Memoirs of an Academic and Clinical Psychiatrist

Michael Fitzgerald — A Chronological Reconstruction

PRELUDE: THE LONDON YEARS (c. 1977–1981)

1977/78

Becomes psychiatric adviser to the Catholic Marriage Advisory Council (CMAC) in London, succeeding a Maudsley-based psychiatrist. Role involves counsellor selection, training, and psychosexual work. Attached to the Westminster centre. Dr. John Marshall, Professor of Clinical Neurology at the University of London, also involved.

1980 (January–May)

10 January: Nina Coltart, Director of the London Clinic of Psychoanalysis, confirms low-fee analysis: patient contribution £2.50 per session (training analysis had cost £10.00/session).
15 April – 20 May: First teaching of medical students, at St. Bartholomew's Medical School, London. Topics: interviewing techniques, talking about death, epidemiology of child psychiatry, autism, child psychosis.
Attends psychoanalytic diagnostic conferences with Anna Freud at The Hampstead Child-Therapy Clinic (later the Anna Freud Centre). Fitzgerald's verdict: "Anna Freud was the best expositor of psychoanalysis that I ever heard. I found her utterly convincing and she understood her father's work in a way nobody else did." Also attends a five-day course on Anna Freud's developmental profile.
4 March: Dr. Donal Cotter writes to Fitzgerald about a consultant child psychiatry post coming up in Dublin. Cotter thinks it may be too soon, but Fitzgerald applies.

1981: THE PIVOT — QUALIFICATION, RETURN, AND APPOINTMENT

10 April 1981

Qualifies as a psychoanalyst with the British Psychoanalytic Society / International Psychoanalytic Association. Subscription: £7.00 (half-year rate). Mr. John Jarrett, General Secretary, writes to confirm.

Early 1981

Returns to Ireland.
Contacted by Cormac Gallagher (St. Vincent's Hospital, Elm Park). This leads to meetings, and ultimately to the establishment of a Master of Medical Science in Psychotherapy at University College Dublin (UCD).
- Fitzgerald's original plan was a three-year course (personal psychotherapy + theoretical input + individual and group supervision). Fitting into the university framework required reduction to two years.
- Professor Noel Walsh assists Fitzgerald, Gallagher, and colleagues in launching the course.
- Professor Ivor Browne organizes a parallel, more constructivist/eclectic strand. A third strand — family therapy — is later set up by the Mater Hospital.
- 22 students trained in the first two years across the three strands.

1981

Invited to a meeting with Professor George Fenton (Professor of Psychiatry, Queen's University Belfast) and Professor Joe Meehan (Professor of Psychiatry, Trinity College Dublin) about psychotherapy training in Belfast. This leads to appointment as tutor in psychotherapy, Department of Psychiatry, Belfast City Hospital. Begins discussions with Dr. John Alderdice on setting up a similar psychotherapy course in Belfast. This inaugurates almost twenty years of weekly supervision of health professionals from the North of Ireland.

1 May 1981

Formally appointed Consultant Child Psychiatrist to the Eastern Health Board, assigned to the Ballyfermot Child & Family Centre (then at Claddagh Green) and the Children's Unit at St. Loman's Hospital. Salary: £18,000 p.a. Programme manager: Mr. T.P. Keyes. This turns out to be the last consultant child psychiatrist appointment the Eastern Health Board makes "for many, many years afterwards."

Late 1981

Founds the Irish Paediatric Obstetric Psychiatric Society (Chairperson: Dr. P. McKenna, Rotunda Hospital; first treasurer: Dr. Elizabeth Griffin, Our Lady's Hospital for Sick Children). Annual meetings held at the National Maternity Hospital, Coombe Hospital, etc.
20 October: Post-graduate lecture at St. Patrick's Hospital / TCD Department of Psychiatry: "The Contribution of Psychoanalysis to Psychiatry."

