Kay Redfield Jamison arrives punctually past a towering marble statue of Jesus Christ at the entrance to the Old Hospital Building on the Johns Hopkins Medical Campus. Next to it, two guest books are left open to receive the wishes and prayers of those who pass through these rooms. “Dear God, help our daughter feel better. …” “Dear Lord, please heal my grandfather and let him live happily ever after. …”
This building, decorated with rows of oil paintings of Hopkins doctors and nurses through the ages, evokes the story of healing. The desperate, uncertain, even heroic attempt at healing is the focus of Jamison’s new book, “Fires in the Dark: Healing the Unquiet Mind,” out May 23 from Knopf.
“If I could have captioned it ‘A Love Song to Psychotherapy,’ I would have,” she said.
Jamison, 76, her blonde hair bobbed in a bob, wears a colorful floral dress as she makes her way through hallways packed with people in scrubs to a quiet corridor reserved for psychiatry. She is co-director of the Center for Mood Disorders and professor of psychiatry. Its library presents its many publications: its psychobiography of the poet Robert Lowellwho was nominated for the Pulitzer Prize, and her books on suicideon exuberance and on the link between mania and artistic genius. And, of course, her best-known work, “An Unquiet Mind,” a memoir she published in 1995 in which she made her own manic depression public, at considerable personal cost.
Jamison had been a thriving and athletic high school student in the Pacific Palisades neighborhood of Los Angeles until suddenly, falling into a deep depression after a mild mania, “I couldn’t rely on my mind to be on my side”, she said. She was devastated by what she was going through. Her high school English teacher gave her a book of poems by Robert Lowell, who had struggled with manic depression all her life, and with whom she felt an instant connection. This same teacher also gave him “Sherston’s Progress”, by the English poet Siegfried Sassoon. More than fifty years later, Sassoon’s book would become one of the central inspirations for “Fires in the Dark”.
Jamison’s symptoms subsided and she made her way through college and then a doctorate. program in clinical psychology. At the time she had a full manic break, she was 28 and an assistant professor of psychiatry at the University of California, Los Angeles. This time, she had no choice but to ask for help: in a psychotic state, she had racked up tens of thousands of dollars in debt, purchased items like state-of-the-art furniture and a lifetime supply of snakebite kits.
When she first walked into the office of her psychiatrist, Daniel Auerbach, she was shaking with fear. “I didn’t know if I could work again,” she said.
He diagnosed her with manic depression (she still prefers that term to the more common “bipolar disorder”) and prescribed her lithium, and their years of working together began. He never claimed their task would be easy, she said. The condition that would be difficult to cure is one of the healing principles Jamison holds dear now.
“You tell somebody, look, it’s going to be tough — but that’s the interesting part,” she said. “Because in the end, you will have survived something, you will have created something, and you will go into the rest of your life stronger for it.”
Years after her diagnosis, and then on the faculty of Johns Hopkins, she decided to tell the story of her manic depression. It was a tough decision, in part because “I was raised as a WASP-y,” she said. “You didn’t talk about your problems.” Jamison also knew that going public would mean no longer treating patients: “I felt strongly that a patient has a right to come into your practice and deal with their issues and problems, not what they perceive to be being your problems and your problems,” she said.
His book was to become a turning point.
“There were all these scientific books about bipolar disease and there were memoirs of people who had written about their disease, but no one had been able to put it all together like she did,” the writer said. . Andrew Solomon, whose own approach to writing about his depression, in “The Midday Demonwas influenced by Jamison. She was, he noted, “the first person in the field of psychiatry who wrote about her own illness and its extended depths”.
She also encountered a lot of rejection. When she went on a book tour, she received hundreds of letters expressing sentiments such as “May you die tomorrow” and “Don’t have kids, don’t pass on those genes,” he said. she stated.
“There are a lot of people who really don’t like the mentally ill,” she said. “It’s wired in many species to be acutely aware of differences.”
Still, “An Unquiet Mind” resonated with countless readers struggling with the same illness. Jamison’s niece, the writer Leslie Jamisson, remembers when her aunt came to talk to her freshman class at Harvard. “She was bright and witty and everyone adored her, but what I remember most clearly was this man cleaning the building,” she said. “He approached her, very quickly, and said, ‘I just want to tell you that your book has changed my life.'”
She added: “It still gives me chills when I think about it, that feeling that underneath his fame and his fame, there’s this really powerful push towards human healing.”
A “worried spirit” opened up Kay Jamison’s life as a writer. Since then, she has drawn explicitly from her own experience. In her book “Night Falls Fast,” for example, she writes about her own suicide attempt during a particularly difficult time in her twenties.
Now, in “Fires in the Dark,” she emphasizes “psychotherapy,” which English psychiatrist WH Rivers called “the oldest form of medicine.” “I wanted to get back to psychotherapy — to think about it and get emotionally involved in it,” Jamison said.
During lunch at her light-filled farmhouse in the countryside outside Baltimore, which she shares with her husband, cardiologist Thomas A. Traill, and their basset hound Harriet (named after Robert Lowell’s daughter), the conversation turns to Rivers.
Born in the late 19th century, he trained and worked as an anthropologist before serving as a military doctor in World War I, treating “shocked” soldiers. He didn’t like the term: the problem was psychological trauma, not concussion, he would later say. In time, the diagnosis would come to be known as post-traumatic stress disorder. Rivers believed that “to be a healer is to make a patient’s ‘intolerable memories’ tolerable, to share the darkness of the patient’s mind,” Jamison writes.
Rivers’ best-known patient was the poet Siegfried Sassoon, whose vivid account of their sessions together had been etched in Jamison’s mind ever since his high school teacher gave him Sassoon’s book. When Sassoon first met Rivers, in July 1917, the young poet had been diagnosed with “shell shock” after months of trench warfare and had been sent to Craiglockhart War Hospital in Edinburgh to recuperate. He met Rivers five minutes after he arrived.
“He immediately made me feel safe and seemed to know everything about me,” Sassoon wrote. “What he didn’t know, he soon found out.” It was Rivers’ job, as a military medic, to nurse him back to health – and send him back to battle.
Their sessions were aimed at “autognosis” – “to know yourself”, as Rivers put it. Sassoon returned to the front in November. The following year he was shot in the head but survived. Rivers came to see him in the hospital. “Calm and alert, determined and unhesitating, he seemed to empty the room of everything that needed to be exorcised,” Sassoon later wrote in his semi-autobiographical book “Sherston’s Progress.” “It was the beginning of the new life to which he had shown me the way.”
Rivers is, for Jamison, an example of a healer, a doctor who instinctively knew that “psychotherapy is a quest to find out who the patient is and how he became that way.” She encourages her residents at Hopkins to take the time to ask their patients about particular symptoms, to understand the meaning behind them, not just tick a box. If the patient has racing thoughts, “What does it do? What are you feeling?” are questions in the service of a larger inquiry, she said. “Where have you been? How can I help you? How can I know you better?
Along with Rivers, Jamison included a swirling constellation of other healers, both professional and unofficial, including Dr. William Osler, singer Paul Robeson and King Arthur. It’s a kaleidoscopic view of treatment and recovery that reflects his own exciting and varied intellectual life. But a guideline in his book is the constant proximity to loss, to pain, to suffering.
Jamison has experienced and described her own pain and loss, but most importantly, her work is filled with the kindnesses she has encountered during her long experience of struggling and reflecting on mental illness. She still remembers a conversation she had with her department chair at UCLA shortly after the manic break that started her life as a patient.
His advice, as she recalls, would shape her notion of healing and the rest of her career: learn from it. Teach from that. write from this.