Robert Lowell: Setting the River on Fire

Jamison, Kay Redfield

Last Updated: Jun-14-2017

Glass, Guy

Summary:

Robert Lowell: Setting the River on Fire is “a study of genius, mania, and character” of American poet Robert Lowell (1917-1977). It is meant to be neither an autobiography nor a critical study of Lowell’s literary output, but a study of an artist and his lifelong battle with Bipolar I Disorder, and an appreciation of how his art and illness were inseparably linked. The author, Kay Redfield Jamison, is a distinguished psychologist who has been quite open about her own struggles with the same disease, and whose lifework consists of exploring the link between Bipolar Disorder and creativity.

Eschewing a purely chronological approach, Jamison divides her work into sections entitled “Origins,” “Illness,” “Character,” “Illness and Art,” and “Mortality.” In the first, she traces the history of mental illness within the poet’s illustrious Boston family. We learn that Lowell’s great-great-grandmother was institutionalized at McLean Asylum for the Insane, which was to be the site of several of the poet’s own hospitalizations. “Illness” is a clinical case study in prodromal childhood symptoms that progress to full-blown manic episodes. We follow the progress made by 20th century psychiatry from psychotherapy and ECT to Thorazine, and, finally, with the introduction of Lithium, to the possibility of prophylaxis against recurrences. Later, in “Illness and Art,” Jamison brings her thoughts about creativity and art to full fruition by discussing what her research reveals about writers and artists.

Appendices include diagnostic criteria for Bipolar Disorder, and an explanation of how Lowell’s psychiatric and medical records were made available by his daughter for the benefit of this volume.

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Instrumental: A Memoir of Madness, Medication, and Music

Rhodes, James

Last Updated: May-11-2017

Glass, Guy

Primary Category: Literature / Literature

Genre: Memoir

Summary:

James Rhodes is a British classical concert pianist who is known for his iconoclastic, pop-inspired performing style. He is also an outspoken survivor of childhood sexual abuse who is equally frank about his struggles with severe mental illness. Rhodes’s memoir Instrumental is a tribute to the healing power of music. Indeed, music quite literally saves the author’s life; it is only when a friend smuggles an iPod loaded with Bach into his psych ward that Rhodes regains the will to live.

Rhodes does not mince words. We learn that he was violently raped by a gym teacher on a regular basis for five years from the age of five. Left with severe internal injuries that produce wracking pain, he requires multiple surgeries. He soon also develops dissociative symptoms, drug and alcohol addiction, self-injurious behaviors, and chronic suicidal ideation. Barely able to function, he endures many tumultuous years during which he abandons the piano. The author’s subsequent journey from physical and emotional fragmentation to wholeness through music provides the substance of his book.

The preface to Instrumental is designated “Prelude,” and the ensuing twenty chapters, labeled “tracks,” all correspond to musical works. (All twenty tracks may be listened to, for free, on Spotify.) In addition, as if to assure the reader he is in good company, Rhodes offers psychological profiles of famous composers. We learn, for example, that Bruckner suffered from a morbid obsession with numbers, and that Schumann, after throwing himself in the Rhine, died in an asylum.

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Dear Evan Hansen

Paul, Justin; Pasek, Benj ; Levenson, Steven

Last Updated: Apr-24-2017

Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

Evan Hansen, an awkward, lonely high school senior, struggles with Social Anxiety Disorder. On the advice of his therapist, he pens supportive letters to himself: “Dear Evan Hansen, Today is going to be an amazing day, and here’s why. Because today all you have to do is be yourself. But also confident.”

Connor, another loner student, picks up one of Evan’s letters and, several days later, commits suicide. When Connor’s parents find the letter, they take it to be their son’s suicide note. Instead of dissuading them, Evan concocts an account of a close friendship with the classmate he barely knew, creating an email trail. Connor’s family swallows the story.

As Evan gains the attention he has always craved and comes out of his shell, he finds that he cannot stop himself. He founds the “Connor Project,” an organization dedicated to preserving his “friend’s” memory where he shares his musings on social media: “Have you ever felt like nobody was there? Have you ever felt forgotten in the middle of nowhere? Have you ever felt like you could disappear? Like you could fall, and no one would hear? ...Well, let that lonely feeling wash away…Lift your head and look around. You will be found. You will be found.” Once Evan’s postings go viral, the Connor Project becomes a veritable industry, with a budget, and fans who look to it for inspiration. As the stakes rise, the Project can flourish only by being fed more lies.