1982–1985: FOUNDING THE INSTITUTIONAL INFRASTRUCTURE

1982

Founds the Irish Balint Society (Chairman: Dr. John Dillon; Treasurer: Dr. Kieran Lynch; Fitzgerald as Honorary Secretary). The group meets fortnightly for about a year and a half with 5–8 regular GP members, discussing cases from the Balint perspective. In April 1983 presents the Balint Approach to the Royal Academy Section of General Practice; in July 1983 participates at the International Conference on "Psychosomatic Illness in the Young Woman" at Trinity College.
Founds the Irish Association for Psychoanalytic Psychotherapy (Chairperson: Dr. C.P. Noone; Treasurer: Dr. John Alderdice; Fitzgerald as Secretary).
Initiates the Child Psychoanalytic Psychotherapy Group — meetings many times a year on psychoanalysis and child psychotherapy for professionals working with children and adolescents.

1983

First Annual Paediatric/Obstetric/Psychiatric Conference (initiated by Fitzgerald to bring together paediatricians, obstetricians, and psychiatrists). Held at St. Brendan's Hospital. Chairman: Dr. P. McKenna; Honorary Treasurer: Dr. E. Griffin; Fitzgerald as Honorary Secretary. Speakers include Mr. Ernest Freud (grandson of Sigmund Freud) on "Perspectives on Perinatology."
7 October: First recorded Annual Behaviour Therapy Conference at Unit B, St. Loman's Hospital, organized by Bridget Butler and colleagues. Visiting speaker: Maria Callias from The Maudsley Hospital. Fitzgerald's role: consultant to the unit, which operates on behavioural principles for "some of the most challenging children and adolescents in the country."
Psychotherapy supervision sessions begin at Hospital 6, St. James's Hospital (with Professor Marcus Webb's psychiatric unit). By 1985 these become "an established feature of post-graduate training."

1983 (Second Conference)

9 November: Second Annual Paediatric/Obstetric/Psychiatric Conference at the Coombe Hospital. Speakers include Professor K. Mind (Canada) on "Trends in Infancy Research," sessions on single fathers, neonatal units, Galway Mother/Baby Development Study, pregnancy and contraception, the unmarried mother.

1984

Appointed Clinical Teacher at Trinity College Dublin.
Irish Psychoanalytic Association founded by Jonathan Hanagan (Mary Myles, president; Mark Hartman, vice-president). Fitzgerald is training in London at the time but is involved.
Third Paediatric/Obstetric Conference at the National Maternity Hospital, Holles Street (5 October). Speakers: Dr. Wolkind (Great Ormond Street), Dr. E.A. Grace (Harvard), Dr. M. O'Malley (University of Texas), Dr. John Alderdice, Ms. J. O'Reilly (QUB), Frances Fitzgerald.
April: Dr. Claire Adams (Belfast City Hospital) thanks Fitzgerald for lectures given.

1985

The Irish Association for Psychoanalytic Psychotherapy is renamed the Irish Forum for Psychoanalytic Psychotherapy (IFPP) (at John Alderdice's suggestion, inspired by the New Ireland Forum). Fitzgerald becomes first Chairperson; Alderdice, first secretary; Mary Pyle, first treasurer.
Meetings include: Dr. N. Thompson (New York Psychoanalytic Institute) on "Psychoanalysis and Women" (11 January 1985, St. James's Hospital); Mary Fennessy (Maudsley) on group work (7 January 1985).

1986–1989: EXPANSION — JOURNALS, FORUMS, PUBLIC SERVICE

1986

Founds the Irish Forum for Child Psychotherapy with Fr. Paul Andrews, Dr. Mary Smith, and Dr. Louise Tansey. First meeting at Broc House.
Founds the Irish Journal of Psychoanalytic Psychotherapy (with Dr. John Alderdice).
14 May: Post-Graduate Medical Education Council of Northern Ireland thanks Fitzgerald for supervisory sessions and sends honorarium.
Becomes involved with The Sanctuary Trust (one of the earliest Irish organizations dealing with sexual abuse). Chairman: Mr. D. Egan, barrister. Trustees include Senator M.D. Higgins (later President of Ireland), Monica Barnes, Dr. M. Woods. Meeting of 22 October 1986 at St. Michael's House discusses a proposed National Survey on child sexual abuse and coordination with RTE's Today/Tonight programme and the Market Research Bureau of Ireland.

1987

Appointed Lecturer in Psychiatry at Trinity College Dublin.
Appointed External Examiner at Queen's University Belfast for the academic year 1987–88 (observations required on course content, balance, structure, degree schemes, teaching and assessment, and accreditation).

