Dear Doctor: Ellen Vora, MD
The integrative psychiatrist on forming her approach to mental health care through writing and educating.
Informed by the discovery of yoga and the guidance of a great mentor, Ellen Vora’s path to psychiatry could be described as a series of steps toward a new perspective on medicine. From the start, her practice has sought to better combine conventional and integrative approaches to mental health treatment. Read on to learn about how this psychiatrist took a bold step out of the box to contribute to the shift in wellness that’s rapidly gaining momentum today.
“I was barely drawn to medicine. I was into biology and the brain, as well as English, but in college I just wanted to be a hip hop dancer, particularly one of the fly girls on the In Living Color variety show. Eventually, that dream evolved into wanting to be one of Beyoncé’s backup dancers. Unfortunately, being a dancer never really panned out for me. As a result, I kept defaulting to taking my pre-med classes and studying for the MCAT, which led me right into medical school.”
Getting Through Medical School
Medical school felt all wrong from the beginning. I thought about dropping out on several occasions. But I’m a creature of inertia, a rule follower, and a people pleaser. I wasn’t radical enough to take the big jump to leave medical school. I kept going since I had already come so far. Little did I know how much work lay ahead of me. What I struggled with the most throughout school was the sense that we were not creating health and wellbeing for our patients. It truly felt like being a physician was an out-of-balance profession. People were burned out and miserable — I felt totally at odds.
While I took pre-med classes, I ended up being an English major at Yale, which led me to focus on psychiatry in medical school. There, I had a mentor, Dr. Deborah Cabaniss, who had also been an English major at Yale. She was a Freudian psychoanalyst. It reminded me of what I had enjoyed studying English — understanding the grey areas in life. I missed the nuances and grappling with the human condition. Deborah’s approach showed me a new side of psychiatry, and it was really compelling.
That said, in my psychiatry training I was disillusioned because we were shown how to translate symptoms into a diagnosis and then to convert that into a medication. With medication, patients may go and try it for a few weeks, but when they come back, they don’t necessarily feel better. I did not feel like I was creating wellness.
This is why at the end of my psychiatry residency, I found other trainings to help keep me aligned. I began studying Chinese medicine and acupuncture. I became a yoga instructor and studied Ayurveda. I also learned about nutrition, functional and integrative medicine, and even a little hypnosis. I had no idea how all of these things would come together, but I knew that I had to pursue them to feel a sense of purpose. I was building towards something that I really believed in.
Forming an Integrative Approach to Psychiatry
After residency, I started working for One Medical Group. As the only psychiatrist in the whole organization, I often found myself not only treating my own patients, but also supporting all the primary care doctors, who were treating the mental health issues of their patients. One Medical really encouraged me to write everything down. I often found myself repeating information over and over again — so having something written made things much easier. I created a series of handouts that my patients could take home with them and that other providers could give to their patients.
After working at One Medical, I went to work with Dr. Frank Lipman at Eleven Eleven Wellness Center. Dr. Lipman is one of the original integrative medicine doctors. He was the one who originally connected me to mindbodygreen. Mindbodygreen is an incredible group to work with and similarly to One Medical, they pushed me to put my ideas on paper. My mind is always coming up with new ideas about mental health, but I usually resist sitting down to put it all into words. As soon as I started working with mindbodygreen, they wanted me to create a course on insomnia. I had to write a script for the course, which ended up being a 70-page Google document. From there, I created a course on anxiety and another on depression.
Recently, I presented at their big annual conference in Arizona, which was the most incredible experience. I spoke on “psychedelics, wellness, and mental health,” which is a great topic. It’s a big trend right now and is controversial, but really meaningful. Using psychedelics as a treatment option for mental health is not for everyone. It has real risks, but it also has huge potential for real benefits. There’s so much more research developing on this topic, like with breakthrough therapy for MDMA-assisted psychotherapy for PTSD. It’s really just the beginning. It’s a real paradigm shift on the way we’ve been approaching mental health.
Educating the World on Integrative Approaches
My two favorite topics to talk about are anxiety and sleep. I lecture a lot on both, and I’m currently writing a book on anxiety. They’re both widespread problems right now. I also think the available approaches for these issues are not so satisfactory. I like to think originally and create a pioneering approach to these things that makes sense. With both sleep and anxiety, there’s a lot we can do to optimize diet and lifestyle factors, which can improve them dramatically.
About once a week, I give corporate presentations on wellness. I just did one about sleep. It’s very exciting to go into these companies and hear all the different perspectives. I’m so used to working with people who are on board with wellness approaches that it’s always humbling to be reminded that not everyone has had exposure to integrative approaches. It’s really rewarding to show people how they can make a small shift that can have a huge impact on how they feel.
Building A Private Practice
The way I practice doesn’t resemble what I learned in medical school. I do really like having an understanding of the human body. It helps me define a new narrative and pick a model. People come into my office and I draw on all these different tools to see how I can help them get back into a state of balance and feel well in their life.
When I first started doing this about seven years ago, the idea that I was telling people to heal their gut, stabilize their blood sugar for anxiety, or even to eat healthy fats was pretty daring. Now, there’s so much more awareness of real food with the paleo diet and the Whole30 movement — it’s changed so much. I’ve also seen a shift in medical students and psychiatry residents as well. Almost every week, someone reaches out to me expressing interest in becoming a holistic psychiatrist. There’s definitely a growing trend in people practicing this way.
The hardest question that I come across from my patients is how to make a behavioral change. They usually understand the change and why they need to do it, but it’s difficult for them to determine how to do it, especially when they’re feeling stressed, anxious, depressed, or unmotivated. Working with them to realistically make that change is challenging, but rewarding. My goal is to help them get their body back in balance, which requires diet and lifestyle adjustments — it’s a lot of hard work.
It’s a privilege to sit in a room with someone and be the safe container for them to bare their soul into. It’s so hard today to be our authentic selves. If you think about Instagram, everybody’s filtering and curating the appearance of their lives.
In the therapist’s office, you get to be the opposite of your Instagram profile. You get to be exactly who you are, the good, the bad, and the ugly. You can say the wrong thing. It’s a safe space to be yourself and to be honest.
I feel grateful that I get to sit face-to-face with people and talk. I get to use my brain and think creatively to help people. What’s most amazing is seeing people months and years later who are doing so well; there’s nothing better than that.
Lightning Round
Everybody needs a nap sometimes.
One thing I wish more people knew…how to love themselves.
If you could live anywhere in the world besides NY, where would it be? My husband, daughter, and I took seven months to travel around the world and visit all the spots on our bucket list. When we got to Byron Bay, Australia, I was partly convinced we’d never leave.
Fun fact: I took a summer off to bike across the U.S. for charity. We started in New Haven, CT and biked all the way to the Golden Gate Bridge. It was the best summer of my life.
Favorites
NYC neighborhood: Fort Greene, Brooklyn
Yoga Spot: My living room
You can learn more about Dr. Ellen Vora here.
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