Kay Redfield Jamison punctually arrives at a towering marble statue of Jesus Christ at the entrance to the old hospital building on the Johns Hopkins Medical Campus. In addition, two guest books are open to receive the wishes and prayers of those who pass through these corridors. “Dear God, please help our daughter feel better. …” “Dear Lord, please heal my grandfather and let him live happily. …”
Decorated with rows of oil paintings of Hopkins doctors and nurses through the ages, this building is reminiscent of the history 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,” published May 23 by Knopf.
“If I could have subtitled it ‘A Love Song to Psychotherapy,’ I would have,” she said.
Jamison, 76, her blonde hair cut into a bob, wears a colorful floral dress as she makes her way through corridors full of people in scrubs to a quiet corridor reserved for psychiatry. She is co-director of the Center for Mood Disorders and professor of psychiatry. Her bookcase displays her many publications: her psychobiography of the Pulitzer Prize-nominated poet Robert Lowell, and her books on suicide, on exuberance, and on the connection between mania and artistic genius. And, of course, her most famous work, “An Unquiet Mind,” a memoir she published in 1995, in which she made public her own manic depression, at considerable personal cost.
Jamison had been a thriving, athletic senior in the Pacific Palisades neighborhood of Los Angeles until she suddenly fell into a deep depression after a mild mania: “I couldn’t count on my mind being on my side,” she said. She was stunned by what she was going through. Her high school English teacher handed her a book of poems by Robert Lowell, who had struggled with manic depression all his life and to whom she felt an instant connection. The same teacher also gave her ‘Sherston’s Progress’ by the English poet Siegfried Sassoon. More than fifty years later, Sassoon’s book would become one of the central inspirations of ‘Fires in the Dark’.
Jamison’s symptoms subsided, and she made her way through college and then a Ph.D. clinical psychology program. By the time she went on 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 seek help: While in a psychotic state, she had racked up tens of thousands of dollars in debt by purchasing items such as state-of-the-art furniture and a lifelong supply of snakebite kits.
When she first walked into the office of her psychiatrist, Daniel Auerbach, she was trembling with fear. “I had no idea if I would be able to work again,” she says.
He diagnosed her with manic depression (she still prefers the term to the more common “bipolar disorder”) and prescribed her lithium, and their years of collaboration began. He never claimed their job would be easy, she said. The condition that getting well would be difficult is one of the tenets of healing that Jamison now holds dear.
“You say to someone, look, it’s going to be hard — but that’s the interesting thing,” she said. “Because at the end of it, you’ve survived something, you’ve created something, and you’re going into it stronger for the rest of your life.”
Years after her diagnosis, and then on the faculty at Johns Hopkins, she decided to tell the story of her manic depression. It was a tough decision, in part because “I was raised pretty WASP-y,” she said. “You didn’t talk about your problems.” Jamison also knew that going public would mean no more patients being treated: “I felt very strongly that a patient has a right to come to your office and deal with their problems and issues, not what they see as your problems and your problems.” she said.
Her book would become a turning point.
“There were all these science books about bipolar disorder and there were memoirs from people who had written about their illness, but there was no one who could have sewed it all together the same way,” the author said. Andrew Solomon, whose own approach to writing about his depression in ‘The Noonday Demon’ was influenced by Jamison’s. She was, he noted, “the first person in psychiatry to write about her own illness and its extensive depth.”
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 children, don’t pass on these genes,” she said.
“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 Jamison, remembers when her aunt came to speak to her freshman class at Harvard. “She was brilliant and witty and everyone adored her, but what I remember most clearly was this man who cleaned the building,” she said. “He came up to 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 her fame and acclaim there is a really powerful impetus for human healing.”
A “troubled mind” unlocked Kay Jamison’s life as a writer. Since then she draws explicitly from her own experience. In her book ‘Night Falls Fast’, for example, she writes about her own suicide attempt during a particularly bad period in her twenties.
Now, in “Fires in the Dark,” her emphasis is on “psychotherapeutics,” which English psychiatrist WH Rivers called “the oldest form of medicine.” “I wanted to get back into psychotherapy — think about it and be emotionally involved in it,” Jamison said.
Over lunch at her bright farm 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 an army doctor during World War I, treating the “shellshocked” soldiers. He didn’t like the term: the problem was psychological trauma, not concussion, he would later claim. Over time, the diagnosis would be known as post-traumatic stress disorder. Rivers believed that “to be a healer was to make bearable a patient’s ‘unbearable memories’, to share in the darkness of the patient’s mind,” writes Jamison.
Rivers’ most famous patient was the poet Siegfried Sassoon, whose vivid account of their sessions together had stuck in Jamison’s mind ever since her teacher gave her Sassoon’s book. When Sassoon first met Rivers, in July 1917, the young poet was diagnosed with “shell shock” after months of trench warfare and sent to Craiglockhart War Hospital in Edinburgh to recuperate. He met Rivers five minutes after arriving.
“He made me feel safe right away and seemed to know everything about me,” Sassoon would write. “What he didn’t know, he soon found out.” It was Rivers’ job, as an army medic, to cure him – and send him back to fight.
Their sessions focused on “autognosis”—”getting to know oneself,” 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 at the hospital. “Calm and alert, purposeful and unhesitating, he seemed to clear the room of all that should have been exorcised,” Sassoon later wrote in his semi-autobiographical book, “Sherston’s Progress.” “This was the beginning of the new life to which he had shown me the way.”
Rivers, for Jamison, is an example of a healer, a doctor who knew instinctively that “psychotherapy is a quest to find out who the patient is and how he or she came to be that way.” She encourages her Hopkins residents to take the time to question their patients about certain symptoms, to understand the meaning behind them, not just to check a box. If the patient has racing thoughts, “How does it feel?” What are you experiencing?” are questions in the service of a larger investigation, she said. “Where have you been? How can I help you? How can I get to know you better?”
Along with Rivers, Jamison has taken on a swirling constellation of other healers, both professional and unofficial, including Dr. William Osler, the singer Paul Robeson and King Arthur. It is a kaleidoscopic vision of treatment and recovery that mirrors her own passionately diverse intellectual life. But a common thread in her book is the constant proximity of loss, pain and suffering.
Jamison has known and described her own suffering and loss, but most of all, her work is filled with the kindness she has encountered in her long experience of struggling with and thinking about mental illness. She recalls a conversation she had with the chair of her department at UCLA not long after the manic pause that first began her life as a patient.
His advice, she recalls, would shape her idea of healing and the rest of her career: learn from it. Learn from it. Write it out.
