health problem. We're we're talking about a medical condition here. We're not, even though it seems like a fairly casual comment to make, I think terminology like that, you know, or just sort of lay, you know, someone who comes forward with a depression that's like, oh, they're crazy, you know, it's it really misses the mark.

SPEAKER_00 28:08

I think also like if you say something like they're battling their demons, that gets people's uh wheels moving and they're like, oh, there's something in their past that you know explains all of this, and yeah and that you know that they maybe they did a really bad thing or so. So it gives people a lot of uh like fuel for just speculation about the person that's not really warranted.

SPEAKER_02 28:29

Yeah, yeah, that's right. So so again, so in the book, I try to as much as I can work that work that into it. I mean, we still have the old chestnut of you know, people believing that schizophrenia is the same as someone who has a multiple personality disorder or dissociative identity. Yeah, that's still, and that's something that I try to address uh a little bit in the in in the book as uh as well to a degree.

SPEAKER_00 28:57

Because you also do a great job on your podcast of kind of so the podcast actually would be a fantastic companion to the book in a lot of ways, yeah, especially for anyone who's not all that familiar with with psychiatry or forensic psychiatry in general. Because you you you explain things that are very much in the popular uh media, things like narcissism, you know, like other personality disorders and like what it means to be psychotic, you know, but what uh uh yeah, the differences between like schizophrenia and other things. And yeah, um and your podcast is very accessible to just about anyone, just like the book. So I think that's when I was listening to it, like one of your major strengths, and I think it comes from your literary bent, is to be able to explain things in a way that is both simple and profound, and to really tell a great story. You you also start out almost every podcast episode with uh a story. Um and uh so it it it grabs it grabs me right at the beginning, and I'm really invested in it almost immediately. Oh, well, thank you, Ryan.

SPEAKER_02 30:01

That's that's lovely to hear. I very much appreciate you saying that. That that that's that's fabulous. Yeah, but yeah, but you're right. I wanted to try to each, as you said, each podcast episode covers one particular theme. And you're right, I try to have a particular case that can be discussed, and then we get into the sort of the theoretical sides and try to explain what does this actually mean? You know, when someone's having a manic episode in bipolar disorder, you know, what does that actually mean? Or someone has a psychopathic personality, what does that actually mean and how does it manifest? And then try to tie that into to popular culture.

SPEAKER_00 30:41

Yeah, but there's a you you present cases not like we do, kind of dry, here's the facts like your cases are these these fleshed out stories that have a plot and like are it's very well, very well done.

SPEAKER_02 30:56

Well, thanks. Well, yeah, well, as you said, so for for listeners there, so the the very much so the um the mind hunting forensic psychiatry podcast is very I've tried to make that's more down the line of non-fiction and trying to, whereas the book, of course, is is fiction. But I think you're right, I think the two do complement one another and can can help with with each other. So so with the book, as you know, that there's an overarching theme, I guess, there of from a clinical point of view, talking about psychosis and, for example, schizophrenia and the different ways that psychosis might manifest as well. So I do have uh a plan for a follow-up book, uh, also featuring Dr. Giorgio, but that will then have a different um psychiatric diagnosis as an overarching theme, again, hopefully kind of wrapped up within a thriller bottom line.

SPEAKER_00 31:58

And and just to clarify kind of what you said, because I've read the book, um, you really try to present patients with psychosis as a story, you know, like you are you're portraying their struggles, uh their inner struggles, and then their struggles with the the world around them, and and also the people who have who uh are dealing with them and trying to either you know help them or manipulate them or stop them. Like there's that interplay, and it's and I think that you do a great job of really putting uh the person who has psychosis perspective out front or distracting.

