I think what steered me into psychiatry was the fact that I was one of those types that preferred reading over sports, not exclusively, but I always liked reading. I always have liked humanities, history, literature, music and other intellectual pursuits. When I went to college, I naturally chose all of these subjects to study with the exception of music. I thought that psychology was a study of what made people tick. In a way it was a science that synthesized elements of history and anthropology and philosophy and all of these things put together. I was interested, once again being a narcissistic person, in what made me tick. I was also interested in what made others tick and I thought it would be a nice way to learn about the world where people occupied both in and outside of their minds.

I define success in many multiple levels. On a very personal, existential level I define success as having achieved some piece of mind. If I get to a point where I'm comfortable with myself and my place in the world and the people I've chosen to surround myself with, then I will have defined that as being a successful human being. Having said that I think there are other levels of success: financial success, success in one's career. Another very important aspect of success to me is being satisfied with what one does for a living. I think that if I get to a point that I'm excited about what I'm doing much of the time, not just a little of the time, where I'm confident about what I'm doing, then I will define that as success.

Financial success is self explanatory. I think that if I'm comfortable financially and I don't have to count pennies and my loans are paid off, I will have become successful financially. I'm proud of the fact that I am where I am.

I'm kind of a person who it seems has had some kind of unconscious plan or a certain knowledge that things had to be a certain way, but I can't say that I'm a great planner. I ended up in good places in my life, but sometimes I think almost in spite of myself. There are people who research a great deal the residency they want to attend, and they know exactly why they want to go there, or they knew exactly why they went to such-and-such medical school, or knew which med school had a good department for this or that.

I was never one of those people who planned things out that way. I ended up in good schools and I ended up getting a good education, but it wasn't because I planned to go to these particular places. It's that certain situations presented themselves in certain ways and I took the opportunities when they arose. I was able to get to those opportunities because, once again, I enabled myself or my family enabled me or my intelligence enabled me or something like that, but good things have always come my way. I can't say that I planned them that way.

In other words, I'm very conscious of the fact that things might very well have been otherwise, but they weren't. I'm a bit of a fatalist. Things were meant for me to be this way. It's what we call in psychiatry "magical thinking" [laughs]. I really do believe that certain paths are outlined for you and maybe this was outlined for me. I don't know. I'm a great believer in the fact that situations present themselves to people, but people have to be there at the right place and right time. I think it is up to us as to how to react to these situations. You have no control over walking down the street and having a brick fall on your head. You have no control over a job opportunity that opens up next week. Certain things just happen. They are completely outside your locus of control, but it is up to you how you are going to react to the situation. So I think chance determines a lot, but it's not only chance because then you have to make a choice and not making a choice is a choice in itself.

I think it's very difficult to live in this country and not be financially successful. I think that the only reason to live in this country is so that you can live comfortably. I came here from a country where the economic system was very, very different and the distribution of wealth was very different. The values on what made you a human being were very different. We were all equally poor. My family did not own an automobile and neither did most of my other friends and acquaintance. My parents, despite the fact that both were highly educated professionals, made just enough to live from paycheck to paycheck. We did not have a savings account. Sure people liked things. People wanted to have the bedroom from Czechoslovakia because the Russian bedroom sets sucked. You wanted to have a pair of jeans that cost a month's salary or you wanted to have a pair of shoes that wouldn't fall apart, but there was not such an intense emphasis on things as there is in America.

This is one of my favorite subjects of mine and I take a somewhat paranoid view of the advertising industry in this country, but the advertising industry in this country is one of the most successful propaganda machines that has yet to be invented by man that far surpasses any propaganda machine in Nazi Germany or the Soviet Union for the simple reason that people don't think it's a propaganda machine. At least when we saw banners in the Soviet Union that read, "Long live the Party," everyone knew that this was a slogan. I think when you are surrounded everywhere you go and you see all the ads that are directed to you to drink this coffee and use this antiperspirant and be such and such and tell us we are in the Jeep generation or the Pepsi generation, they sell so much more than a thing. They sell a way of being that will cause you to want to buy this or that thing. It's not only to be content to have bought that thing, but to actually be discontented so that you can buy the next thing they are trying to sell you.

