Friday, September 18, 2009

Dr. Charles Atkins on Mother's Milk

ROBERTA: Today JR is pleased to welcome psychiatrist Dr. Charles Atkins whose new book MOTHER'S MILK has just been released by Severn House. MOTHER'S MILK is his sixth novel, the third in his series featuring forensic psychiatrist Barrett Conyors. Welcome Charles! Please start by telling us a little about the book--where did the idea for this come from?

CHARLES: Like most of my books, MOTHER’S MILK is a fusion of what I find interesting as a psychiatrist and an author. In this case, I have my heroine—forensic psychiatrist Barrett Conyors—embroiled in a thriller that deals with the issues of opiate dependence (pain pill to heroin) and the knotty question of just what happens to all of those kids under the care of state systems (Department of Children, Social Services, etc.) as they turn eighteen and are no longer wards of the state.
While clearly fiction, the ideas for this book are deeply rooted in reality and in the work I do—and have done--as a psychiatrist. A few years back I left a job working for the state of Connecticut’s Department of Mental Health and Addiction Services (DMHAS)—I had been a regional medical director. My six years with the DMHAS gave me a fabulous view of how state agencies operate: the politics, the over-the-top funding, resources that exceed anything available in the private sector, the constant struggle with powerful unions and so forth. All of this I gave to my heroine, Barrett, who in this book finds herself in the position of being a medical director of a facility that evaluates people with severe mental illnesses who have also committed—or are suspected of having committed--serious crimes.
After leaving my position at the DMHAS I returned to work in hospital-based clinics—I split my time 50/50 between being a writer and being a psychiatrist. One of my current clinics is for people with chemical dependence. Largely because of the relatively recent availability of buprenorphine—a synthetic compound used to treat opiate dependence—I have found myself learning a tremendous amount about heroin addiction and what it does to people and those who love them. Where opiate dependence typically—although not always--starts in the young, often with deadly results, it seemed a natural fit for getting to my final big social theme—what happens to all those kids under the care of the state as they age out? These are the children who’ve been removed from abusive households, or were too wild for their parents to handle, or too mentally ill or….Each year thousands leave the system. Most have little or no social supports, many haven’t completed high school. It’s a new crop each season, and in MOTHER’S MILK, I introduce a pair of likely villains all too eager to swoop down for the harvest.
As it turns out, MOTHER’S MILK is quite a sexy book, and as I think about the nature of addiction and dependence this makes sense. People turn to drugs and other bad habits because they seem to offer something good: a release from pain, excitement, a walk on the wild side. But once hooked, the story changes, and to feed an addiction people can, and will, do horrible things.

ROBERTA: One of my pet peeves as a psychologist is dreadful portrayals of mental health professionals in books and movies. How close is your fiction to your work as a psychiatrist? How do you make sure the fiction rings true without breaching confidentiality?

CHARLES: Excellent question, and I share your peeve! My fiction hangs close to the truth, but not to a specific case. Confidentiality can never be breached, and what I’ve found as a psychiatrist is that over time patterns emerge.
In the case of MOTHER’S MILK, I’ve evaluated many hundred—possibly thousands of children and young adults. So I take a composite of the young girl/boy who is removed from their home at age two because their crack-addicted mother is bringing strange men into the house. They become wards of the state and are placed in a series of foster homes—at least one in which they are molested. What you find is that these kids will behave in particular ways at the age of eight, ten, twelve. At fourteen he/she will fall into one of two large categories—depressed and withdrawn, or on an emotional roller coaster, often with sexualized behaviors and possibly promiscuity. Drugs and alcohol seem a natural, because they are in tremendous emotional pain--contrary to ill-conceived ‘War on Drugs’ campaigns, drugs do in fact work and that’s the problem…they work too well and these kids get hooked fast.
So the clinical part of the writing reads true, while the actual characters are fictional.

ROBERTA: On your website, you mention an article you wrote for Writer's Digest on creating believable villains. Can you give us some tips on that?

