The long view of psychoanalysis

Tracing her professional lineage to Freud, alumni leader Jocelyn Malkin still sees a place for the couch.

As a high school student in Manhattan, Jocelyn Schoen Malkin, M.D. ’52, found her calling during a lecture by the prominent psychoanalyst Lawrence S. Kubie, M.D. Though Malkin had long been interested in emotional issues, she said, something clicked that day. “I just thought [psychiatry] was the living end,” she recalled, using a colloquialism of the day. Despite the era’s formidable barriers to women in medicine, she made up her mind to become an analyst. More than 60 years after that decision, she continues to practice, teach and advocate for psychoanalysis.

Malkin, who was elected president of the Association of Yale Alumni in Medicine in 2007, has long done things her own way. She grew up in Rockaway Beach, N.Y. Both her mother, who had been admitted to law school but discouraged from entering by Malkin’s grandfather, and her father, an insurance salesman, strongly valued education.

Studying medicine at Yale, though, had not been in Malkin’s plans; it was the unintended consequence of a lark. While an undergraduate at Barnard College, she intended to join her then-boyfriend at Columbia University’s College of Physicians and Surgeons. When Yale invited her for an interview, she decided to have some fun. “I dressed like I was going to a football game. ... like an ‘import’,” she said, using Yale slang from the mostly male era for a woman brought to campus as a date. “Instead of looking like a frump, I ... wore a fur coat.” Fritz Redlich, M.D., then head of the Department of Psychiatry and later dean of the School of Medicine, asked her why she would make a good medical student. “I said I had a sense of humor, so I could tolerate an interview like this. ... He loved it!” Yale offered her early admission to the Class of 1951.

Malkin’s acceptance may have surprised her undergraduate advisor at Barnard, a female chemistry professor who had advised Malkin during her freshman year to forget about medical school. Fond of dating and partygoing, Malkin had earned subpar grades that year. But she suspects her appearance was also part of the problem. “I didn’t look the type,” she said. “In those days, you had to look like an old frump, and I was having a wonderful time. I thanked her and never saw her again.” Malkin raised her grades, and by the time she was pulling on a fur coat for her Yale interview, she was poised to graduate from Barnard a year early, Phi Beta Kappa and cum laude.

In 1948, at the end of her first year of medical school, after parting from her Columbia boyfriend, Malkin married Myron S. Malkin, Ph.D. ’52, a former Marine and a senior in Yale College. Unlike most other men she dated, he was thrilled that Malkin planned to practice medicine. The women in his home town, he said, just “sit and play mah-jongg.”

The Malkins graduated in 1952, he with a Ph.D. in physics and she with an M.D., after taking a fifth year.

In those days eligibility for psychoanalytic training required completion of a medical school internship and a psychiatric residency. After completing a pediatric internship, two years of psychiatric residency and a two-year public health fellowship at the Child Study Center, she applied for a position at the newly established Western New England Psychoanalytic Institute in New Haven. The young mother was advised to “wait until you finish having children—you have enough to do.”

With no positions open to her in New Haven, the Malkins agreed that any move would have to benefit them both. Malkin, her husband and, by then, two children moved to Philadelphia in 1960, where Malkin began training with the Philadelphia Association for Psychoanalysis and her husband worked on a secret project developing re-entry space vehicles.

Malkin and her husband ultimately settled in Bethesda, Md., where she has practiced, taught and supervised trainees for decades. (While there, Myron Malkin went on to head the United States’ first space shuttle program from 1973 to 1980.)

Malkin traces her psychoanalytic pedigree straight back to Sigmund Freud via her Philadelphia supervisor, Robert Waelder, Ph.D., who had undergone analysis by Freud, and her Washington mentor, Jenny Waelder-Hall, M.D., who had undergone analysis by Freud’s daughter Anna.

Malkin presently chairs a biennial seminar in Aspen, Colo., that is attended by psychoanalysts from around the world. She became active in the Association of Yale Alumni in Medicine in 1996 at her 45th reunion, when she asked why there were no women on the executive committee’s nominating slate; she was offered a spot on the committee then and there. Her term as president ends in June.

After a 2006 house fire in which many of her and her late husband’s documents and belongings were destroyed, Malkin began preparations to move to New Haven. She expects to arrive this summer and looks forward to continuing active involvement with the psychoanalytic community and the alumni association as well as spending time with her children, Martha and Peter, who live in Westchester County, N.Y., with their families. Malkin’s granddaughter is a sophomore in Yale College.

