Peter Sifneos, 88; psychiatrist found new therapy approaches

By Bryan Marquard
Globe Staff / February 10, 2009
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A video camera can be a "psychiatric microscope," Peter Sifneos believed, at least when used, with written permission, to record sessions between psychoanalysts and patients. The resulting videotapes helped professors teach aspiring psychiatrists and let some patients see what they had accomplished in treatment.

"Until video came into widespread use as a tool, the psychiatrist-patient relationship was notoriously private," he told the Globe in 1980. "We never were really able to demonstrate what we do, or in what way changes happen to the patient during psychotherapy."

More than 50 years ago, he also created an approach that allowed patients and analysts to focus on a specific issue during intense, short-term treatment, rather than devoting years to psychoanalytic care.

Dr. Sifneos, who dipped into his native Greek language and coined the term alexithymia to describe patients who can't find words to describe the emotions they experience, died in his Belmont home Dec. 9 of complications from prostate cancer. He was 88.

Fluent in Greek, French, and English, he was worldly and a bit formal - often donning a tweed sport coat and tie for casual occasions. At the same time, he could charm a companion by telling a psychiatrist joke or two.

"He was definitely like a sun or a star, in that everyone who met him sort of got pulled into his orbit, immediately liking him because he was just such a sweet person who was really interested in people," said his daughter Ann Callahan of Natick.

Dr. Miguel Leibovich, an assistant clinical professor of psychiatry at Harvard Medical School, where Dr. Sifneos also taught, said "the most striking aspect of Peter's career was his teaching. He was a very engaged, charismatic teacher, and he certainly had people . . . throughout the world, in a kind of trance sometimes when he was teaching."

Dr. William Greenberg, director of the Harvard Longwood Psychiatry Residency and acting psychiatrist in chief at Beth Israel Deaconess Medical Center, said Dr. Sifneos "had a scintillating personality because of the combination of his broad intellect, his international experience, his charm, and his wit."

Still, colleagues said, his most significant legacy was what he called short-term anxiety-provoking psychotherapy, which Dr. Sifneos said could be used only with certain patients. They had to be of above-average intelligence, have a desire to change, and be able to express a range of emotions. They also had to have previously experienced at least one trusting relationship, and be willing to focus on a crucial problem, such as an interpersonal relationship.

Though Dr. Sifneos was using this technique in the 1950s, he acknowledged in the American Psychiatry Association Annual Review in 1983, as managed care became more prevalent, that the short duration also "considerably reduced the costs of psychotherapy, a problem which is becoming increasingly important during the 1980s."

"Peter's contributions in the field of short-term psychotherapy were way ahead of his time," Greenberg said. "He was talking about the value of a more focused treatment, a more focused approach, during a period when many of his colleagues were predominantly interested in long-term therapies."

Dr. Don Meyer, assistant clinical professor of psychiatry at Harvard Medical School and a clinical supervisor at Beth Israel Deaconess, said the breakthrough was all the more notable because Dr. Sifneos was a classically trained psychoanalyst.

"Having been trained in a discipline which offers treatments that go on for years, Peter thought of helping patients in a treatment that went on for 20 weeks," Meyer said. "He was loyal to psychoanalytic thought, but reveled in trying to take those principles into new clinical arenas."

Peter Emanuel Sifneos was born on the Greek Island of Lesbos. He grew up in Athens and studied at the Sorbonne in Paris, until he slipped out of France during the Nazi occupation.

"He actually escaped in the back of a farmer's truck, under a hay bale with a friend," said his daughter Jeannie of Corvallis, Ore.

Immigrating to the United States, Dr. Sifneos attended the Massachusetts Institute of Technology before switching to Harvard Medical School, where he graduated in 1946.

The following year, he married Ann Coit, who now lives in Belmont. Their marriage ended in divorce, as did his second marriage to Jane Paulson of Greeley, Colo.

After medical school, Dr. Sifneos spent a couple of years in the Army as a psychiatrist in Germany. He continued his studies at McLean Hospital in Belmont, completed his training at the Boston Psychoanalytic Institute, then worked at Massachusetts General Hospital. Moving to Beth Israel, Dr. Sifneos was associate director of psychiatry for many years.

Among the books he wrote was "Ascent from Chaos" (1964), about the treatment of a psychosomatic patient.

"It is an intensely moving human document, one which cannot be read without quickly developing a warm admiration and sympathy for both the physician and the patient, engaged as they were in the Herculean effort to overcome a ravishing past and a devastating illness," Dr. George L. Engel wrote in a review published by the journal Psychosomatic Medicine.

Teaching and seeing patients consumed much of his time, but Dr. Sifneos adhered to Greek traditions at home and while vacationing on Lesbos. In Belmont, he roasted a lamb on Easter and cooked a goose on Christmas, his daughters said. On Lesbos, he went for daily swims in the Aegean Sea and joined two dozen or more members of his extended family for long lunches.

Psychiatry, meanwhile, was hardly his only field of expertise.

"One thing that strikes me is that he had this all-encompassing career, but he knew a lot about other areas," Jeannie Sifneos said. "For example, he just loved to read, and he read all the time . . . and he loved music."

Tuning into a classical music station, Dr. Sifneos could quickly rattle off the composers' names.

"I have an undergraduate degree in music, and I didn't know them," his daughter said, "but he'd know who composed them, who conducted them, and with which orchestra."

In addition to his daughters and former wives, Dr. Sifneos leaves a son, Peter Gray Sifneos of Arlington; and five grandchildren.

A memorial service will be held at 2 p.m. March 27 in Memorial Church at Harvard University.

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