1987–1989

Institute of Group Analysis training programme set up (under direction of the Institute of Group Analysis, London). Organising committee: Mary Darby, Therese Brady, Cormac Gallagher, Noel Walsh, Michael Fitzgerald, James Kelly, Conal Larkin. Introductory course in group work held at St. Vincent's Hospital.

1988

10 February: Appointed Director of Gheel by CEO Mr. Michael Walsh. Remains a director for well over thirty years. Gheel (originally "Geel," after the Belgian town associated with St. Dymphna) provides residential and outpatient services for persons over 18 with autism. By end of 2019: over 120 persons with autism on books. Fitzgerald: "Persons with autism have, in my opinion, a very good lifestyle in a safe, secure and liberal regime."
Joins the Special Hospital Care Programme / Eastern Health Board Suicide Project Team. First meeting 30 November 1988 at St. Mary's Hospital, Phoenix Park. Fitzgerald circulates a document on suicide and attempted suicide; groups identified: 18–30 age group, 60+ age group, young mothers. Advocates guidelines for front-line professionals.

1989

Appointed Co-ordinator, Psychotherapy Training and Services Committee, Eastern Health Board.
Association for the Study of Psychoanalysis in Northern Ireland founded by Dr. Tom Freeman (first psychoanalyst in Northern Ireland, trained with Anna Freud) and associates. Fitzgerald gives lectures; stays with Freeman.
October: Congratulates Dr. Richard Ekins on the Association for the Study of Psychoanalysis; agrees to give lecture.
November: Attends European Medical Research Council meeting, Brussels. Fellow invitees include the major child psychiatry researchers in Europe: Professor Cox, Professor Kolvin, Professor Hans Papousek, Professor P. Graham, Professor E.A. Sand, Professor P. Tienari, Dr. Eric Fombonne, Dr. John Orley (WHO). Discussion topics: family assessment in schizophrenia, father–child interactions, maternal depression, long-term follow-up studies, parenting and premature babies, outpatient vs. inpatient treatment. Fitzgerald notes: "What was particularly interesting about this meeting was that I met people that I was going to meet for the rest of my career."

1990–1993: THE EUROPEAN PHASE & TRAINING PROGRAMME CONSTRUCTION

1990

15 February: Conference "Psychiatric Services Today?, Tomorrow?" — addressed by Dr. Rory O'Hanlon (Minister for Health), Professor Leonard Stein, Dr. J.L.T. Birley, Nuala O'Faolain.
Founds the Irish Standing Conference on Psychotherapy (later renamed Irish Council for Psychotherapy). First meeting at the Burlington Hotel. Fitzgerald becomes first Chairman. Umbrella body embracing family therapy, psychoanalytic psychotherapy, constructivist psychotherapy, humanistic/integrative psychotherapy, and behavioural/cognitive psychotherapy. Early speakers: Mary Banotti MEP, Dr. Ruth Barrington (Department of Health), Professor Anthony Clare. Aim: to regulate training and practice of psychotherapy in Ireland; to develop psychotherapy as "a profession in its own right, a profession that would not be an appendage to any other profession."
Invited by the Nederlandse Vereniging Voor Psychotherapie (NVP) to a meeting in Holland on organizing psychotherapy Europe-wide. Representatives from nine countries: Belgium, Denmark, Germany, Great Britain, France, Ireland, Italy, Portugal.
30 June: Offered Honorary Membership of the Northern Ireland Association for the Study of Psychoanalysis. Accepts.
20 July: Attends meeting of the European Psychoanalytic Federation and American Psychoanalytic Society at Silver Springs Hotel, Cork. Presidents: Mrs. Han Groen-Prakken (EPF) and Dr. Homer Curtis (APA). 72 attendees.
October: First Child & Adolescent Psychotherapy Diploma Course commences (founded by Fitzgerald with Fr. Paul Andrews, Dr. Mary Smith, Dr. Louise Tansey).