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Psychobook

Rothenstein, Julian

Last Updated: Nov-30-2016

Glass, Guy

Primary Category: Literature / Literature — Secondary Category: Visual Arts /

Genre: Photographs with Commentary

Summary:

The subject of Psychobook is psychological tests, both classic tests and newly created ones. Oversized, with more pictures than text, it is truly an art book.

Psychobook begins with an introduction by Lionel Shriver, a journalist and novelist, which proves to be a very personal indictment of psychological testing. There follows a more even-handed historical essay by Oisin Wall, a curator at the Science Museum in London.

The bulk of Psychobook is comprised of photographs of tests and archival material related to tests. For example, along with intelligence tests designed to screen potential immigrants, we find images of new arrivals being tested at Ellis Island. Likewise, we see beautifully reproduced Rorshach inkblots along with pictures of Rorshach and older inkblots that may have inspired him. The Thematic Apperception Test (TAT) is a projective test in which subjects respond to images with their fantasies. Here we see the 1930s originals cut out of magazines alongside updated images especially commissioned for this volume. Each is provocative in its own way. As an added bonus, a series of photographs of psychotherapists in their offices from the 1930s to the present is interspersed with the content on psychological testing.

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Bad Vibrations: The History of the Idea of Music as a Cause of Disease

Kennaway, James

Last Updated: Sep-07-2016

Glass, Guy

Primary Category: Literature / Nonfiction

Genre: Treatise

Summary:

The therapeutic benefits of music are well known, but the theory that music might be harmful to our health, unless it is so obviously loud it injures our eardrums, comes as a surprise. In this volume, historian of medicine James Kennaway traces the idea of pathological music from antiquity to the present. The book’s introduction considers whether music really can create illness, whether it be of a physiological or a psychological nature. We learn, for example, of arrhythmias and seizure disorders that are set off by music, not to mention the so-called Stendhal Syndrome, a psychosomatic reaction to great works of art.

The second chapter describes how, during the 18th century, disease was thought to result from excessive stimulation of the nerves, and how that created a theoretical framework for the “medical dangers of music” (p. 23) as being rooted in the nervous system. The example of the glass harmonica is given. This musical instrument, invented by Benjamin Franklin, had its status elevated when Mozart composed two pieces for it. However, its success became its undoing, as it was feared the tones would “make women faint, send a dog into convulsions, [and] make a sleeping girl wake screaming through a chord of the diminished seventh” (p. 45). Special gloves were devised so that a performer might, by avoiding direct contact with the apparatus, spare his nerves.

In the following chapter, Kennaway explores how Wagner dominated 19th-century discourse on pathological music in that his work’s eroticism and novel harmonies were thought to produce neurasthenia (a popular catch-all term for an array of anxiety disorders). Listeners were brought to an unhealthy state of ecstasy, and singers, being driven to the abyss, went insane. Women who had recklessly allowed themselves to become “Wagnerized” were punished with a “lack [of] children, or, in the most bearable cases, men” (p. 74).

Moving into the 20th century, the author describes how ideas about pathological music acquired a political connotation. In Germany, the perceived threat of avant-garde Jewish composers (eg. Schoenberg) to public health culminated in the so-called Degenerate Music exhibition of 1938. And in the United States, African American-influenced jazz was credited with the power to “change human physiology, damaging the medulla in the brain” (p. 121).

Finally, the book concludes in the present day with music for brainwashing (e.g. a consideration of whether subliminal messages hidden in rock songs could lead to suicide), and the use of painfully loud or abrasive music as sonic weapons in warfare, or for torture. The author’s verdict is that the notion of music as bad for your health, though emerging in new forms, is more topical than ever.

