TITLE: Kay Redfield Jamison: Healing in Mind (*Lancet*) [Book -- Fires in the Dark: Healing the Unquiet Mind. ]

Thank you Dr. Pope for the summary.

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The new issue of The Lancet includes an article: “Kay Redfield Jamison: healing in mind” by Niall Boyce.

Here are some excerpts:

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I am talking on Zoom with Kay Redfield Jamison, Co-Director of the Mood Disorders Center and Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine, Baltimore, MD, USA, about her new book Fires in the Dark: Healing the Unquiet Mind. Its optimistic title is belied by the dustjacket photograph depicting flames rising from Notre Dame cathedral during the 2019 fire. While pointing out that she does not choose her cover art, Jamison nevertheless thinks it is an appropriate image:

“Since I wrote about Notre Dame, and what it is that you can bring from ruin and destruction, it has some meaning there.” The book's title, meanwhile, is taken from English writer Siegfried Sassoon's poem To a Very Wise Man, a tribute to W H R Rivers, the psychiatrist who helped him cope with trauma sustained in World War 1.

Fires in the Dark is the latest in a series of highly regarded publications by Jamison; previous topics include creativity and mental illness, suicide, bereavement, and exuberance.

The book is concerned with healing, and Jamison has in her life been both the healer and the healed; her experience of bipolar disorder was the subject of her 1995 memoir An Unquiet Mind.

Fires in the Dark is a book about finding a way forward, but it is also a revisitation of Jamison's past, as its subtitle suggests. Jamison recalls an episode of depression that she had as a 17-year-old in California during the 1960s, when help came not from a psychiatrist, but from an English teacher: “Nobody talked about depression. I mean, it just wasn’t done…But he came to me with a couple of volumes by Robert Lowell, and Sherston's Progress by Sassoon, and The Once and Future King by T H White.” Jamison tells me that these books—poetry, fictionalised war memoir, and Arthurian legend—“have just stayed in my life since”.

There is an epic quality to Jamison's own life; her early years were spent moving “from Florida to California to Puerto Rico, Japan, Washington” with her family—her father was a scientist and pilot with the US Air Force. “I actually loved it, and enjoyed meeting new people”, she says. Settling in Pacific Palisades, CA, USA, when her father took a job with the RAND Corporation, Jamison's thoughts turned to the medical world; psychology, she explains, came later.

At one point, she was set to become a veterinarian; and yet, discussing this stage in her life, I detect a hint of where her talents would eventually lead her. Animals, Jamison says, are “different, they go through the same world [as humans] and they sense that differently”. Perhaps this interest in communication across seemingly insuperable barriers meant that her eventual qualification in clinical psychology was on the cards from the start? One of the most frustrating things about mental illness, Jamison tells me, “is that you can’t communicate in your normal way. So it's up to the therapist…How do you find out what someone is feeling and thinking when they’re so ill, and so embarrassed about being ill?”

Jamison has tackled that stigma in her own life, making public her experience of bipolar disorder in An Unquiet Mind. While family and colleagues were largely supportive, she experienced a ferocious backlash from some quarters. “I got a lot of hate mail”, Jamison recalls. “A lot of people saying it's a good thing you didn’t have children [and] pass these genes on.” But it was vital to Jamison to tell her story, other people's accounts of their illness having proved invaluable to her: “When I got manic the first time, I was so terrified…everything was just bleak, bleak. The fact that people had gotten through it was very meaningful, very important.” In a field that is often marked by professional polarisation, Jamison takes a holistic attitude towards healing: “I think psychotherapy is so undervalued. And I think there's no question in my own mind that for myself, psychotherapy kept me as alive as lithium did.”

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We return to the subject of Rivers, one of the key psychological and societal healers featured in Fires in the Dark. Jamison tells me that it was said “that he came by understanding human nature probably through more different paths than anyone else. Through experimental psychology, anthropology, neurology, psychiatry, medical psychology…there's profundity there of wisdom; of human wisdom, and an openness to experience, and a compassion toward suffering.”

I’m struck that Jamison takes a similarly expansive approach: she is focused not only on the acute stages of mental health problems, but also on what comes afterwards: “if you’ve got to spend the rest of your life knowing that you’ve got a recurrent illness—that you may get sick at any time, under the best of circumstances—you’ve got to figure out what you’re going to do with that. And to me…healing is a lot of getting well enough and insightful enough to say: How do I take on the world? How do I take some purpose from this?”

Although the US health-care system—which Jamison describes as “utterly completely broken”—does not make it easy for clinicians to work as healers, she remains optimistic. Towards the end of our conversation, I ask her about her statement in An Unquiet Mind that she “long ago abandoned the notion of a life without storms”. Is this still the case?

“I’ve been very lucky”, she replies. “By medical standards, I have a bad version of bipolar illness, but by treatment standards, I have a very good response.” She looks thoughtful. “The idea that there are storms out there doesn’t bother me.”

Ken Pope

Ken Pope, Nayeli Y. Chavez-Dueñas, Hector Y. Adames, Janet L. Sonne, and Beverly A. Greene
Speaking the Unspoken: Breaking the Silence, Myths, and Taboos That Hurt Therapists and Patients (APA, 2023)
“I am not afraid of storms, for I am learning how to sail my ship.”
—Jo March in Louisa May Alcott’s Little Women (1868)

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