Paul Garfinkel

Career

After receiving his F.R.C.P. qualification, Garfinkel was appointed to the University of Toronto as a demonstrator in the Department of Psychiatry in 1974. In the following year, he was promoted to lecturer, and to assistant professor in 1976. He was promoted to associate professor in 1978 and became a professor of psychiatry in 1982.

Garfinkel has also held several administrative appointments. He was appointed as vice-chair and chair of department of psychiatry at University of Toronto from 1982 till 1990 and from 1990 till 2000, respectively.

Garfinkel held clinical and hospital appointments simultaneously with his academic appointments. At the Clarke Institute of Psychiatry, he was appointed staff physician in 1974. From 1975 till 1979, he served as staff psychiatrist at different units at the Institute. He was appointed as the chief of Psychosomatic Medicine Unit in 1979.. He served as president and psychiatrist-in-chief from 1990 until 1997.

At the Toronto General Hospital, Garfinkel served as an associate psychiatrist from 1978 until 1982 and as psychiatrist-in-chief from 1982 until 1990. He has also served as a consultant at the Addiction Research Foundation, Women's College Hospital, the Wellesley Hospital, the Toronto Hospital and Mount Sinai Hospital. He was appointed as an honorary consultant at St. Michael's Hospital in 1988.

In 1998 Garfinkel was appointed the inaugural president and CEO of the newly formed Centre for Addiction and Mental Health – a merger of four hospitals – the Queen St Mental health Centre, the Addiction Research Foundation, the Donwood Institute and the Clarke institute of Psychiatry – a position he held until the end of 2009. His vision for CAMH resulted in a long-term plan to redesign the organization and its programs, to build an urban village that promoted dignity and respect and fought the stigma directed to the mentally ill and addicted.

Research

Garfinkel’s research expertise lies in eating disorders. He has conducted extensive research regarding eating disorders, with a special emphasis on Anorexia Nervosa and Bulimia Nervosa. He is responsible for a multi-dimensional understanding of anorexia nervosa that highlights a variety of risk factors. He studied the link between the cultural expectations of thinness in women and development of serious eating disorders and worked on classification and diagnosis of eating disorders. He described criteria for anorexia nervosa, bulimia nervosa and binge eating disorder. He conducted research regarding the clinical similarities and psychological morbidity between men and women with eating disorders and also investigated the relationship between bipolar illness and binge eating disorders.

Garfinkel also conducted research on the Eating Attitudes Test, a measure of the symptoms of anorexia nervosa and related these to psychometric and clinical parameterssociated with it. Other research involved studying the hormonal factors in anorexia nervosa, and the perception of hunger and satiety. Garfinkel discussed body image disturbances in anorexia nervosa and conducted research on Bulimia as a subgroup of Anorexia Nervosa and studied the distinction regarding the two eating disorders. He also studied the personality disorders and co-morbidities in anorexic patients.

His treatment approach became known as Multi-dimensional, aimed at removing the starvation effects of the illness, addressing faulty cognition and then examining the risk factors that brought on the disorder. Medications were used to treat symptoms but were not the primary treatment modality. For the treatment of bulimia, Garfinkel worked with antidepressants, including a trial using isocarboxazid and found that it reduced the level of symptoms associated with the disorder.

Garfinkel had a secondary interest in studying the problems of psychiatrists and conducted research on this.