An unexpected career

Ann Sellew has overcome dyslexia to distinguish herself as a psychiatrist

I n Ann Sellew's first-floor office on New York City's East 89th Street, high ceilings, tall windows, and large green plants create an atmosphere of peacefulness and light. It is into this environment that her psychiatric patients bring their troubled souls. Certainly, none of them suspects the personal struggles that Sellew has had to surmount in order to help them.

A transfer student who arrived at Kenyon in 1970 in the early days of coeducation and went on to graduate in 1972, Sellew was seeking to round out her two-year degree from Pine Manor Junior College. That she was pursuing higher education at all was surprising, given that her serious, and then-undiagnosed, disability. Sellew is dyslexic, but it was not until the middle of the second semester of her senior year at Kenyon that a definitive diagnosis was made. "I never wrote a single paper on my own during my two years at the College," she recalls. "I got by with the help of my friends, a bit of con-artistry, and the strength of my classroom participation." It was only a last-minute telephone call from her art-history professor to her doctor in Boston, Massachusetts, confirming her difficulty that enabled her to pass the professor's course and to graduate.

"While all her friends helped her, I don't think Ann realized how much of a mentor she was to us," recalls Elizabeth R. Forman '73, a member of Kenyon's first full class of women and a long-time friend. "Academically, she was often in the shadow of her sister, Patsy [Sellew Cimarosa '71], also a transfer student, who became Kenyon's first female inductee into Phi Beta Kappa. But Ann is the sort of person who is always there for others, and many of us can say we benefited from her friendship."

During summer vacation, Sellew, who is from Port Chester, New York, worked in the political campaigns of various New York candidates, and she continued this work following graduation. "Every candidate I worked for lost," she says ruefully, but with good humor.

Sensing that politics was not to be her metier, she moved on to a secretarial/production-assistant position at Channel 13 television in New York. "I worked on the `Woman Alive' program," she recalls, "and I was totally incompetent."

Despite this self-description, it is difficult to imagine Ann Sellew being totally incompetent at anything. Calm and self-possessed, she has steadfastly set goals and achieved them, always having to work around her inability to translate words into visual symbols.

After some soul-searching, Sellew arrived at the somewhat surprising decision that she wanted to become a physician. "I wanted to do something that I viewed as noncompetitive," she explains. "In medicine, I thought, you would not have to vie for jobs or take orders. You could be your own boss." She enrolled in night school at Columbia University to complete the premedical course requirements and earned her keep by working in a sleep-research laboratory.

Sellew admits she did not do well on the premedical entrance examinations, despite having developed methods of coping with her dyslexia. Nevertheless, she persuaded the University of Buffalo Medical School that she was fully capable of doing the work, as attested to by letters of recommendation from professors at Kenyon and Columbia.

"When I entered medical school," she recalls, "I was quite sure that the last thing I would become would be a psychiatrist. I envisioned myself engaged in primary care in a community-based facility, such as a prison. However, as I tried to look to the future, I couldn't imagine myself reading one New England Journal of Medicine article after another on thyroid-function tests and trying to apply that information to patients."

Among her rotations through the various specialties, Sellew found herself unexpectedly attracted to psychiatric medicine. Following the awarding of her medical degree from Buffalo in 1982 and her year of internship and three years of residency at Mount Sinai Hospital, she landed a research fellowship in clinical depression and schizophrenia, also at Mount Sinai.

While in her private practice Sellew now treats patients with many kinds of mental disorders, her specialty--and the area in which she teaches at Columbia Presbyterian Medical Center--is dissociative disorders and trauma.

A complex neuropsychological process, dissociation, as defined by the Diagnostic and Statistical Manual of Mental Disorders, is the disconnection from full awareness of self, time, and/or external circumstances. It exists along a continuum from normal, everyday experiences such as highway hypnosis or daydreaming, to disorders that interfere with day-to-day functioning.

Many researchers and clinicians believe that dissociation is a common, naturally occurring defense against childhood trauma. They also agree that children tend to dissociate more readily than adults. Thus, especially when faced with overwhelming abuse, for example, it is not surprising that children would psychologically flee from full awareness of their experiences.

Adults, however, are not immune to dissociative disorders, which can affect a person's identity, memory, or consciousness. The spectrum ranges from post-traumatic-stress disorder (usually classified as an anxiety disorder), to acute loss of memory, to dissociative-identity disorder (formerly called multiple-personality disorder). And there are any number of variations in between.

The core treatment for dissociative disorders is long-term psychodynamic or cognitive psychotherapy, sometimes facilitated by hypnotherapy. It is not uncommon for victims to need three to five years of intensive therapy. Sometimes hospitalization is required.

Sellew is reluctant to talk freely about certain aspects of her work because of generalized misconceptions in both the public mind and the media, which she says tend to sensationalize psychiatric topics. There has been, for example, dramatic publicity surrounding the issue of recovered memories of abuse and whether these memories are, in fact, real.

Another major frustration for Sellew arises from managed-care programs and what they mean for her patients. "Insurance companies now want entirely too much personal information about our patients, and they are not sufficiently concerned about confidentiality," she says. "They also think we should be able to sit down with someone and work things out in a few sessions, a notion that is completely unrealistic."

Despite the bureaucratic annoyances and intrusions, Sellew finds her chosen field to be a rewarding one. She enjoys supervising her students at Columbia Presbyterian, along with the intellectual stimulation of the teaching and learning environment. "I love discussing problems and diverse treatment options," she says. "It must be very difficult to practice psychiatry in a geographically isolated area where you don't have colleagues with whom to exchange ideas."

Meanwhile, Sellew continues to find better ways to manage her dyslexia. "Computers have helped a great deal," she says. "Being able to dictate to a computer and having the words appear on a screen is enormously helpful. I've also gotten very good at writing without looking at what I'm writing, so I can take notes while keeping my eyes on my patient. It prevents the loss of a train of thought that occurs if I think about what I'm writing and look at the page."

To escape the pressures of her work and the intensity of living in New York, Sellew enjoys spending time with her husband, Michael Beldoch, at her second home in Millerton, New York, about one hundred miles north of the city near the Connecticut border. The dwelling, an old barn converted to a house, and grounds afford her the opportunity to pursue her carpentry, furniture-refinishing, gardening, and woodworking hobbies.

Sellew tends to shrug off any suggestion that what she has accomplished is particularly noteworthy. Finding the right balance in one's life, the right order--be it in the simple structure of words or the complex nature of life experiences--is, she believes, critical to personal growth and happiness, regardless of the obstacles.

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