1991

February: Professor Marcus Webb writes to Fitzgerald suggesting he explore the award of M.D. on the basis of published work (extensive epidemiological studies in child and adolescent psychiatry completed). Fitzgerald instead goes the standard M.D. route. Thesis: "Epidemiology and Psychosocial Factors in Autism in the Eastern Health Board."
February: Invited to inaugural meeting of the European Federation of Specialists in Psychoanalytic Psychotherapy (EFPP) in London; Fitzgerald becomes Irish representative. Child section later represented by Dr. Louise Tansey and Dr. Mary Smith.
March: Fitzgerald writes to Minister for Health Dr. Rory O'Hanlon proposing a working party for a national register of psychotherapists.
March: Takes over from Dr. Gerry O'Neill as child psychiatry representative on the Research and Training Committee, Eastern Health Board.
27 August: Meeting of the Gheel Training Group; Peter Byrne seconded to the Gheel Programme for five years (remains until 2019).
July: Lord Alderdice writes to thank Fitzgerald for "the enormous encouragement and help to Claire [Adams] and me all along the way" regarding the Northern Ireland Institute of Human Relations. Alderdice: "In a very real way, not only did the development of psychotherapy in the South, but also in the North owes much to your vision and work."
The Northern Ireland Institute of Human Relations is founded by Alderdice, Adams, and others; Fitzgerald elected Honorary Foundation Member.

1992

3 July: The European Association for Psychotherapy (EAP) is incorporated in Brussels. Fitzgerald is one of the fifteen signatories to the document of incorporation. The EAP is an umbrella organization of national umbrella organizations across the EU.
Founds the Irish Journal of Psychoanalytic Psychotherapy (published under auspices of the IFPP). Also continues as Associate Editor of the Irish Journal of Psychological Medicine (founded earlier as the Irish Journal of Psychotherapy by Mark Hartman) for many decades. Fitzgerald on Hartman: "He was, during my time, the outstanding intellectual in Irish psychiatry."
Involved in the Comprehensive Academic Review at TCD under Patrick J. O'Meara.
Serves on Appointments Committees (e.g., Local Appointments Commission, 22 October 1992).
Attends Irish Psychiatric Tutor's Association AGM (September 1992): 34 doctors entered professional training; 182 approved consultant posts with 22 vacancies; pass rate for Irish graduates in MRC Psych Part 1 = 55% vs. 70% for British-trained doctors.

1992–1993: Child & Adolescent Psychotherapy Training

Approached by childcare workers to give a course; this leads to a one-year introductory course: "Understanding Child and Adolescence: An Analytical Approach" — 18 weeks, Wednesdays, Buswell's Hotel, from 21 October 1992. Dr. Mary Smith key organizer.
Fitzgerald approaches Professor Marcus Webb and the Faculty of Health Sciences at TCD to convert the Diploma in Child & Adolescent Psychotherapy into a Master's degree. Successfully achieved — course operates as a Master's degree in Child and Adolescent Psychotherapy from October 1993.

1993

Irish Institute of Psychoanalytic Psychotherapy (IIPP) founded. Founding members: Felicity Casserly (treasurer), Nessa Childers, Michael Fitzgerald (co-chairperson), Rita McCarthy, Ann Murphy (co-chairperson), Ellen O'Malley Dunlop, Mary Pyle (co-ordinator of training course), Ross Skelton (examinations secretary), Patricia Skar (secretary). First intake of 15 students in October 1993. Course described as "an integrative/integrated dynamic psychotherapy course with all the major psychoanalytic schools." Includes group psychotherapy training and infant observation.
The MSc in Psychoanalytic Psychotherapy at TCD established (course directors: Michael Fitzgerald and Anne Murphy). Teaching staff: Felicity Casserly, Nessa Childers, Anne Murphy, Ellen O'Malley-Dunlop, Mary Pyle, Ross Skelton.

1994–1996: HOSPITAL APPOINTMENTS & CONSOLIDATION

1994

Appointed Consultant Psychiatrist to Our Lady's Hospital for Sick Children and the National Children's Hospital, Harcourt Street (also maintains sessions at Drumheath Hostel for Disturbed Children & Adolescents).

1995

12 September: Probationary period completed at Our Lady's Hospital (confirmed by Paul Kavanagh, Secretary Manager).
Founds the Irish Journal of Child & Adolescent Psychotherapy. First editor; Sherry Doyle, associate editor. Editorial board: Margaret Connolly, Maighread Ní Ghallchobhair, Mary Smith, Paul Andrews, Brenda Dowling. First issue includes: Paul Andrews on the adolescent in psychotherapy; Mary Smith on Attachment Theory and Child Psychoanalysis.
Publishes "Developments in Psychoanalytic Psychotherapy in Ireland, A Personal View, 1981–1993" (Irish Journal of Child & Adolescent Psychotherapy, Vol. 1, No. 1).
Appointed to the Irish Government Commission on the Family by the Minister for Social Welfare (serves until 1998).