SPEAKER_02 32:34

Yeah, well, well, thanks for for making that observation. And again, that was something that I wanted to try to achieve. And again, without too much, you know, certain characters in the book who are you know psychiatrically unwell, despite those struggles, both within themselves, with their symptoms, with their treatment, and with how they interact with the outside world, um, can find you know the courage actually to come through and you know deliver some pretty amazing um outcomes and and do some incredible things, you know, because that's one of the things that I really, you know, again, we were talking about stigma that can be so frustrating is that you know, people who suffer from psychiatric illnesses like schizophrenia and bipolar disorder, you know, they're they're people first, of course. They they're they're human beings first, they're human beings who happen to have a condition, but they're human beings. And because of that, of course, they all have a you know a personality, they all have opinions, they have views about the world and experiences and all of that. And I wanted it to come through in the book that even though people can go through horrible illnesses at times in their life, they are still intelligent people, they are still emotional people, they're still people who can who can, of course, function out there in the world and do incredible things. You know, I think that and you know, that's something that again, I think we can all get lost in sometimes to just see someone, oh, they're just a schizophrenic. That's it. You know, no, well, they know that's not the case. These are people who have a condition, but they're still people who can who can you know live incredible lives despite their struggles, you know.

SPEAKER_00 34:22

You also maybe this this seems like it probably comes from experience uh for you, but you mention in different places in the books how people react like in in public, like at dinner parties or something, when they find out that someone's a psychiatrist, and like how they might take a few steps back. And I've actually experienced this myself, and I have, you know, I've I have my own line. I'm like, when they ask me what I do, you know, I'm like, I'm a physician, and then like when they ask me more, I'm like, I am a psychiatrist, and then I I see their face, and yeah, one of two things happens, they're either like, uh, or um, or they're fascinated and they want to ask me about it. Um, but there's it's generally not a like, oh, I'm an accountant kind of response. Oh, that's cool. But it makes people have some sort of reaction.

SPEAKER_02 35:10

It does, it evokes a reaction, that's for sure. Yeah, yeah, that's right. So um, so yes, I wanted, yeah, I've I've conveyed a little bit of that experience in in the book as well, of you know, people often you know wanting to step forward at times as well and just say, Oh, can I just tell you uh about asking for a friend?

SPEAKER_00 35:32

And uh this might be a little bit too personal, but you know, we can cut it out, we can cut it out if it is. But um, I was looking back over your your website, and I think it's been updated recently, but you have more like personal information than I was able to find earlier. And uh some of it reminds me of Dr. Jack uh Giordia, like uh the that you are a marathon, you know, like you've recently run marathons, like long distance running is something you really enjoy. Yeah, how much of yourself did you put into this character? And then maybe how much of this character is sort of like a fantasy you like yeah, isn't that a very psychiatrist question to ask?

SPEAKER_02 36:11

Yeah, no, no, that's right. It's a projection of my internal conflicts onto the page, without doubt, you know, and all my well, there are, I mean, yeah, there are elements, so so so I've taken it's a bit like the general plot line with some of the patients, even though, of course, I haven't co-opted a patient's story and just put it on the page. There are elements or traces here and there where over my career where I thought, oh, that that's an interesting line or an interesting symptom or an interesting event. Oh, I should remember that. And it's a bit the same with myself and Dr. Giorgio. There are parts of him that are very much me. So, for example, readers will see one of the one of the mechanisms that Dr. Giorgio uses to manage his own mental health is to go running after work, which is something that I have done myself, learning, you know, as you know, Ryan, we have to learn mechanisms to manage our own mental health and stress levels. And so for me, I found that running was something that really just cleared my head after after work and just you know made me feel better. But then with him, with Jack, I was like, oh, imagine if he, when he was doing that, he could he he as he started running, he would throw these sort of cases around in his mind and these clinical dilemmas. And in fact, that was something he did to to try to work out clinical mysteries and and you know, so I sort of started to incorporate that. So that element of running and clearing, that's very much me. But then I took it a step further with him in terms of his um uh his uh his sort of clinical problem solving. So there there are elements uh like that, you know. Um, I mean he's he's he's probably more appealing to the you know the the ladies than I ever was. I think I was wondering about that. So is that where we're getting into like the fantasy if I could, you know, yeah, right. He's probably in better shape than me, but but that's okay. He's a bit younger as well. Um, but also I think as people will see, he he's someone who who wants to to fit in and and be part of something for sure. And I I mean I was like that. I think that's part of me as well. I think you know, in in a medical career, you do want to feel part of the medical community and you do want to fit in, and sometimes you will do what you feel you need to do to fit in. But I think again, Jack can sometimes just take that a little too far and can get seduced a bit too much by some of the people around him a bit too easily. Sometimes, as readers will see, in a in a literal sense with his love interest, but also, of course, in a in a more metaphorical sense by his relationship with uh Professor Mortimer as well. You know, there's certainly a seduction, um, you know, seduction going on there in a different type of way as well.

