Peter Emanuel Sifneos, M.D. Professor Emeritus of Psychiatry at Harvard Medical School, died at his home in Belmont on December 9, 2008, at the age of 88. He was an internationally renowned pioneer in the areas of short-term psychotherapy and psychosomatic medicine. His work and writing constitute a creative and significant contribution to the field.
Born October 22, 1920, on the Greek island of Lesbos, he graduated from Athens College and received his degree in chemistry at the Sorbonne in Paris. He escaped German occupied France and immigrated to the USA where he continued his studies at the Massachusetts Institute of Technology, Harvard Graduate School and Harvard Medical School from which he graduated in 1946. After completing his medical internship at Boston City Hospital he served as a United States Army psychiatrist for three years in Frankfurt, Germany.
Returning to Boston in 1950 he completed his psychiatry residency and worked at McLean and Massachusetts General Hospital. He received his psychoanalytic training at the Boston Psychoanalytic Institute. He served as director of the outpatient psychiatric service of the Massachusetts General Hospital until 1968, when he joined the staff of the Beth Israel Hospital as Associate Director of Psychiatry under the stewardship of Dr John Nemiah.
It was there in his somewhat removed third floor walk-up office in the Rabb Building (that he himself chose) that Dr Sifneos saw his patients and his trainees (psychiatry residents and psychology interns), and grew the ideas that his innovative talent had been nurturing through his formative professional years. He had treated a few patients with limited problems successfully, in a half dozen sessions guided by psycho-analytic principles. This opened up the possibility of a protocol to resolve mild neurotic symptoms in selected patients, in a limited number of visits. The parameters of Short Term Anxiety Provoking Psychotherapy (STAPP), evolved in the late 1960s and early 70s against a backdrop of an unbending psychoanalytic bias toward long term, classically non-directive psychoanalytic treatment.
Differing from psychoanalysis and other psychoanalytically derived psychotherapies, STAPP is a highly interactive process for well motivated and psychologically resilient individuals with a circumscribed emotional problem. Patients learn fairly early in the treatment how they tend to reenact (in their interaction with the therapist) the suppressed conflicts at the core of their difficulties. They are also provided with enduring tools for dealing with problems in the future. The anxiety provoking component of STAPP is a result of the therapist’s early clarification and interpretation of the hidden material. Outcome studies have shown that a large majority of carefully selected patients benefit from the treatment.
It is a testament to his legendary creativity, his originality and his courage, (when psychotherapy was a slow and very private event) that Dr Sifneos chose to record his interviews on videotape. He obtained permission from many of his patients to record their treatment sessions, and used the tapes in his lectures and seminars to demonstrate precisely what is crucial to his process. Viewers were able to observe how he uncovered the core of a problem, seeming to chisel away like a sculptor removing what obscured it. He has left us with a library of almost 280 videotapes.
In 1971 he accepted the invitation to come as a visiting professor to the University Psychiatric Clinic in Oslo, Norway, to promote research. He visited there annually until 1974, the first foreign visitor to come on a regular basis. It was he who brought psychotherapy research to Norway. The first doctoral thesis on the subject appeared in 1983. Short term dynamic psychotherapy has been a central and successful theme in psychotherapy research in Norway since then. The reports from Oslo and from his own widely read publications and presentations, brought several invitations to lecture and teach in Europe and the Americas.
Dr Sifneos’s interest in psychosomatic medicine started early in his career when treating patients with so called psychosomatic illness. He observed that they often had an inability to find the appropriate words to describe their feelings. He discussed this at length with Dr John Nemiah, a close friend, who affirmed the observation. As a result, in 1972 Dr Sifneos introduced the term alexithymia from the Greek a for lack, lexis for word, and thymos for emotion, meaning lack of words for emotions. The term described a marked difficulty in experiencing, identifying, differentiating and expressing feelings; as well as a paucity of fantasies and a utilitarian (stimulus bound and tied to reality) way of thinking. Clinical and research studies since have indicated that alexithymic characteristics are present not only in patients with psychosomatic illness, but in patients with other medical and psychiatric disorders as well as in individuals in the general population. The steadily increasing literature on individuals with alexithymia has proven to be of considerable help in a better understanding of their therapeutic needs, and the development of appropriate treatments for the alleviation of their suffering.
Dr Sifneos published 125 articles in various journals on the subjects of psychotherapy and psychotherapy training, medical illness associated with strong psychological factors, and mental health. He authored four books on psychotherapy that have been translated from English into many languages. He made important contributions to the psychiatric literature not only in his own writings, but in encouraging and helping younger colleagues to contribute by mentoring them. He was editor-in-chief of “Psychotherapy and Psychosomatics” for nearly two decades, and vice-president of the International Federation of Medical Psychotherapy for fifteen years.
He was invited to numerous countries around the world to present his work, and to run workshops in North and South America, Japan, Scandinavia, the Netherlands, Belgium, France, Italy and Greece. He had first offered systematic training in STAPP in educational programs in the 1970s in Oslo, and in 1997 he established a two year training program in Athens where over a period of ten years he taught and supervised five groups of interdisciplinary therapists. He visited Athens three to four times per year, and despite the physical stresses of his health problems he continued to teach with indomitable spirit until September 2007. For his scientific work and accomplishments he was awarded an honorary doctorate (PhD) by the University of Athens in February 1998.
Fascinated by the richness of the human mind, he was an inspiring and enthusiastic clinical teacher. He was constantly curious and open-minded, and although always warm and welcoming to his trainees, he was also critical and precise. He had a remarkable memory, not only for history, the Greek philosophers and music, all of which filled much of his limited free time, but also for the smallest details of what patients said in the interviews. He constantly encouraged his trainees, “Listen closely, and remember a patient’s words, they connect to his feelings.” He was, himself, a sensitive and brilliantly insightful interviewer, who appeared to miss nothing that occurred in the interview and who never lost his compassion for human suffering.
Although deeply appreciative of the opportunities afforded him by his country of adoption, he remained a cultured European in his attitudes and his manners. He retained his passion for life, music, art and French wine; and was very proud of his mother’s Huguenot ancestry. Most summers he spent with his friends and family at the Sifneos family’s seaside home in Lesbos where he loved to swim in the Aegean sea. He was an ardent reader, and thrived on challenging discussion. His children recall his devotion to them, and rich weekends filled with laughter, music, Mediterranean food and intellectual games.
He will be remembered for his loyalty to his friends and colleagues, and for his commitment to his students and his constant support of their goals; for his independence and courage in standing up to the prevailing theoretical forces of the time, and recording his therapeutic process in hundreds of taped interviews for trainees and critics alike to see. He is survived by his first wife Ann Coit Sifneos of Belmont; by his second wife Jane Paulson of Greeley, Colorado; his son Peter Gray Sifneos of Arlington; his daughters and their husbands, Ann and Kevin Callahan of Natick, and Jeannie Sifneos and Daniel Schafer of Corvallis, Oregon; and his five grandchildren.
Freddy Frankel (Chairman)
Astrid Heiberg (Oslo)
Yannis Tsamasiros (Athens)