1996

National Children's Hospital, Harcourt Street closes and transfers to Tallaght Hospital. Fitzgerald transfers his sessions with the hospital.

1997: THE PINNACLE — FIRST PROFESSOR OF CHILD PSYCHIATRY IN IRELAND

6 March 1997

Appointment as first Professor of Child Psychiatry in Ireland — the Henry Marsh Chair in Child & Adolescent Psychiatry, Trinity College Dublin — notified by Michael Gleeson, Secretary to Trinity College.
Fitzgerald emphasizes debts: "I would never have made any progress in Trinity without the support of Professor Marcus Webb. I am always very grateful to him for his support. Professor Davis Coakley, Dean of Faculty of Medicine in the past, was also very supportive of me and indeed, throughout my career."

1998–2009: INTERNATIONAL RECOGNITION & AUTISM SPECIALIZATION

1998

30 October: Invitational lecture: "New Focus on Autism," Talbot Hotel, Wexford.

1999

19 October: Lecture to the American Academy of Child & Adolescent Psychiatry, Chicago: "Did Ludwig Wittgenstein have Asperger's Syndrome?"
Multiple presentations at European Child & Adolescent Psychiatry International Congress, Hamburg: suicide and gender issues in Irish children; biochemical parameters in autism; personality traits in parents of people with autism; parenting autistic adolescents; alcohol use in early adolescence; Wittgenstein and Asperger's.
Book on autism described by Simon Baron-Cohen (University of Cambridge) as "the best book on autism." Baron-Cohen also describes Fitzgerald as an "exceptional scholar."

2000

24 November: The Northern Institute of Human Relations celebrates its tenth anniversary at Stormont Castle.

2001

Appointed by the Minister for Education & Science to the Irish Department of Education & Science Task Force on Autism.
Lecture to American Academy of Child & Adolescent Psychiatry, Hawaii, Honolulu: "Creativity in Mental Illness."
Co-presents on effects of domestic violence on children (American Academy of Child & Adolescent Psychiatry / Royal Australian and New Zealand Child Psychiatry, Annual Meeting, Hawaii).

2002

Becomes Chairman of the Irish Association of Suicidology (remains in position for over six years). Regular meetings at Dáil Éireann, courtesy of Dan Neville TD. Founding members (1996): Dan Neville TD, Dr. John Connolly. Fitzgerald on Neville: "the number one politician in relation to this problem in Dáil Éireann." Neville instrumental in decriminalizing suicide (suicide and attempted suicide had been a crime in Irish law until 1993; last person charged for attempted suicide was in 1967).

2003

Presentations at European Child & Adolescent Psychiatry International Congress, Paris: identification of a susceptibility region for autism on chromosome 2q (Gallagher, Ennis, Conroy, Fitzgerald, Green, Gill); audit of an inpatient child psychiatric unit; psychological screening of children post-Omagh Bomb; "Did Sir Winston Churchill have hyperkinetic or bipolar affective disorder?" (Siddiqui, Fitzgerald).

2004

Presentation at World Autism Congress, Herning: "Autism and Creativity."

2005

21 November: Article in The University Observer: "Unravelling the Secret of Genius" — reviews Fitzgerald's work on creativity and autism.

2006

17 March: "Autism, Humour and Genius" — 6th National Autism Congress, Rotterdam.
September: "Creativity in Autism" — 1st Cambridge Autism Research Conference, Cambridge.
November: "Creativity in Autism (Psychiatric Disorder): Historical Review and New Associations" — 2nd World Autism Congress, South Africa.
7–9 April: Teaching at Penang Medical College (associated with Royal College of Surgeons in Ireland). Workshop on dynamic psychotherapy organized by Professor Leela Ryan. Evening lecture at Eastern & Oriental Hotel, Penang, on ADHD.