The reason this is so successful is that people don't realize this is going on. Those people who were born here and who have not had the experience of living in another country think that this is a normal part of reality. All it takes is for you to stop and think about it for a second to realize how scary this is.

To get back to the original point, with the kind of philosophy that exists in this country that equates success with financial success, that sells you images of bliss everywhere you go and emphasizes endless consumption rather than looking around and smelling the roses or looking at yourself or seeing another person, I think it's very difficult to live otherwise. I think one of the reasons America is so seductive is because once you come from a poor country to this one where you can have a hot shower everyday and can use a different shampoo on your hair everyday, where you can have five silk suits and drive the best possible car that money can buy, that kind of thing is very seductive. All of these cost money so I think it's very difficult to live in America and not buy into this, unless you build some kind of electromagnetic wall around you, but then you become alone. If you want to function, if you want to have friends, if you want to be a part of society rather than live in a certain elitist ivory tower, it's very isolating to resist the system. I'm not sure that that is good for one either.

My path is to find some kind of happy medium and to see the advertising industry for what it is and to decide for myself what I really need. For example, I'm not thirsty for a BMW. I drive a Nissan now and it gets me places and as long as it's in good working order and is clean then I'd be satisfied with buying another Nissan. I'm saying that right now and things change [laughs]. I'm trying to identify the things in my life where I can say, "This is enough for me. I don't need more." The more I can say that to myself that I don't need the latest thing then I can concentrate on other things that are probably more important.

I think that people need to wake up. You need to drop out to an extent and open your eyes or sometimes close your eyes and just stop, because this society encourages you to keep moving all the time. The pace of life is very fast and stopping has its dangers and can be scary. Why is it that we have so much white noise. Think of all the televisions that are on 16 hours a day in dining rooms where people used to talk. We're addicted to this constant go, go, go, go, go. Someone needs to say, "Wake up!" I think people need to wake up before they can determine what's important to them.

I think that human struggles are probably the same everywhere. I think that when your health is poor and you hurt, you hurt the same everywhere. If your marriage is unhappy, you hurt whether you're in Uganda or Alaska. Having said that, society in Russia was different so it created a different set of struggles. I don't know any American, at least in my circle, who is worried about what they are going to eat. There's too much choice if anything and we're paralyzed by the choices so we sit with this ambivalence about whether we should eat steak or pork chops. But when you go to the store and there is no fish and there's no meat, there is no pork, you kind of have to improvise. You are faced with 50 to 100 people in line who are similarly frustrated that there is nothing to eat. Nobody went hungry. There was potatoes and bread and cabbage. I was never hungry. My friends were never hungry, but people had to fight for existence on a very different level. They weren't paralyzed by choice and they took what they could get. If there was a line in the Soviet Union, first you got in line and then you asked what the line was for. There was a lot of animosity that way because the tomato that you will get will be the tomato that I will not get.

So there was the this basic struggle for getting stuff. People here [in America] are concerned with getting stuff, but they're more concerned with whether they can afford it. It's not, "If you get a BMW maybe there will be once less BMW for me." Over in Russia there was a concern that the piece of bread you get may be the bread you are stealing from my mouth and the mouth of my children. So there was a great deal of this primitive, limited resource anxiety and anger that was fostered in people. It's difficult to say which society is better, resources were distributed equally, but there was no incentive to do better in your job because no matter how hard you worked, you got the same pay. So definitely I think that different societies create different struggles, but it was much more visceral, life stuff. It was the sort of thing where you really had to think about how you were going to live. You couldn't say, "By Mom and Dad, I'm moving out." Moving out to where? You couldn't just go and rent an apartment or do what you guys are doing traveling around the country. If you had an education, you had to have a job. It was against the law to not have a job. So the struggles are difficult to understand and all of these things are stressful, but in a very different way than the stresses here are.

One of the things I did to learn more about myself was go into therapy, partially to help myself as a psychotherapist and to help myself deal with stuff as well. A lot of your own stuff comes up when you deal with patients. This is not to say that therapy is for everybody. I really flatly reject the idea that everybody should be in psychotherapy. I think that life is psychotherapy. I think successful psychotherapy can infuse a meaning to your existence that will probably come to you by living your life, but maybe in a shorter amount to time. I think that some people are naturally more introspective and others are not. I think you have to be curious about anything, then you have it in you to look inside and find answers.