Dear Doctor: Yana Bekker
The psychiatrist and founder of My Best Self, LLC on the importance of active listening and approaching mental health concerns and their underlying causes from a holistic perspective, especially in times of crisis.
As the first doctor in her family, Dr. Yana Bekker stood out from the creative professionals in her lineage. Early on, her passion and skill for active listening led her to become a psychiatrist. Today, she offers a holistic approach to mental health at her private practice, My Best Self, LLC in Brooklyn, New York. Dr. Bekker believes in personalizing care by addressing physical, emotional, and spiritual health as contributing factors to one’s overall well-being. Read on to learn about her comprehensive care approach, how she’s adapting to virtual care during COVID-19, and why destigmatizing treatment is so important.
How did you get started in medicine and what inspired you to choose your specialty?
Growing up in a family of performers, actors, and dancers, I had a generous and genuine interest in listening to people’s stories. From a young age, I enjoyed listening and helping my friends process different experiences and get things off their chest. As I got older, I realized that this was a unique skill — many people are not good listeners. Most prefer to give advice or interject their own opinions, but I understood the importance of being an active listener. Not to mention that I’ve always had a great fascination for the mechanics of the mind. Finding psychiatry was a natural progression from these early interests and skill sets. It’s such a great field to be in because it’s so personal. There’s no other specialty where patients invite you into their lives in such an intimate and meaningful way.
How do you see physical, emotional, and spiritual health coming together in how you approach psychiatry?
I think psychiatry is wonderfully unique in how it enables practitioners to approach concerns from a more holistic perspective. Many doctors, especially in Western medicine, focus on their particular specialty and use that focus to hone in on one specific body part, while often ignoring or neglecting the rest.
But I was trained as a D.O. that everything matters. If you’re having back pain, for example, or if you’re not feeling great physically, it’s going to affect how you feel mentally. Similarly, how you interact with your family or whether or not something specific altered your routine one day will affect your overall mental health. Physical, emotional, and spiritual health all come together in this field. Or at least, they should. As psychiatrists, we’re not just focusing on the brain. We’re focusing on what happened during the week and how that may have affected your sleep hygiene, your exercise routine, and what you’ve been eating.
How do you think about the roles of lifestyle and comprehensive care in how you treat patients?
When patients come in for an evaluation, they’re often concerned that the very first thing that we’re going to talk about is medication. But as I’ve mentioned, there are so many different factors that can contribute to how you feel mentally. This includes dietary habits, the gut-brain connection, your activity level, your body posture throughout the day, what you do for work, sleep hygiene, and so on. When I first meet with a patient, I like to address all of these factors to determine whether or not there is something there that could be affecting their mental health.
Medication is an important part of the field, but I don’t believe it should be a first resource. If I was to primarily focus on prescribing medication and trying to alter my patients’ brain chemistry, I would never be successful. That’s why my focus as a psychiatrist is always on addressing lifestyle factors first and then adding in supportive measures like therapy to ensure that we’re actively focusing on what we can improve. If a patient needs additional support after that, then medication can come into play.
What do you see as some of the primary mental and emotional health issues that are surfacing in light of recent events — in patients or in our city at large?
Anxiety is probably the biggest thing that is surfacing right now. Especially since our day-to-day lives are changing so drastically every week, which is very unsettling for many people. It’s hard to get a grasp on what’s going on in the world and many people who may have never experienced anxiety before are now starting to feel anxious about the uncertainty of what we’re all living through. Some of these shared anxieties include whether or not it’s safe to leave the home, what the future is going to look like, how personal finances may be impacted by the recession, and the growing feelings of isolation.
I think this new normal has been particularly hard on those of us living in New York City (or similar urban areas), which is such a celebrated center of culture, activity, and connection. Now, all of a sudden, urban dwellers are forced to drop important connections and remain inside — often in homes with little to no outdoor space. What makes it even more difficult is that they cannot access many of their usual coping strategies to help with these newfound feelings of isolation, like visiting a museum exhibit or spending an evening with friends who live in different homes.
And, of course, many routines have also been disrupted during shelter-in-place. Many people are now either working from home, which they’re not used to doing, or they’ve been furloughed or may have lost their job. These sudden and difficult changes can have an impact on your diet, sleeping health, and exercise habits — all of which can also affect your mental health.
