This is part of a series of biographies excerpted from the new book Women in Psychiatry: Personal Perspectives published by American Psychiatric Publishing. The book was edited by Donna M. Norris, M.D., Geetha Jayaram, M.D., and Annelle B. Primm, M.D. The book may be ordered here; APA members are eligible for a discount.

Emerging From the Shadow, Exposed to the Light

by hind benjelloun, m.d.

Under a Shadow
My impression of my role as a woman is strongly shaped by my upbringing. The Moroccan culture, as many Arab cultures do, places a great emphasis on the first-born child; the first son in particular grants great pride and esteem to a family. Although the legal-religious organization of no two Arab countries is identical, women are stereotypically represented as oppressed and subordinate. This perception is reinforced by a patriarchal class system that has dominated the Arab world for thousands of years. Unlike in the West where the individual is the basic unit of the state, it is the family that is the basis of Arab states. Within this framework, the rights of women are expressed solely in their roles as wives and mothers. And within this framework I was raised.

In 1974, my parents moved to the United States after my father accepted a prestigious position at the Moroccan Embassy in Washington, D.C. My brother was their firstborn and I the second, 20 months later. The story was traditionally perfect.

From the time of my earliest memories, I felt inadequate to my older brother in a multitude of ways. As we were growing up, the power differential was palpable, and to me, it felt clear that my deficiencies were because I was a girl. Culturally, that was the accepted standard. In my superficial child’s mind, my brother was bigger, stronger, meaner, and faster. And he was obviously smarter than I was. I was just a girl.

My self-esteem suffered living under this perceived shadow. I became isolative in my elementary school years, finding the most pleasure immersing myself in the life of another. I was particularly intrigued with the mystery novel character Nancy Drew; I fantasized being like her, but understood that I never would. My impression was that she was a girl who was capable of doing whatever a boy can do. Of course to me, the concept was absolutely fictitious; I thought, “a girl could never really do the things Nancy Drew did.”

Nancy Drew’s spirit stayed with me throughout my childhood and teen years. I started to slowly believe that a girl, or woman, could accomplish whatever she sets her mind to accomplish. Indeed, among her most vocal fans are international female leaders. U.S. Supreme Court Justice Sonia Sotomayor said Nancy Drew represented “boldness and intelligence”; other fans include Oprah Winfrey, Laura Bush, Hillary Rodham Clinton, Diane Sawyer, Nancy Pelosi, and Ruth Bader Ginsburg.

In high school, I began to develop a greater vision for myself in life. As expected of me culturally, I never dated and was home with my family during most of my free time. It started becoming more evident that I had missed out on exploring life and was continuing to miss out. To escape the life that for years I had conformed to and accepted, I went away to college. Despite resistance from my parents to letting me loose, I started my new life at the University of Virginia.

Blackjack
As I embarked on my adult life, the game of blackjack became my sanctuary. I carry both pride and shame with this admission. The blackjack table is where I matured the most as a human being as a woman. Through a friend, I learned about venues in southern Maryland where blackjack was dealt. I was intrigued. “Gambling? I don’t drink, I don’t smoke, I don’t have sex; I’m a good girl. I come from a good Moroccan family.” Yet immediately, I felt an intense and much-needed sense of rebellion. Gamblers seemed street-smart, strong, confident. Could I be that? The mere suggestion was intoxicating. I spent months researching and intellectualizing blackjack from a scientific perspective. I had beginner’s luck, and I moved on to gambling in Atlantic City casinos. Hours to days to weeks I spent playing blackjack and establishing a name and a rating for myself.

At the blackjack table I have met unique, extraordinary people: taxi drivers, movie stars, Harvard professors, tattoo artists, boxers, teachers, ex-cons, doctors, lawyers. People, and all their complexities, became more and more fascinating to me. The foundation of my interest in psychiatry was developing.

Awakening
I embarked on a career as an editor in New York City. But my life was transformed in January 1999 when my 11-year-old sister was hit head on by a van while crossing the street in front of her school in Virginia. The neurologists indicated the prognosis was poor. Somehow she lived through the next few weeks, emerged from a coma, and ultimately was transferred to the Kennedy Krieger Institute in Baltimore, Maryland, for many weeks of rehabilitation.

As she progressed, a peculiar irritability, impulsivity, and disinhibition emerged that were uncharacteristic of my sweet, well-mannered Sonia. Her language was offensive and vulgar. She often required physical and chemical restraints. A psychiatric consultation was critical. The psychiatry consultation team explained Sonia’s behavior was a frontal lobe phenomenon and her experience was characteristic of pediatric frontal lobe traumatic brain injuries. Psychotropic medications were needed and were incredibly effective.

During her recovery, I became fascinated with the connection between the brain and behavior. The field of psychiatry appeared so innovative, so stimulatingly puzzling, with vast room for breakthroughs! In psychiatry, we are just at the beginning of discovery and we have a tremendous way to go. Sonia finally was discharged home following a seemingly miraculous recovery. This experience fully transformed me. I decided it was time to pursue the field about which I had recently developed an unsurpassed passion: I wanted to study the mind.

Women and Leadership
In the transition out of my training years, I have been increasingly mindful of the strong, unspoken differential in the impressions and expectations of women versus men as leaders. A woman, because of defined and learned perspectives, will encounter challenges to her desire to be viewed as a competent, valuable, and potent leader.

And as career opportunities for leadership and advancement multiply for women, so too does the potential to become overwhelmed or exploited. Although I initially believed saying no would make me appear ineffective or weak, it is an essential component to success. I am learning that efficiently creating a team and delegating tasks is essential to saying no in a way that is diplomatic, graceful, and respectful.

Hind Benjelloun, M.D., is Assistant Professor of Clinical Psychiatry, Associate Psychiatry Residency Training Director, and Associate Medical Director, Inpatient Psychiatry Unit, Georgetown University Hospital, Washington, D.C.

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