SPEAKER_00 39:18

It's somewhat of a bromance in a way.

SPEAKER_02 39:21

Um it absolutely is. But as the as the plot goes on, um that dynamic, well, people see what what's going on actually with that dynamic and where that heads, but I'll I'll say no more. But that that's something that plays out.

SPEAKER_00 39:43

You've already, from what I've read so far, raised a lot of different ethical dilemmas that um psychiatrists might find, you know, in their practice, and especially someone working in an inpatient unit or forensic unit. You know, some of those include things like pharma reps that come and you know, yeah, and they uh that they want to shower doctors with like gifts and food and attention, them to prescribe their medications, of course, or whatever treatment it is that they're trying to push. Um and then uh there's also the difference between uh for-profit um medicine and more socialized medicine. So I think you spend a lot of time in the book, like having the characters struggle over the strengths and weaknesses of each of those and and how you know uh they can present what what I call it, perverse incentives in either case, you know, or allow for certain behaviors that uh you know the other one might exclude, but you know, neither are perfect. And I thought that was one of the, you know, since I've been reading so far that I enjoyed about it.

SPEAKER_02 40:48

Yeah, oh thank you. Thank you for that. But you're right, I think that was one of the themes as well that I wanted to, because as you know all too well, also, you know, there's there are different healthcare systems around the world, and no one system is is perfect, of course. So we're left with this curious mixture of different types of treatments, resources, facilities, attitudes, even though people may be presenting, say, more or less with the same condition, their pathway to treatment or recovery or not recovering can be affected by so many different factors that are almost outside of their control, or some people have more control over them than others. And what does that mean? And and how do we manage all of that? You know, and here we are the clinicians are kind of caught in the middle of all of this who just want to help the patients at the end of the day, but it can be so constrained at times.

SPEAKER_00 41:51

Exactly. Yeah, and there's also an issue, you raise an issue of privacy as well, um, and you know, who can afford it and who can't, and things like that, um, and how far should privacy be taken? Um and yeah, yeah, absolutely. And you raised a question about what if someone gets pregnant and they're an inpatient on a ward? Like what kinds of things do you have to consider in a situation like that?

SPEAKER_01 42:16

Yeah, and that's yeah.

SPEAKER_02 42:18

Oh, well, it's again that that's something, you know, again, writing from experience, from you know, having having female patients, both in non-forensic and forensic settings, who say have bipolar disorder or schizophrenia, or in and in a forensic setting have been convicted of a crime, and then suddenly, oh, and just to throw in a layer of complexity, they're pregnant as well. And it's like, okay, now what do we okay, how do we manage this? So again, there are so many decisions and and uh to to sort of weigh up as to well, what is the right thing to do? Is there a right thing? How do we how do we sort of balance all of this up to to come to some sort of human, reasonable, ethical decision at the end of the day? And it yeah, yeah, it's it's very you know complex. And I think uh because you know that Jack is faced with a similar sort of dilemma, and I think he sort of throws his hands up in the air and says, Oh, I should have done radiology. They never get to they never have to worry about these things. Right?

SPEAKER_00 43:28

They just they just write something down and let the other doctors deal with it.

SPEAKER_02 43:31

Yeah, yeah, that's right.

SPEAKER_00 43:33

Um and uh I I I liked how real you made the doctors and their decisions. I think sometimes people see physicians as being like above other people, like somehow they exist on a plane that isn't like like the plane that they're on. When really uh for physicians, every every day is it's not just a I know something and this is what we should do. It's always like, okay, there's a risk and there's a benefit. How do I how do I communicate that to my patient? What am I comfortable with myself in the um and all these sorts of questions that are very, very different depending on the individual doctor and situation that you're in? Um, and I think you you incorporate that into this book very in a yeah.