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A Streetcar Named Desire

Williams, Tennessee

Last Updated: May-24-2016

Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

The play is set in 1947 (the year it premiered) in New Orleans. Having lost their ancestral Mississippi home to creditors, Blanche Dubois arrives at the shabby French Quarter flat of her sister Stella. When we first meet Blanche she explains she is on a leave of absence from teaching high school English on account of her “nerves.” From her first meeting with Stella’s husband Stanley Kowalski, a World War II vet, we detect class conflict and sexual tension between the two of them. As Blanche’s visit becomes more and more protracted, Stanley becomes increasingly suspicious of her motives and background. Meanwhile, she begins to date Mitch, one of Stanley’s poker buddies. Gradually we learn more about Blanche’s checkered past. She was once married to a young man who committed suicide after she discovered him in a sexual encounter with another man. Stanley uncovers rumors that she was fired from her teaching job for having sex with a student. As the play progresses, fueled by her surreptitious drinking, Blanche’s mental state unravels. When Stanley warns Mitch about Blanche’s notorious reputation, Mitch rejects her. Adding insult to injury, while Stella is having a baby, Stanley rapes his sister-in-law. Blanche’s emotional deterioration is complete. In the final scene, a doctor and nurse arrive to take Blanche to a mental hospital. She initially resists them, but when the doctor helps her up she willingly surrenders: “Whoever you are - I have always depended on the kindness of strangers"(p. 178).

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Performance and the Medical Body

Bouchard, Gianna; Mermikides, Alex

Last Updated: Mar-23-2016

Glass, Guy

Primary Category: Literature / Plays

Genre: Essay

Summary:

This is a collection of essays by (mostly British) artists, performers, and academics on the intersection between medicine and theater. It appears in a series entitled “Performance and Science: Interdisciplinary Dialogues” put out by Bloomsbury Methuen Drama. The introduction makes it clear there are many points of convergence beyond the scope of this volume, such as how medicine is depicted in plays and therapeutic uses of theater (e.g. drama therapy). The focus here, then, is on “the ways in which the body is understood, displayed and represented in performance” (p. 11). And the “medical body” of the title refers to one that is ’acted upon’ by illness or disability and/or by the diagnostic and therapeutic activities of the medical profession” (Ibid).

The book is divided into three sections: “Performing the Medical,” “Performing Patients,” and “Performing Body Parts.” The first section includes an essay by Roger Kneebone, a surgeon, who explores the parallels between his field and theatrical performance. Kneebone has devised simulations that enable laypersons to get a sense of what it is like to participate in surgery. In his view, this encourages cross-fertilization of ideas. For example, his collaboration with a jazz pianist has demonstrated to him that musical improvisation, in its spontaneity, is somewhat like emergency surgery. And his work with a choreographer led to the development of a dance piece depicting the movements of a surgical team during a procedure.

In the second section we read about Brian Lobel, a theater artist who has used his experience with testicular cancer to create a solo performance piece entitled “BALL.” This not only allowed Lobel to “regain a sense of mastery over the illness experience” (p. 88), but has also earned him a niche within the theater community. Lobel now works with other cancer sufferers helping them develop their own narratives in a project called “Fun with Cancer Patients.”

The final section of the book includes a description of “Under Glass,” a forty-minute performance piece consisting of eight specimen jars each containing a solo performer, said to be “at once museum exhibit, gallery and medical laboratory” (p. 141), which also provides the book's front cover image. "Under Glass" was devised by Clod Ensemble, whose Performing Medicine project is known for its teaching programs in numerous London medical schools. Meant to provoke discourse about the public display of specimens, it brings to mind the Victorian “freak show” as well as the more recent controversial touring Body Worlds exhibition of plastinated cadavers and body parts.

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Dr. Mütter's Marvels

O'Keefe, Cristin

Last Updated: Jan-25-2016

Glass, Guy

Primary Category: Literature / Nonfiction — Secondary Category: Literature / Nonfiction

Genre: Biography

Summary:

Those who are familiar with the Mütter Museum of the College of Physicians of Philadelphia, best known for its anatomical oddities, may have wondered about the institution’s namesake. The author of this book, a poet and native of Philadelphia, endeavors to place Thomas Dent Mütter within the context of 19th-century American medicine.

We learn here that notwithstanding being “medicated” with wine, surgical patients emitted such agonized screams that observers were known to vomit and pass out in their seats. We learn that Philadelphia was a cesspool of infectious disease for which there was no effective treatment. We learn too of the rivalry (including behavior that would be considered unprofessional today) between the well-established school of medicine at the University of Pennsylvania (Mütter’s alma mater) and upstart Jefferson (whose faculty Mütter would join).

In an era before the germ theory of disease became widely accepted, there was of course no concept of sterile technique. To suggest that a surgeon should wash his hands was to imply he was not a gentleman because “all gentlemen were clean” (page 104). Resistance to anesthesia was based not so much on concerns about potential danger but on the notion, when it came to obstetrics, that pain was a punishment for the sins of Eve. Doctors could be downright sadistic to their patients, to the point of beating them like livestock. That there was no concept of surgical aftercare meant that patients would be sent home immediately following an amputation. Victims of grotesque tumors and disfiguring accidents were considered “monsters” who lived lives of unimaginable misery.

