We know her as the psychiatrist who’s breaking the mould. Dr. Caro De Witt is not only young, full of joy, and an exquisite singer, but she’s also known as one of the most caring (and joyful) doctors around.
And even though she’s not based at Hanya House, Dr. Caro works closely with clinical psychologist, Lindsey Hyson, and functional medicine specialist, Dr. Rav James to provide holistic treatment approaches to patients with varying degrees of mental health concerns. In fact, there’s not a week that goes by where Dr. Caro, Lindsey, and Dr. Rav aren’t problem-solving to find the best outcomes for patients who – in the past – have often felt like there is little or no hope.
We caught up with Dr. Caro and began with “where did it all start…”
As a little girl, did you know you wanted to be a doctor? If not, what did you want to be?
No (laughs) – I thought doctors gave injections and hurt you! I wanted to be a teacher like my mom [more below about Caro’s role model].
When you started studying medicine, did you already know that you wanted to become a psychiatrist?
I was advised to be a doctor by a very good guidance counselor when I was in high school. I thought I was going into arts and drama or maybe even music. And then once I was in medical school, I liked psychiatry from the beginning: It spoke to me. I am blessed with the skill of listening and I feel into things very intuitively, so I think my personality was naturally drawn to psychiatry.
What else about you is suited to being a psychiatry doctor?
I’m a critical thinker and there’s a lot of problem solving involved in psychiatry, and I feel like I’m also really caring. A lot of healing happens through caring, before anything else. When I worked in Internal Medicine, I would be the doctor to stay behind in the ward to counsel the family. I felt privileged to be that person for others.
The other piece is that I’m okay to sit in the discomfort of grey areas. This profession asks for a lot of patience as we figure things out. And this understanding needs to transfer to the patient. As a psychiatrist we need to reassure patients that we should trust the process.
I think I have a healthy relationship with myself and with my friends, family, colleagues, and patients. And this is important because if I am going to stand in the integrity of my purpose then I want to be “walking the talk” as much as possible.
People often have the “movie” perception of psychiatry. What is psychiatry actually like?
Psychiatry is a good blend of medicine and psychology. There are degrees of mental health, from mild to severe and wherever your patient is on that spectrum it’s so important to remember that sitting in front of you is a human, not just a diagnosis. Psychiatry for me is about loving the problem solving of the diagnosis while at the same time staying connected to the beauty of the human story.
Who have your role models been and why? Both in life and psychiatry.
I have the most amazing role models. My mom and dad helped me to develop my own strong moral compass. My mom was a remedial teacher and she worked at the old hospital school in Pretoria. I have a memory of her taking me to work when I was a little girl. There was a patient who was a similar age to me and we started playing together. After a while she said she wanted to show me a secret and she pulled up her shirt to show me a colostomy bag. I remember feeling so privileged and that memory is with me strongly to this day. If you can help someone who feels vulnerable to trust you – is there anything more magical than that moment of pure connection?
Another role model was one of my professors: Prof Dana Niehaus. I have always been inspired by his professionalism, steadiness, and calmness. I once had a very difficult case and I phoned him for a consult. It was a public holiday, but he took my call and helped me plan a way through the case. I want to be there for my colleagues the way that he has been there for me.
Do you have a specialisation within psychiatry and/or an area of specific interest and why?
I work in general psychiatry but I’m often drawn to child and adolescent psychiatry. I really like the team approach because I’m working with the child, the parents, school, and teachers. Together we must try to solve a puzzle for the child and we’re all critical to the team. I also enjoy maternal psychiatry. There can be peripartum symptoms in pregnancy and we sometimes find that mental health challenges are exacerbated and so I love to help set the tone for a better attachment for the child and mother. This can really help to prevent future problems for the child too.
What research are you currently doing?
The last research that I was involved in was around the stigma to mental health in medical students. The research asked how we could adjust the medical curriculum to improve the experience of psychiatry for medical students and therefore improve the numbers of young doctors interested in this profession.
In the last five years, what mental health challenge/s do you see as growing in our region? And does this correlate with the data from the rest of the world?
There is no doubt that the pandemic sparked a marked increase in anxiety and depression, not only because of the fear of the virus but also because of the socio-economic difficulties that came with it. And of course, children and adolescents had a very difficult time – school wasn’t easy and their parents were vulnerable. I think the digital experience of working has also gone through a revolution in the last decade or so which means that people have very little breathing space. We struggle to find focused, mindful time and this way of life worsens anxiety.
What advice would you give to people who have chronic mild anxiety?
I love the metaphor of crystal and rubber balls. Rubber balls are things we can drop that will bounce back. For example, you forgot to get back to someone at work or you switched off your phone and missed an important call. Crystal balls are the ones that hurt when they drop, like our physical and mental health or attention to the people we love the most. And for some reason, so many of us are ready to drop our own health ahead of something “recoverable” at work for instance. I think we need to work harder at keeping our crystal balls in the air and perhaps there is the opportunity to be more resilient when we drop the rubber balls. I think – a lot of the time – as we do this, our anxiety improves. Any scenario where we look after ourselves better, our anxiety has the opportunity to improve.
