The Road...
Following the Road . . .
Valley psychiatrist goes off the beaten path to treat depression before it
becomes too late
Story and photo illustration by Matthew Stewart,
Reporter for The Evening Review
Published October 20, 2002
Building
upon a diagnostic technique called "The Road Interview he introduced seven
years ago, Steubenville psychiatrist Dr. Robert Roerich continues to advocate
the method as a tool to predict and prevent suicide in severely depressed
patients.
Although the American mental health
community has yet to embrace his ideas, Roerich has found a more receptive
audience in eastern Europe.
Two years ago he received an e-mail message
from a Major Ungureanu at the Center for Psychosocial Studies in Bucharest,
Romania who said he'd come across Roerich's " The Road Interview"
software on the Internet. Police had asked Ungureanu to search for a
suicide prevention tool that could be used to examine new recruits.
"Because it came from a hotmail.com address,
I thought at first that it was a college student at Yale playing games,"
Roerich said. "So I asked for some formal verification like a letter
with Romanian stamps and maybe the letterhead of the center. I finally got
a phone call found the inquiry to be legitimate."
Roerich was invited to the Center for
Psychosocial Studies to make a presentation and eventually inspired enough
interest to have his book based upon the principles of " The Road
Interview" published in Romania under the title of "Drumul"
("The Road").
Roerich said " The Road
Interview" , which involves a series of questions asking a severely
depressed subject to visualize walking down a road, is meant to be used in an
emergency room. Interpretation of the answers given to the 15 questions
helps physicians determine the level of stress the patient is experiencing.
Here's how it works:
The interviewer asks you to imagine walking
along a road and then asks about the condition and color of the road.
You continue walking until you come to a
river. How clean is the water? How fast is the current? Is
anything in the water? You have to get to the other side, so how do you
cross the river?
After crossing, you come to a house.
What color is the house, and what is it's condition? Does anyone live
there? If so, who? You need to enter the house. How do you get
in? Once in, it's dark, so you turn on a light. What room are you in
and what does it look like?
You leave the house and come across a cup.
What color is the cup? What condition is it in? What, if anything,
is inside the cup?
As you continue, there is an obstacle in
the road. Describe it. How do you get by the obstacle. Once
you get by, there is another obstacle and still another and another.
Describe them and tell how you overcome the obstacles.
Finally, you come to the end of the road.
What do you see there? Is it an inviting field with tall grass? Is
the grass high, medium or cut low?
From the information supplied by Roerich,
some of the particular questions involved in the Road Interview can take
different forms, but the essential issues are the same. The idea is to let
the mind of the subject operate in the world of mental symbols. Those
symbols then are interpreted based upon certain principles derived from
psychoanalytic tradition and universal symbol codes.
Roerich says that because " The Road
Interview" forces the subject to imagine the experience and respond in ways
that prohibit calculated responses, it renders a more valid evaluation of the
subconscious mind, which can be reached only through the language of symbols.
By interpreting the answers, the skilled
interviewer ultimately can come up with a "score" that determines the
anxiety and stress level of the subject, which Roerich says can be used to gauge
the likelihood of drastic behaviors like suicide.
" Other interviews rely on the honesty
of the patient," he said. "But the groups most at-risk for
suicide often are not honest about their true feelings under such conditions.
Instead they try to beat the test by supplying answers they think you want to
hear."
Developed by Sigmund Freud, psychoanalysis
attempts to locate a mental struggle hidden deep inside the unconscious mind,
and therefore, unavailable to the patient. This psychodynamic perspective
divides the mind into three compartments: the conscious, preconscious, and
unconscious mind.
A practitioner of psychoanalysis uses
various means to gain access to a patient's subconscious mind-- dream analysis,
hypnosis and interviews among them. The assumption is that the true
conflict at the root of the patient's current condition has been locked away due
to some form of trauma, which is often traceable to childhood experience.
Because there are no direct links between
the conscious and unconscious mind, symbols are used to open the otherwise
closed door. As such, the Freudian places a great deal of emphasis on the
language of dreams, which is seen as symbolic.
Although Roerich admits that psychoanalysis
is currently out of fashion in treatment circles and that "no one has ever
statistically validated it," he believes " The Road Interview" is
a way of making the best of the psychoanalytical tool box. Because it so
easily and successfully bypasses the filters of the conscious mind, the
interview is a very useful tool for doctors to get vital information quickly.
Roerich did not invent the principles
behind " The Road Interview," but he found a way to turn the
ideas into a diagnostic instrument based upon the language of mental imagery.
"What I'm hoping for is statistical
validation," he said, " because that's what the American psychiatric
establishment wants. The gold standard here is still the MMPI (Minnesota
Multiphasic Personality Inventory). It is very useful for severely anxious
people, but it's also a very complex test with hundreds of questions, and clever
patients can beat it. " The Road Interview" is very simple and
can be assessed quickly, but on this issue, the Americans just don't want to
think outside the box."
In September of this year, Romanian
psychologist Stefan Lita presented statistical validation of Roerich's method at
a conference held in that country. The Romanian military and police
already use " The Road Interview" and Dr. Roerich was awarded the
Jandarmeria bronze medal for his contribution.
" It is my hope that mental health
professionals around the world will avail themselves of this new knowledge and
help treat depression and suicide before it becomes unmanageable," Roerich
said.
A basic version of " The Road
Interview" can be located for download on the Internet at
www.shrinktank.com.
Or if you'd like to see the very latest (1/6/2003) compelling statistical research regarding THE ROAD, then click on this link for a short Power Point Presentation (virus free to be sure)....