2007

Appointed by the Minister for Health, Social Services and Public Safety, Northern Ireland (Michael McGimpsey) to the Independent Review of Autism Services in Northern Ireland, chaired by Lord Maginnis of Drumglass.
International Association for Suicide Prevention World Congress, Killarney — hosted by the Irish Association of Suicidology.
September: Appointed by Minister for Health, Northern Ireland, to Independent Review of Autism Services.
14 February 2009: Invited to Charter Day Dinner, Royal College of Surgeons in Ireland, by President Professor Frank B. Keane. Dr. Ronnie M. Delaney receives honorary fellowship.

2008

Invited to Evaluation Panel for commissioned research on suicide prevention (psychological autopsy), Research & Development Office, Belfast, on behalf of Health & Social Care, Northern Ireland.
29 September: Invitational conference at The Royal Society / British Academy: "Critical Evaluation of the Concept of Autistic Creativity."
May: "Creativity, Evolutionary Psychology and Psychiatry, with Particular Reference to Autism and Asperger's Syndrome" — 18th World Congress of the International Association for Child & Adolescent Psychiatry and Allied Professions, Istanbul.
Interview with Ronald Harwood (Oscar-winning screenwriter of "The Pianist") at the Screen Writers' Festival — conducted in the style of "In the Psychiatrist's Chair."
Neuroscience Conference, Washington: "Fundamental Principles by Which the Brain Can Process Information — An Information Management Perspective" (Oetringer, Casanova, Fitzgerald).

2010–2016: LATE CAREER — GLOBAL LECTURING & CONTINUED RESEARCH

2010

2–6 June: 19th Congress of the International Association of Child & Adolescent Psychiatry, Beijing, China: "Autism."
28–29 May: University Integrata, Verona: "Aspetti Clinici e Neurofunzionali."

2011

May: ADHD Congress, Berlin: "ADHD in Association with Impairment in Everyday Life — Results of the European Lifetime Impairment Survey."
July: International Congress of the Royal College of Psychiatrists, Brighton: "ADHD/ASD — Overlap and Differences."
November: Advanced Expert Symposium, Korea: "Treating ADHD with Long Acting Stimulants."
17 November: Article in Metro In Focus (London) summing up Fitzgerald's work on historical figures with autism.

2012

February: Association of Psychology and Psychiatry for Adults and Children, Athens, Greece: "Criminal Autistic Psychopathy" and "Schizophrenia and Autism — Overlap and Difference."
24 April: Meeting of the European Parliament Interest Group on Mental Health, Wellbeing and the Brain, Brussels.
December: Full-day series of lectures on autism at Teacher's Training Centre, Katowice, Poland.

2013

15th International Congress of ESCAP, Dublin (July): Multiple presentations — epidemiological studies in child & adolescent psychiatry in Ireland; history of child psychiatry in Ireland; studies of autism spectrum disorder in Irish populations; ADHD and European Lifetime Impairment Survey; methylphenidate side-effects and CES1 gene variation; attitudes of healthcare professionals in ADHD management.
8–9 November: "Challenging DSM 5" — International Autism Conference, Aspire, Dublin.
Lectures in Norway (Oslo) and Istanbul on ADHD.

2014

October: "Creativity and Autism" — Invited lecture, Stockholm.
October: "Autism and ADHD" — Prism Conference, Stillorgan Park Hotel, Dublin.
XVII World Congress of Psychiatry, Madrid: "Criminality: The Overlap Between Autism and Schizophrenia and Personality Disorder."

2015

30 September: ADHD lecture, South Tipperary Autism Support Group.
ICD 10 Symposium, Royal College of Psychiatrists Annual Child Psychiatry Meeting: "Diagnosing ASD in the 21st Century."
28 November: Irish Institute of Psychoanalytic Psychotherapy Open Day, 107 Lower Baggot Street, Dublin. Organisers: Dr. Margaret Boyle-Spellman, Dr. Noreen Giffney, Dr. John O'Connor.

2016

Appointed Reviewer for the German Federal Ministry of Education and Science for "Healthy Life-Long: Child and Adolescent Health." Work takes place in Berlin near the Reichstag.
25 February: Invited lecture: "Jack B. Yeats" — Friends of the National Gallery of Ireland.
30 January: "Humour and Autism" — Symposium on Autism and Humour, University of Kent.
International Congress of the Royal College of Psychiatrists, London: "Are There Clear Distinctions Between Neurology and Psychiatry, Between Neurological Disorders and Psychiatric Disorders?"
Irish Association of Suicidology last conference, Killarney.