Despite the waning reputation of psychoanalysis and the rise of other therapies, Malkin said the older approach has a place in modern psychiatry. It was, she suggests, greatly oversold in the past.

“[Psychoanalysis] is like an appendectomy. It’s a great operation, but you don’t do it on everybody,” Malkin said. “Analysis is the treatment of choice for certain kinds of patients, and [for them] there’s no better treatment.” She is concerned, though, about the future of psychoanalysis. “There are fewer and fewer people going into it, and the analytic organizations are lowering standards to be able to do anything to get bodies. ... [But] I think analysis will survive, and should survive, as one important part of the whole armamentarium available for the treatment of mental illness.”

—Jenny Blair

From art to medicine and back—how one physician pursued her dreams

As a high school student in New Britain, Conn., Sophie Trent-Stevens, M.D. ’43, made up her mind to see and paint the far-flung places she saw in exotic landscape paintings at the local art museum. “I thought that if you were an artist you’d go out and see this magnificent scenery,” she said. A half-century later, after a prestigious medical career, she did.

While the 17-year-old knew that she wanted to become an artist, her mother had other ideas. “Artists starve. You can either be a teacher or be a nurse,” her mother told her. Neither option suited Trent-Stevens, so she decided to go to Brown University after a teacher told her she could take art classes while earning her degree there.

At Brown, though, she developed different ambitions. “Marie Curie was a hero at that time. … I wanted to be another Madame Curie,” she said. She spent a summer as an animal technician at a cancer research institute in Maine. Back at Brown, an advisor told her that if she wanted to make her mark in medicine, she ought to pursue an M.D. instead of a Ph.D.

During her years at the School of Medicine, the United States became involved in World War II. With servicemen falling ill in the South Pacific, Trent-Stevens decided to pursue tropical medicine. After an internship at Vanderbilt University, she went to the School of Tropical Medicine in Puerto Rico. “They had the mosquitoes, they had the germs, they had the bugs,” she said. Art became, for the moment, less important, though she sketched when she could—mostly skulls and patients—and occasionally painted with a mixture of watercolors and white shoe polish.

After a research fellowship in tropical diseases at the National Institutes of Health and a residency in internal medicine in Jacksonville, Fla., Trent-Stevens became chief of medicine at St. Thomas General Hospital in the U.S. Virgin Islands. For nine months, she traveled between St. Thomas and neighboring St. John by sailboat and made house calls on the backs of donkeys. She used an old Navy brig on St. Thomas as a quiet room for a violent patient. She remembers the scene of a suicide by hanging; no one had thought to cut the victim down, which might have saved him. And she remembers seeing a priest in full habit riding on the back of a donkey, with his Bible propped open on the beast’s neck. “You saw things that were so different from everyday life that you felt you were living in a dream,” she said. The vivid images have remained in her mind for decades.

Trent-Stevens returned to Connecticut in 1949 and pursued a career in internal medicine. She had a private practice as well as an associate professorship at the University of Connecticut, and she served as senior ward physician at a tuberculosis sanatorium in Norwich, the Meriden-Wallingford Hospital and the Veterans Affairs hospitals in Meriden and Newington. She was a founding member of the American Society of Tropical Medicine and Hygiene and played important roles in the American Medical Women’s Association and the Pan-American Medical Women’s Alliance, among many other organizations.

Once she retired from medicine, though, Trent-Stevens returned to art. In 1982, at the age of 65, she earned a master’s degree in art from Central Connecticut State University. (She noticed that the young art students spent a lot of time seeking out free food at campus events, and noted, “My mother was right.”) She became a docent at the New Britain Museum of American Art—where she’d seen landscape paintings as a child—and published reproductions of her paintings in Connecticut Medicine, the magazine of the Connecticut State Medical Society.

And—at long last—she began to paint the faraway places of her childhood fantasies. She painted her former workplace, the stunningly beautiful island of St. Thomas. She traveled to Bora Bora and painted the Pacific island’s mountains and the fish she saw from a glass-bottomed boat. She painted tropical flowers in Hawaii, the Matterhorn in Europe and a harbor in Maine, where her interest in medicine began.

The large oils and acrylics adorn the walls of Trent-Stevens’ home in Meriden, which she and her late husband, Ronald Stevens, a colonel in the U.S. Air Force, designed and built decades ago. Thanks to medicine, Sophie Trent-Stevens got her wish and became an artist, and she didn’t have to starve.

—Jenny Blair


			Originally published in Yale Medicine, Winter 2009. Copyright © 2009 Yale University School of Medicine. All rights reserved.