The call came out of the blue from the secretary of a psychiatric director of a large and prestigious teaching hospital.  The director wanted to see if I would be interested in applying for the recently vacated position of Chief Psychologist.

 

I had been working in a small CBT unit of what once had been the largest Anglophone mental hospital in Quebec.  Although the hospital was the first clinical site in North America to administer the first effective medications (phenothiazines) to patients with schizophrenia.  But when I was working there, it had many of the stigmas associated with mental illnesses including many shuffling and pajama-clad patients in locked wards.   The new job involved leading a department of psychology in a psychiatric division of a large general hospital with a respected tradition and prominent university affiliation.

 

In my career, this call and the subsequent job came about thirty years ago. However, a similar call will come to many other psychologists at some promising stage in their professional lives.

The point is that I was totally unprepared for what was about to unfold.  I had little or no leadership training, no experience in managing people and my only budget involved planning for family vacations.  I remained as Chief Psychologist for over 25 years and accomplished numerous feats including a tripling of the size of the department, fostering the development and management of numerous specialized clinics from depression to sexual dysfunctions and overseeing the concretization of training programs from practica to post-doctorate level students. I learned quite a lot on the way, and in these next posts, I would like to provide some advice to young psychologists about to accept that promotion.

 

 First off, don’t share any of my initial delusions. 

 

You didn’t get the job as a recognition of your clinical acumen, hard work or any other positive attribute you think that you might possess.  When the hiring committee that interviewed me was privately mulling over my suitability, each administrator, clinical director or staff representative on that committee was asking just one key question: “will he be good for me?”  Of course, there was the “can I work cooperatively with him” question, but most interviewed candidates put on social and compliant faces for a job interview, so the real issue was how did I fit with their needs.  Although I didn’t know it tat he time, the administration of the hospital wanted someone who could bring some coherent and unified psychological presence to the larger organization.  The finance director on the committee wanted someone who could keep the department under budget and the research rep wanted someone who could help psychiatrists analyze their data for publication.

 

It’s easy to see why I fell into my own delusional trap.  Most psychologists in hospital settings work with patients on specific units or programs.  Sometimes, a psychologist might direct a social anxiety unit or an OCD program, but there is only one chief psychologist and after that nothing.   Rarely do psychologists advance to become CEOs or Director Generals.  Therefore, it seems like a big deal to get promoted, but rarity is not recognition or reward.  Promotion is just a different job, not necessarily better or worse.

 

My second delusion involved my peers – I thought that I would be admired and maybe even loved. Wrong!

 

Henry Kissinger once said that the reason there was so much competition in academia was that the financial rewards are so meager.  The same is true in clinical psychology, and in Quebec where I worked, the rewards were even worse than academia.  Compounding the situation, clinical psychologists lack any objective metric of competition.  The productivity of a university prof can easily be quantified and then compared using publications, either number or quality.  When clinical psychologists sit around a table supposedly discussing a case, there is a unspoken competition about who is more insightful or deeper or empathetic in their thinking and analysis. The competition is rarely overt, but it provides a strong emotional undercurrent to every case conference.

 

Promotions do not fit with insight, deep understanding or empathy. In fact, the opinion of promotions among one’s clinical peers is typically negative with “success” being attributed to some philistine or nefarious network of office politics rather than personal merit.  Take the job if you want, but don’t expected adulation from your peers.

 

In my next post, I’ll describe one of the major organizational challenges that every newly appointed manager faces.