2017–2019: HONOURS, RETIREMENT, AND CONTINUED TEACHING

2017

Overall winner of the "Excellence in Psychiatry" Award in Ireland. Judges include Professor Freddie Wood, President of the Irish Medical Council.
11 May: University Council ratifies Fitzgerald's continued teaching post-retirement; University Board ratifies on 25 May 2017.
Recommendation from Professor Aiden Corvin, Head of Department of Psychiatry, TCD (and Fitzgerald's former registrar — "incidentally the best registrar I ever had the honour to work with"):
"He is the first Professor of Child Psychiatry in the country and had a profound impact on the development of autism services in Ireland. He's a polymath with a deep interest in research and substantial publication record in journal and book form. (H. Index > 70, more than three hundred peer reviewed publications). He developed our MSc in Psychoanalytic Psychotherapy and has always been a committed teacher."
23 May: Interview in The Times (Irish edition) on cannabis oil and the treatment of autism.
Autism Conference, Convention Centre, Dublin: "Autism and Aggression."
8 December: 9th European Excellence in Paediatrics Conference, Vienna: "Neurodevelopmental Disorders."

2018

April: Reattach Conference, Eindhoven: "The Predator–Prey Dilemma: Can We Reduce the Risk of Criminal Psychopathy by Neutralising Power and Training Affective Mentalisation?"
27–29 September: National Scientific Conference, Krakow, Poland: "Autism and Co-Morbidities, and Quality of Life."
29 November: Association for Criminal Justice Research and Development, Law Society of Ireland: "Challenges for Children on the Autism Spectrum."

2019

Teaching at Trinity College Dublin concludes (teaching had begun in the 1980s and continued to 2019).
18–26 April: 7th International Symposium on Child & Adolescent Psychopharmacology, Antalya, Turkey: "The Genesis of Artistic Creativity: Genius, Genes and Autism."
Visits Geel, Belgium — the town of St. Dymphna and the original model of community-based care for the mentally ill.
Peter Byrne retires from Gheel after continuous service since 1991 (seconded in 1991, remained until 2019).
Gheel has over 120 persons with autism on its books.

POST-RETIREMENT (2020s)

Continues scholarly activity:
- ResearchGate metrics: H-index = 50; Reads = 197,259
- 35 books written, co-written, and co-edited (including Japanese and Polish translations)
- ~5,000 persons diagnosed with autism spectrum disorders over career
- 300+ media interviews, many with RTE
- Lectured at: The Royal Society/British Academy, British Library (London), New York, Buenos Aires, Tbilisi, Melbourne, multiple European countries, China, Malaysia, Korea, Hawaii.
Departmental administration at TCD: Ms. Anne Phillips succeeded by Siobhan Doyle — "No matter what problem I had, she always had the solution, never flapped and was always in good humour."

MAJOR RECURRING THEMATIC STRANDS (Cross-Cutting the Chronology)

I. THE PSYCHOANALYTIC PSYCHOTHERAPY INSTITUTION-BUILDER

An almost unbroken chain of foundings, 1981–1993:

Irish Paediatric Obstetric Psychiatric Society (1981) → Irish Balint Society (1982) → Irish Association for Psychoanalytic Psychotherapy (1982) → Child Psychoanalytic Psychotherapy Group (1982) → Irish Forum for Psychoanalytic Psychotherapy (1985) → Irish Forum for Child Psychotherapy (1986) → Irish Standing Conference on Psychotherapy / Irish Council for Psychotherapy (1990) → European Association for Psychotherapy (1992, signatory) → Irish Institute of Psychoanalytic Psychotherapy (1993) → MSc in Psychoanalytic Psychotherapy at TCD (1993) → Diploma converted to Master's in Child & Adolescent Psychotherapy (1993).

II. THE AUTISM SPECIALIST

From the M.D. thesis on epidemiology and psychosocial factors in autism through to ~5,000 diagnoses; 35 books; the Gheel directorship (1988–2019+); the Task Force on Autism (2001); the Independent Review of Autism Services in Northern Ireland (2007); the "best book on autism" endorsement from Simon Baron-Cohen; the international lecture circuit on autism and creativity.