How does your specialisation as a psychiatrist shape the way that you live your own life? In other words, what do you “know, know” as a psychiatrist that you apply to your own life?
I preach and practice and know “balance.” I often say to my patients that a table has four legs: Physical, spiritual, emotional, and social and if one of those is out, then your table won’t balance. While it’s not always easy, it’s our responsibility to find balance through self-care practices that work for us. This is important for ourselves and for the people around us. A healthy parent, emotionally, makes for a much better parent.
You work in close concert with Hanya Psychologist, Lindsey Hyson, and Hanya Functional Medicine specialist, Dr. Rav James. Is this kind of collaboration common and how would you say it benefits the patient?
I don’t think it’s common enough! This kind of collaboration and teamwork makes treatment much more efficient. The patient has the opportunity to embrace a true holistic approach – and the support to balance his or her table. I have seen time and time again how much safer a patient feels when they are being supported by a team and you can see that in the progress that is made.
How has psychiatry evolved in the last 10 years, and where would you like to see it evolve in the next 10 years?
I am very excited to see the new treatment approaches that are emerging for patients who – for a long time – felt like there was very little hope. For example, for patients with post-traumatic stress disorder (PTSD), therapy and conventional medications are shown to be effective but are often required for many years or even a lifetime. Now more and more research is showing that psychedelic-based therapies are treating PTSD to the point that patients do not necessarily require multi-year or life-long therapy. I think all medical professionals are concerned that patients find these approaches in non-regulated ways, which can be extremely unsafe so I would love to see better protocols for psychedelic therapies that protect patients and practitioners.
We have heard – rightly or wrongly, that there aren’t enough psychiatrists in the Lowveld. Do you think psychiatry – as a body – is working hard enough to attract more doctors with a holistic approach into the profession?
Luckily in the last five years or so, the number of psychiatrists in the Lowveld has doubled. We still have a shortage and sometimes long waiting lists but organisations like PsychMG are doing a lot of work to attract more doctors into the field.
Complete the sentence:
If I was the mayor of Mbombela for a day, I would…
…make the day a fun holiday and then appoint someone else very quickly (laughs).
If I could meet any person, it would be…
…Nelson Mandela. It’s cliché but he sounds like a person who had a whole-hearted approach to life and people.
If I was an animal, I would be…
…a dolphin. They seem to have so much fun and don’t ever seem to get bored. They’re inquisitive and caring and always under water with their families.
My healthiest habit is…
… that I wear sunscreen every day and try to encourage my children to do the same.
Our lives often have an important turning point. So far, what would you say yours has been?
When I had my children. My perspective on life really changed. I needed to grow and mature. Parenthood is rich and it blesses you so much. But it is such a big responsibility and I take it seriously. The support my parents gave me was so strong, and I would love to do the same for my kids.
What colour would you say you are, and why?
I’m green. Green has so many dimensions. It can be fun, joyful and naughty. It can be calming. And it can symbolize growth and life. It’s a colour that contains so much!
When you’re feeling out of alignment, what do you do to support your mindset and your spirit?
I take a long, hot bubble-bath. I also spend time in nature – this is the best way for me to ground. I love pebble streams and oceans and gardens and flowers. Dullstroom is one of my favourite places, especially where we go because there is no cell phone reception. I also really enjoy scuba diving and love going to Sodwana.
Is there something about yourself that you are willing to share that most people don’t know?
I have bad hand-writing (laughs). And I love singing. In fact, I sing in a small ensemble and we have regular concerts.
What has surprised you the most about this decade of life? Is there a lesson that stands out?
I am in my early forties and people often say that you get a better sense of self. I would agree – there is a real acceptance of who I am and my understanding of self is improving all the time. As we understand self better we also have the opportunity to live our purpose. This is a real privilege. And of course life surprises us along the way so we may connect with multiple purposes, but at least we are striving for a sense of purpose.
What’s one health thing that you’re working on and why?
I’m trying to improve my sleep patterns. I often try to convince myself that I can go with little sleep, but I fall flat on my face. For so many working parents, the night-time is quiet and we often catch up on work or watch TV uninterrupted, but I need my sleep, so I’m being much more mindful.
I also want to say that when I exercise I feel less anxious and worried about everything. Movement is such a powerful regulator. And I have the best trainer and the best training group!
Is there anything else that you would like to share about this phase of your life?
Joy is my oxygen. I feel privileged to spend so much time in a naturally joyful state and I don’t take it for granted. I love sharing it too.
Dr. Caro De Witt is based at Akeso Psychiatric Hospital in Nelspruit. To contact the practice:
drdewittpractice@gmail.com or 087 098 0460.
