FEATURED MEMBER - FIONA BARWICK, PHD
For the past 2.5 years, I have been the Director of the Cognitive Behavioral Sleep Medicine (CBSM) Program at the Stanford Sleep Medicine Center, which is one of the oldest sleep medicine centers in the country and part of the Stanford Center for Sleep Sciences and Medicine. I help to coordinate and integrate patient care, oversee supervision and training for PhD and MD fellows, and collaborate with colleagues on research projects. I also have the incredible privilege of interacting with some of the most illustrious figures in the field of sleep medicine, including William Dement, Christian Guilleminault, Emmanuel Mignot, and Clete Kushida.
WHAT IS THE NEXT STEP YOU PLAN ON TAKING EITHER IN YOUR RESEARCH PROGRAM OR CLINICAL PRACTICE?
As I spent the first couple of years in my position setting up clinical programs, I am only now building up our research program. Currently, I am working with psychologists and psychiatrists at Stanford’s Student Counseling and Psychological Services to develop a brief transdiagnostic protocol that just received small grant funding to address sleep problems in university students. I am also collaborating with colleagues in our chronic pain and psychosis clinics to develop modified protocols for improving sleep in these populations.
WHERE WOULD YOU LIKE TO SEE THE FIELD IN 10 YEARS?
I am intrigued by the idea that identifying insomnia phenotypes might allow us to optimize treatment for specific subgroups. For example, insomnia in anxious individuals looks different than it does in individuals with delayed sleep phase, bipolar disorder, new onset sleep apnea, or other medical conditions. I am also excited by the incorporation of “third wave” CBT techniques into the field, such as Mindfulness Based Therapy for Insomnia (MBT-I), for which our own president, Dr. Jason Ong, has been a leading proponent and innovator. Finally, I am very much in favor of bringing together sleep medicine and circadian biology to optimize treatment of sleep problems. Allison Harvey’s transdiagnostic approach for treating the disruption in sleep-wake and circadian systems that occurs in almost every psychiatric disorder is a perfect expression of this trend. Other influential figures in cognitive behavioral sleep medicine -- including Kenneth Lichstein, Rachel Manber, Jack Edinger, and Colleen Carney -- have been exploring this nexus for years, but we are still in the early stages of recognizing and adapting CBSM techniques to address the varying presentations and pathophysiology of specific insomnia subgroups.
WHO GOES ON YOUR BSM MOUNT RUSHMORE?
Rather than carvings on Mount Rushmore, I would like to eavesdrop on past and present sleep medicine and chronobiology luminaries as they mingle at a cocktail party or eat and drink around a communal table, rather like Judy Chicago’s “The Dinner Party.” Arthur Spielman talking with Richard Bootzin, William Dement arguing with Mary Carskadon, Alexander Borbely conferring with Charles Czeisler, Michael Perlis debating Daniel Buysse, Phyllis Zee deliberating with Fred Turek, Colin Espie disputing Charles Morin…I would love to hear the conversations that occur between these brilliant and opinionated experts as they discuss the ideas about which they are so passionate.
WHAT IS YOUR ADVICE TO EARLY CAREER INDIVIDUALS, OR THOSE RE-SPECIALISING INTO BEHAVIORAL SLEEP MEDICINE?
As someone who had an earlier career managing restaurants in New York City, I feel remarkably unqualified to offer career advice. Everyone’s career path takes unexpected twists and turns, which offer both risks and opportunities. The wonderful appeal of cognitive behavioral sleep medicine is its ability to merge with almost any interest, whether a particular population, a specific disorder, a preferred treatment modality, or another area of medicine. If you follow your passion, despite the obstacles you will inevitably encounter, and hold onto your intrinsic desire to do good work, you will almost certainly find yourself rewarded in the field both personally and professionally. And, as Dr. Dreup emphasized in this feature in January, be an educator about and advocate for cognitive behavioral sleep medicine! It is an easy case to make with other professionals and organizations because sleep is such an integral part of overall physical and mental health.