He is Clinical Professor of Psychiatry at Baylor College of Medicine in Houston, Texas, and is also training and supervising analyst at the Center for Psychoanalytic Studies in Houston. He then earned his M.D. from Rush Medical College in Chicago in 1975. He then served on the staff of the Menninger Clinic for 26 years and served as Director of the Menninger Hospital from 1989 to 1994 and Director of the Topeka Institute for Psychoanalysis from 1996 to 2001.
In 2001, he moved to Baylor College of Medicine, where he served as Professor of Psychiatry and Brown Foundation Chair of Psychoanalysis until 2011. He was Joint Editor-in-Chief of the International Journal of Psychoanalysis and was Associate Editor of the American Journal of Psychiatry.
Vice president Topeka Civic Theatre, 1981-1982, president 1982-1983, board directors 1981-1983. Member American Association for the Advancement of Science, American Psychoanalytic Association (associate editor journal, member editorial board), American Psychiatric Association (Falk fellow 1976, Edward A. Strecker award 1994, Distinguished Psychiatrist lecturer 1995, C. Charles Burlingame award 1997, Mary S. Sigourney award 2000, Distinguished Service award 2002, Adolf Meyer award 2004), School Psychotherapy Research, Menninger School Psychiatry Alumni Association (president 1982-1983), Alpha Omega Alpha.