CHARLES: This again speaks to patterns of human behavior. Understanding broad categories of personality—and when this crosses into the terrain of a disorder—can be extremely useful to anyone writing crime fiction, or involved with criminals in general. For instance, let’s look at the broad diagnostic category of antisocial personality disorder. This is where a person over time shows little regard for the rights and feelings of others. They are mostly driven by their own desires. In a child who is developing antisocial traits this could be the school bully, or even the kid who gets bullied, but plots their revenge—think Columbine. The budding young thug is driven by desires—“I like your bike, I want your bike, give it to me…or else.” They develop a taste for power, which often goes along with cruelty—both to people and sadly to animals (I sometimes have more sympathy for our little furry friends than the two-legged kind). Sometimes they operate alone, sometimes they hook up with a buddy—here too familiar patterns emerge with one partner dominant over their willing accomplice.
The fun of understanding personality types is that you can easily generate believable characters and put them into whatever shape you’d like. If we stick to the sociopath, and want to have someone truly deadly, give them a high IQ, make them physically attractive and you’ve got a powerhouse villain. And the scary bit is that these dudes and dudettes aren’t just in the pages of fiction they’re out there. They have insight and know enough to keep their nasty bits hidden. So don’t automatically think they’ll get caught and wind up in jail—most don’t. Their smiles are white, they’re everyone’s good buddy, just be careful you don’t cross them, or have something—or someone--they want.

ROBERTA: What's your take on the state of publishing today? Any tips for discouraged new or midlist writers?

CHARLES: MOTHER’S MILK is my eighth published book—six novels and two non-fiction books on Bipolar Disorder and Alzheimer’s. I’m most-definitely mid-list with an eye to becoming a best-seller. And yes, the book business has changed radically. That said I don’t think my advice to new writers has changed…or changed much.
• Be persistent. Rejection is part of the game…a big part. Many talented writers back off from publishing after their first few rejections. Ultimately it’s the ability to stick with it that separates the published author from the wannabee. Like most writers I have enough rejection letters to paper a room.
• If you want to have your book published, get a reputable literary agent. Yes, occasionally publishers will publish without one, but this is very much the exception and not the rule. Increasingly publishing houses are not willing to develop the work of a new—and promising author. By the time your manuscript gets to an editor with the clout to give you the green light, it needs to be in A-one shape.
• Listen to advice from people who know the business.
o One of my very first rejection letters was a form letter that on the bottom had scrawled in red pencil, “this is very unprofessionally formatted!!!” While I associate three exclamation remarks in a row with twelve-year-old girls, I did take the hint, bought a copy of WRITER’S DIGEST GUIDE TO MANUSCRIPT FORMATTING and never had that problem again.
o A well-established author, when I was just starting out, recommended getting some smaller pieces published as a way of establishing credentials. To date I’ve had a couple hundred essays, articles, short stories etc. printed in everything from medical journals to major magazines and newspapers. It does make a difference.
• Write daily. Do it at the same time. If you don’t practice the craft you’ll never get good.
• Develop a support network of readers. Starting with your mom who loves you, to people who are in the business and can give you solid criticism.
• Be persistent
• Be persistent
• Be persistent

And with that, thanks so much for having me on your Blog.

Psychiatrist and author Charles Atkins has published six novels—the last three with forensic-psychiatrist heroine, Barrett Conyors. In addition to fiction (mysteries and thrillers) he has written books on Bipolar Disorder and Alzheimer’s disease and has published hundreds of short stories, columns and articles. Visit his website at


  1. Hi Charles,

    Welcome to Jungle Red. I'm fascinated by your villian strategy, but I'm always alittle confused by the psychiatric terminology. Is a psychopath and socialpath the same disorder with new name or are their differences?? And what are the differences between a sociopath and borderline personality disorder (in terms of creating good villians). Thanks!!!!

  2. Nice to meet you Charles. I like to read books where I know at least the basic stuff is real, so I'll look out for yours. Mother's Milk certainly seems to cover some fascinating issues.