III. THE PUBLIC SERVICE PSYCHIATRIST

Ballyfermot Child & Family Centre (1981–); Unit B, St. Loman's Hospital (decades, until closure); Chair of Boards of Management (Ballyowen Primary, Setanta Secondary, James Connolly House Special School) — fifty years total across three schools; Suicide Project Team (1988); Specialty Tutor, Eastern Health Board; Government Commission on the Family (1995–1998); Irish Association of Suicidology Chairman (2002–2008+).

IV. THE CROSS-BORDER FACILITATOR

Nearly twenty years of weekly supervision of Northern Ireland health professionals; Queen's University Belfast appointments (tutor, external examiner 1987–1992); Northern Ireland Institute of Human Relations (Honorary Foundation Member); Association for the Study of Psychoanalysis in Northern Ireland (Honorary Member, 1990); Independent Review of Autism Services in Northern Ireland (2007); suicide prevention research evaluation panel, Belfast (2008). Fitzgerald's own gloss: "The fact that the 'troubles' were not over during my time there, didn't interfere with my involvement there. During all my time there, I was treated extremely well by all denominations. This, in one sense, was slightly surreal considering the political history of the times."

V. THE EPIDEMIOLOGIST & RESEARCHER

Extensive epidemiological studies in child and adolescent psychiatry in the Eastern Health Board (completed by 1991); M.D. on epidemiology and psychosocial factors in autism; 300+ peer-reviewed publications; H-index 50–70+; studies on behavioural deviance, sleep disturbance, enuresis, life events, physical illness and soft neurological signs, maternal depression, suicide, ADHD, autism genetics (chromosome 2q), creativity and psychopathology.

VI. THE CRITIC & DISSENTER

The memoir contains a persistent critical counter-narrative:

"ADHD, which underlies many patients with forensic problems; depression, anxiety, personality disorder etc, was seriously underdiagnosed in the public service for decades. They were mostly misdiagnosed as having attachment disorder, a rare condition. This caused enormous stress to parents. In the public service, parents were generally put on parenting skills courses and the parents interpreted this as blaming them for the child's problems. That was a feature of child psychiatry for the last fifty years."

"'Blaming the mother' was always central to child psychiatry, with serious consequences."

"A vast amount of public service time was lost in multidisciplinary meetings when patients should be seen." (Fitzgerald reports having no waiting lists during thirty years as consultant to a CAMHS clinic, using a longitudinal model.)

On CBT's dominance: "In actual fact, it had no particular extra benefit except in certain anxiety states. Indeed, all the psychotherapy approaches have a pretty similar outcome."

On psychotherapy: "'Psychotherapy — Nothing More than High Quality Friendships?' I said it was and still stick to that position."

On biological psychiatry: "I remember writing early in the 1980s, as psychiatry became more biological, particularly adult psychiatry there was a danger of it, 'losing the mind.'"

Quoting Dr. Jonathan Pedder: "Medicine and psychiatry without psychotherapy at any level, would be more like veterinary medicine."

TONAL CONTRADICTIONS & TEXTUAL FEATURES (Interpretive Note)

The memoir exhibits a characteristic tension between relentless institutional entrepreneurship (the sheer volume of organizations founded is extraordinary) and professed reluctance about certain roles (Chairman of Boards of Management: "I did try for many years to be relieved of my job as Chairman… I didn't succeed. It seemed like people wanted 'a safe pair of hands'"; Appointments Committees: "I didn't particularly enjoy being on appointments boards, but they were part of one's duty").

The voice shifts between the archival-forensic (preserving precise dates, salaries — £18,000; consultation fees — £2.50; mileage rates — 22p/26p/29p per mile; lunch tickets — £1.00) and the reflective-aphoristic (the Winnicott quotations, the "high quality friendships" provocation). The repeated invocation of letters as documentary evidence — "I have a letter from…" — constitutes a distinctive rhetorical signature, as does the formula "To the best of my knowledge, what follows is the correct history, but I would be grateful if the reader would contact me if there are any amendments needed" — a gesture toward historical fallibilism that coexists with the document's implicit claim to authoritative witness.