SPEAKER_02 44:19

Oh, again, thanks. Thanks for that, Ryan. I think that's right. I think the decision making process in medicine, and I do believe particularly in psychiatry, it is it is so it's often very subtle, and that there's a lot of you know, a lot of complexities that that are that are so difficult to to to weigh up. And you know, a lot of things just can't be quantified either. There's a lot of qualitative decisions that need to be made, and and often you've got two very much opposing ideas that you need to reconcile somehow. Um and you know, sometimes you just at the end of the day have to make a decision and and and really hope that what you're doing is is the right thing by the patient. But I think, you know, I think mostly if we're guided by that principle of, well, what's the best thing I can think of for this patient? Generally, it does work out pretty well. And if you can put some of the other noise to the side, other influences, and focus on that, I think that that does help. But you're right. The decision making is uh can keep us up at night sometimes, ruminating over clinical dilemmas.

SPEAKER_00 45:33

Yeah, and and uh so you you've read the book before this, it says on your umsite. Uh tell me about that one.

SPEAKER_02 45:42

About my grandfather, yeah. Yeah. So um so that was one of the things that kind of was a bit of a prelude to me writing the Mind Hunt book, even though they're not related in terms of plot. So um, so my grandfather, who who was an Italian migrant, who came out from southern Italy as a very young man, he was only 16, and he came out on his own after his own father was was killed back in it. He was the eldest of five kids. So he decided, look, we had no future here. So he came out on his own. It took two months on a ship to to come to Australia, and he settled here and eventually worked his way through and brought his whole family out eventually, his siblings, his mother. And so as he was getting older, he he would be telling these stories, again, as we were saying, storytelling about his life. And I was like, Wow, I better I should get this down because this is real history, family history. And once he's gone, you know, these stories may be gone with him. So he was approaching 90, and um I uh started to do a series of recordings with him just to get some of these stories down, and I thought, oh, I could turn this, this is fascinating, I could turn this into a book. So I wrote a biography essentially of his life story. And um when he was 90, I had it turned into a um a book, and uh we presented it to him for his 90th birthday, and it was a very lovely moment, very, very, but the good thing was that kind of got me into the the mode of writing every day. That was the benefit of it, trying to establish a routine everyday habit of writing. And so I'd started with Mindhunt then. What was the the the the origins of mine? I thought I've got this idea that I wouldn't mind kind of so tch, you know, so I'll um so I'll stay. And then so it just sort of went from there, and then over the last few years it's been back and forth to getting that done. But it was a lovely thing to be able to get his story down and now generations that have been born since he he's now long passed away, but generations that have been born since then uh can now read his story and get more of a sense as to where they've come from.

SPEAKER_00 48:10

Yeah, sounds like you might have picked up some of your storytelling abilities from him.

SPEAKER_02 48:14

Yeah, I think so. I think so. He could he could really uh hold an audience with some of his stories.

SPEAKER_00 48:22

You have a book out now, it's Mind Hunt, and I was able to find it on Amazon.

SPEAKER_02 48:28

Amazon, yeah.

SPEAKER_00 48:29

Yeah, you also have a website, michaelsharipa.com. That's it, yeah. I'll I'll include that in our uh like show notes to transcript just to see if anyone can click on that as well.

SPEAKER_02 48:40

Yeah, um people can find me on Instagram as well, under Michael Sharipa author as well, if they want to follow me there for any uh because I do some reels um short videos on Instagram as well, where I talk about some psychiatric things, talk a little bit about some pop culture as well quickly. And uh so if people are interested in that side of things, they could follow me there as well.

SPEAKER_00 49:06

Yeah, and you you have uh an enormous knowledge of of pop culture. Um I I can tell this from your from your podcast because you always include like somewhere uh near the near the end while you're wrapping everything up, uh a pop culture reference, and you kind of explain how it relates to the topic, uh, or maybe how it deviates from the topic a little bit and shows maybe a uh not completely accurate version of what's going on.

SPEAKER_02 49:33

Yes, yeah, yeah, yeah. I've always been fascinated with that interplay between films, TV, books, and and and particularly you know mental illness, how it like you said, how it can be accurate, but how it can be so inaccurate as well, and what and what are the differences there, yeah.

SPEAKER_00 49:51

Yeah, I annoy I annoy my wife because when she's watching like she loves the medical dramas, you know, the ones that are basically soap operas, you know, in the emergency room or in the with surgeons and stuff. And so I have to I really have to keep my mouth shut or try to because I just ruin it for her and then I don't want to do that.