Enter Mütter, whose importation of plastic surgery from Paris to America brought hope to thousands of incurables. He had an intuitive sense of the role of cleanliness in reducing morbidity and mortality. He was a passionate advocate for anesthesia when it was seen as little more than a fad. He abandoned traditional teaching methods that held a professor should be distant and unapproachable, and became beloved by generations of Jefferson students.

In short, Mütter emerges as not just a likeable guy, but the forerunner of a whole new concept of what a good doctor should be, a sort of cross between P.T. Barnum and Mother Teresa.

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4:48 Psychosis

Kane, Sarah

Last Updated: Dec-15-2015

Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

4:48 Psychosis was the last work of controversial British playwright Sarah Kane. In 1999, soon after her twenty-eighth birthday, having completed the play, she took her own life.

Naturally, these tragic circumstances can never be far from the reader’s mind. But to dismiss 4:48 Psychosis as a suicide note is to negate Kane’s achievement. The play was, in fact, meticulously researched and carefully written. Kane’s first play, Blasted, had considerable shock value, and throughout her short career she pushed the boundaries of what might be considered stageworthy. 4:48 Psychosis is both the final product of a life marked by recurrent episodes of depression (the play gets its name from the time she found herself waking up every day during the last episode) and the final chapter in her writing’s progression towards disintegration. It represents her deteriorating mental state, but is also a conscious stylistic decision.

The text of 4:48 Psychosis is unrecognizable as a conventional play. The author has left neither stage directions nor an indication of the number or gender of performers. Words and numbers appear to be arranged ornamentally on the page. However, meaning that is not apparent emerges from the chaos, as in the way that sense may be made from a psychotic mind. The numbers are not random, but “serial 7’s” from the mental status exam. Quotations from the Book of Revelations appear side by side with excerpts from a medical chart, and extracts from self-help books are interspersed with dialogue between a patient and her psychiatrist. The latter provides an illustration of the patient’s attempt to reconcile her anger with her neediness: “I cannot believe that I can feel this for you and you feel nothing” (p. 214). We learn too of her struggle with self-mutilation and her suicidal impulses, and follow her moods from dark humor to despair to hopefulness. Indeed, the last line of the play, “Please open the curtains” (p. 245) appears to leave open the possibility that she will pull through. That option was unfortunately not the one the author chose for herself.

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Next To Normal

Kitt, Tom; Yorkey, Brian

Last Updated: Nov-18-2015

Glass, Guy

Primary Category: Literature / Plays

Genre: Play

Summary:

Next to Normal is a musical, composed in a rock idiom.

Meet the Goodmans, (father Dan, mother Diana, daughter Natalie) who on the surface resemble a “perfect loving family” like any one of millions. However, from the outset we see that they are, in fact, a hair’s breadth from collapse: Diana’s long-term struggle with bipolar disorder leaves her suffering uncontrollable mood swings. Her illness fuels the chronic tension in her relationships with husband and daughter. In addition, we learn that a son (Gabe), whom we initially believe to be an active family member, actually died years ago and his appearances represent Diana’s hallucination.

As the show begins, Diana is undergoing a hypomanic episode that is resistant to treatment by her psychopharmacologist. Discouraged by side effects and egged on by her phantom son, Diana flushes her pills down the toilet. As she deteriorates, she visits a new psychiatrist who agrees at first to treat her without medication. As she begins in psychotherapy, for the first time, to accept the loss of her son, she descends to a new clinical low. At the close of the first act, after making a suicide attempt, she is hospitalized and agrees to be treated with ECT.

By Act II, the ECT has effected great clinical improvement, with stabilization of Diana’s mood and no further hallucinations. All this, however, has come at the expense of her memory. As it returns, she becomes aware that what she most needs to remember, and process, are her feelings about losing a child. In fact, we learn that she was kept from expressing them at the time because of concerns she might decompensate. She struggles to make sense of all of this while remaining stable. When she confronts Dan about Gabe, it is he who appears unable to discuss their loss. She suddenly becomes aware that Dan has been enabling her in an unhealthy way. She reconciles with her daughter, but realizes that in order to move forward she needs to get out of her dysfunctional marriage. However, the door is left open on this relationship, for at the recommendation of her psychiatrist Dan enters psychotherapy.

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