What are some approaches and coping tools that you’ve been recommending to your patients?
The first approach I often recommend is learning to sit with your anxiety. Many people who start treatment are afraid of anxiety or believe it’s something to be buried below the surface. Of course, this approach is not effective and can often make feelings of anxiety even worse. When not addressed, feelings of anxiety can induce panic attacks, nightmares, or even chronic anxiety. Which is why I like to recommend that if you’re feeling anxious, own it. Pick a time of the day (but avoid bedtime), set an alarm for yourself, and let yourself experience those feelings. If there’s a known trigger for your anxieties, like scrolling through social media or reading the news, take this period of time to dive into that activity and process your emotions. Learn to sit with the discomfort of anxiety. Give yourself the space to feel. You can even journal your anxious thoughts, if that helps. But when the alarm finally rings, that period is over. Change your behavior and do something completely different to mark that change. This practice can help with owning anxiety and acknowledging the feelings that come with it.
I’m also a big fan of using the arts as therapy, perhaps because of my family background. Doing something physical, like painting, coloring, or even baking is a great way to use whatever you’re feeling and produce something tangible.
How has COVID-19 and incorporating more virtual care impacted your practice?
My routine has been completely uprooted, but some of the changes have been positive. Now that I’m working from home, I have more flexibility in my schedule and that, in some ways, has made it easier to continue to be there for my patients fully. For example, I can schedule my video visits easily to ensure that none of my patients have to wait in a virtual — or literal — waiting room. I use a secure, psychiatry-specific video conferencing system that’s built into the EMR so patients don’t have to worry about breaches during our sessions. During this time of global crisis, I’m able to devote myself entirely to delivering care to my patients, and that’s really wonderful.
I’m also a mother of two, so in addition to working from home, I’m learning how to homeschool and create boundaries with my kids. They’re trying to understand that even though Mommy is here and they can see her, she’s working and in that sense, is not really here. Taking commuting out of the equation has also given me more time with family, which I cherish.
Though telemedicine cannot fully replace the in-person element of therapy, virtual care has opened new avenues for my patients to have availability during the day when they wouldn’t normally be available. It has also helped streamline a smooth transition for my patients during this unsettling time.
Are there any changes you’ve made to how the business works that you’re particularly proud of?
I have always been mindful of how important it is to be available for people when they are going through a tough time. That is why I set up a practice where I can provide my patients with personalized treatment, timely appointments, and effective communication that they can rely on. I’m especially proud of the flexibility that I’ve incorporated into my practice that virtual care has enabled during this time. I think it’s important to not be rigid in this field when it comes to meeting your patients when they need and where they feel comfortable. Now, when so many people are temporarily leaving the city, I’ve been able to continue caring for my patients, regardless of where they are living. There has not been any disruption in treatment, which has been a blessing.
Vital Signs
How do you de-stress? I love to bake and, when I have time, I love to paint. I also enjoy reading about child development. Most of all, I love to laugh and play with my kids. That always tops the list.
What’s your favorite part of the city for a walk? Lincoln Center. I went to LaGuardia High School and have fond memories of spending time in that part of the city.
What’s your best tip for people dealing with the depletion of Zoom? Work environment matters. We see the negative effects of extended screen time with kids, too, especially now that schooling is taking place online. The most important thing is to do is to keep your body moving. Invest in a standing desk or try using a yoga ball instead of a standard chair. Getting a pair of blue-light filtering glasses can also help counteract the amount of time we’re spending on the computer these days.
What’s one healthful habit you’d love to see patients adopt? There’s a lot of stigma that’s attached to psychiatry and getting treatment. I’d love to see more people owning their emotions and knowing that there is nothing wrong with being sad or anxious or needing to talk to someone. We’re all human and we all have different ways of reacting. If we can remove some of that stigma, more people would reach out for the help that they need, which is really important these days.
Also, learn how to become an active listener. Teach your kids to listen actively. With everything that’s going on in the world right now, it’s especially important to know how to listen to other people without interjecting your own opinions into the mix.
Know a great female doctor in NYC? We’d love to meet her, introduce us here!