SPEAKER_02 50:12

So yes, I know I know the feeling.

SPEAKER_00 50:18

Yeah, another thing that happens, I think, to to any doctor, um, and is that once once you people find out your doctor, your family members, you suddenly start getting calls, you know, like um, and then from friends, they'll tell their friends and their friends can call you. I think especially with a lot of the stigma around mental health, um, having just a trusted person who who is like in the know about things can for some people be maybe the thing that actually convinces them to finally go see someone when someone they trust, someone like a friend of the family or in the family can say, Hey, you know, you you can get help with this. Um that we were able to do stuff, you know, and and I highly recommend that you go see someone.

SPEAKER_02 51:07

Yes, yeah, very true, very true.

SPEAKER_00 51:15

Michael, if if someone was interested in going into forensic psychiatry, like they they're fascinated by the interplay of things like uh uh crime and mental health and the legal system and or or even uh insurance companies. I I guess there are some people who you know, yeah, yeah. So what what would you recommend they or want them to know ahead of time, like maybe some of the misconceptions that people might have of what it's gonna take to be a forensic psychiatrist, or uh or you know, what advice could you give them about that?

SPEAKER_02 51:54

Oh, that's a great question. I think yeah, I mean, one of the misconceptions that I often get is if you say, Oh, yeah, I'm a forensic psychiatrist, people will, oh, you do you profile serial killers and uh you know write profiles for you know the equivalent of the FBI or the we have the federal police here, you know, and it's like one, it's not like that. It's not like that. It's um it's it's um I mean it's a fascinating juxtaposition between psychiatry and the law. So I would say to someone, look, if you're interested in psychiatry, but also psychiatry, you know, what I call outside of the square, it's psychiatry in a particular context, then you know you should think about forensic psychiatry because if you have keen or interest in analytical skills and really wanting to understand a person in that context of the forensic system, then that that could be an area for you as well. I mean, you you have to you have to love reading and writing, I think, to be a forensic. You just have to, you know. So yeah, so if you're not a if you're not into that, then I would avoid it. But um, because there's a lot of reading, uh, which is fascinating, and um, but there's a lot of a lot of writing as well. But also, you know, look, it it's an area that can be somewhat antagonistic, of course. It's an area of sort of conflict in a way, both in terms of, you know, you're seeing people who for who have committed criminal offenses, so there's that element of conflict that that's part of the dynamic. You are seeing people who who, yes, can be dangerous and are high risk. But then on the upside of that, you can reduce that risk with your treatment or your what you suggest. You can create a safer community by helping these people. So that's one thing. But also, you know, it can bring you into conflict at times with other people, you know. You you have to write reports that can see you in the witness box in court where you're going to be cross-examined by attorneys who are, you know, hell-bent on winning the case. Um, you may also have different opinions to some of your psychiatric colleagues as well at times, which is an important part of the job, too. So you have to be prepared, I think, to have confidence in your clinical skills and your assessment skills and your own abilities, and then convey that to, as we were saying earlier, Ryan, convey that to lay people in order to help this process roll on. So if you're interested in those things, definitely, and uh, you know, talk, see if you can speak to a forensic psychiatrist about it and uh and what advice they might have to offer as well. And of course, you know, you're very much working in institutions, prisons, secure psychiatric facilities. So it's very important that outside of work you have interests and pursuits and things that can take you away from that. Yeah, that is so important as well. I mean, I think that's true in medicine generally, in psychiatry, generally, you've got to have outlets outside of work where you can just release your own anxieties or build up attention or and work stress as well. So all of those elements are important in in forensic psychiatry too.

SPEAKER_00 55:22

Dr. Shripa, I have really enjoyed this conversation today. I highly recommend Mindhunt, your book uh and your podcast, Mindhunting.

SPEAKER_02 55:31

It's been wonderful speaking with you. I've just enjoyed this so much and your podcast as well. Wonderful. So yeah, it's been so great to chat to you. And thanks for your support with all of this and your lovely comments about the book and the podcast. It's been wonderful. We should uh we we could chat again. Thank you, Michael. All right, we'll talk soon. Thanks, mate. We'll see you later. Bye. Bye, bye, bye.