Ahead of her upcoming conversation with #1 New York Times bestselling author and surgeon Atul Gawande (Being Mortal) on September 22, we talked to Pulitzer Prize finalist Kay Redfield Jamison (An Unquiet Mind, Robert Lowell: Setting the River on Fire) about the fascinating history of psychotherapy, her changing perceptions of mental illness in America, how artists have contributed to our understanding of mental health, and her new book, Fires in the Dark.
Fires in the Dark is a follow-up of sorts to An Unquiet Mind, which came out in 1995. How has your understanding of mental health changed since then?
If you start talking about mental illness in public, your perception of it changes. The questions that I get asked by people at book readings touch upon not only what I have gone through, but what they’ve gone through themselves. I have a much broader awareness of how much pain and suffering people have from mental illness, along with their families. I study it, but there’s something about seeing the suffering night after night that is very jarring.
In Fires in the Dark, you write that “psychotherapy is a quest to find out who the patient is, and how he or she came to be that way.” It suggests that you view the project of healing as understanding a whole person, not just a symptom or an illness. Similarly, you seem to approach writing about therapy as a quest to understand who the great healers are. Who was a healer who surprised you while you were researching this book?
If you’re interested in what makes a psychotherapeutic relationship work, you quickly become interested in the great healers. It’s easy to focus on who does it badly — there’s no shortage of that. In medicine or any other field, there are lots of people who do things badly, but I’m interested in the exemplars. I had always been interested the British psychiatrist and anthropologist W.H.R. Rivers from when I was in high school, when a teacher gave me a book about his relationship with the poet Siegfried Sassoon — he met Sassoon while treating him for shell shock during the First World War. But I had no idea of how interesting Rivers’ mind was, and how many ways he had of understanding human nature. It happened that Sassoon, one of the great poets of that time, wrote about their relationship in extraordinary, caring detail. Rivers was a greatly compassionate, tough man. He was in many ways responsible for the acceptance of psychotherapy as a serious branch of medicine through his work with soldiers like Sassoon.
Therapy is undergoing something of a renaissance — there seems to be a renewed interest in mental health after the pandemic. To what do you attribute this?
Most of the major psychiatric illnesses first occur during adolescence. It’s all too easy for adolescents to go off with their peers and to actively seek to be away from their parents. When parents were spending more time with their children during the pandemic, I think many of them saw the pain that some of them were going through up close. In general, all for the better, I think people are more willing to talk openly about anxiety and depression.
How has your thinking about writers and artists affected your view of the relationship between art-making and healing?
You can’t help but read the great writers and be struck by the connection between bipolar disorder, depression and creativity — and it’s been borne out in many scores of studies. I have always gone to the great artists and writers in my teaching of medical students and graduate students because of their ability to articulate emotions and behaviors in a way that most people simply can’t. If you read Robert Lowell, you can’t help but come away from his poetry with a sense of his courage to wake up every day and face what he faced — years of agonizing mental illness and 20 hospitalizations. He had an extraordinary ability to put into words what depression and madness feel like, and how terrifying it is to face the prospect of going psychotic again and again. It’s the same reason I wrote so much about Paul Robeson, the singer and activist, in my book. His true north was his courageous ability to put that expression of both pain and beauty into music.
You’ll be talking with Atul Gawande at 92NY. What appeals to you about his work? What are you most looking forward to in the conversation?
I have enormous admiration for the clarity of his thinking, writing and his desire to take on the most important subjects, such as mortality. So many of us find ways to not look at death and dying, but his book Being Mortal is unrelenting, and deeply human. As a practicing surgeon he is in contact, day in and day out, with the human condition. I admire him a great deal, not only for his writing but for his work in public health. I am very curious to hear what he thinks makes a great healer — it’s not what he most obviously writes about, but as a doctor and a writer he has a unique ability to stand back from the process of healing and observe where it goes wrong, and where it goes right.
What do you hope audiences will come away with from this reading?
A sense of how interesting and various psychotherapy can be. It can be deadly dull when done badly, but done right it can be a real adventure between two people. It is the ultimate accompaniment through suffering.
Kay Redfield Jamison talks to Atul Gawande on Friday, September 22.