Kay Redfield Jamison arrives punctually at a towering marble statue of Jesus Christ in the entrance of the old hospital building on 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 halls. “Dear God please help our daughter feel better. …” “Dear Lord, please heal my grandpa and let him live happily. …”
This building, decorated with rows of oil paintings of Hopkins doctors and nurses through the ages, is redolent of the history of healing. The desperate, uncertain, even heroic attempt to heal is at the center of Jamison’s new book, “Fires in the Dark: Healing the Unquiet Mind,” out on May 23 from Knopf.
“If I could have subtitled it ‘A Love Song to Psychotherapy,’ I would have,” she said.
Jamison, 76, her blond hair cut into a bob, wears a colorful floral dress as she makes her way through hallways filled with people in scrubs to a quiet corridor reserved for psychiatry. She is the co-director of the Center for Mood Disorders and a professor of psychiatry. Her bookcase displays her many publications: her psychobiography of the poet Robert Lowell, which was nominated for the Pulitzer Prize, and her books on suicide, on exuberance and on the connection between mania and artistic genius. And, of course, her best-known work, “An Unquiet Mind,” a memoir she published in 1995 in which she went public with her own manic depression, at considerable personal cost.
Jamison had been a thriving, sporty high school senior in the Pacific Palisades neighborhood of Los Angeles until suddenly, falling into a deep depression after a mild mania, “I couldn’t count on my mind being on my side,” she said. She was bewildered by what she was going through. Her high school English teacher handed her a book of poems by Robert Lowell, who had struggled all his life with manic-depression, and with whom she felt an instant connection. That 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, then a Ph.D. program in clinical psychology. By 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 seek help: In a psychotic state, she had racked up tens of thousands of dollars in debt, buying items like ultramodern furniture and a lifetime supply of snakebite kits.
When she first walked into the office of her psychiatrist, Daniel Auerbach, she was shaking in fear. “I had no idea whether I would be able to work again,” she said.
He diagnosed her with manic depression (she still prefers this term to the more current “bipolar disorder”) and prescribed her lithium, and their years of work together began. He never claimed that their task would be a simple one, she said. The proviso that getting well would be hard is one of the principles of healing that Jamison now holds dear.
“You say to someone, look, it’s going to be difficult — but that’s the interesting part,” she said. “Because, at the end of it, 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 by then on the faculty of Johns Hopkins, she decided to tell the story of her manic depression. It was a difficult decision, in part because “I was brought up pretty 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 very strongly that a patient has a right to come into your office and deal with their issues and their problems, not what they perceive to be your issues and your problems,” she said.
Her book would become a watershed.
“There were all of these science books about bipolar illness and there were memoirs by people who had written about their illness, but there was no one who had been able to stitch all of it together in the way that she did,” said the writer 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 who was in the field of psychiatry who wrote about her own illness and the extended depths of it.”
She also met with much rejection. When she went out on book tour, she received hundreds of letters expressing such sentiments as “May you die tomorrow,” and “Don’t have children, don’t pass along these genes,” she said.
“There are a lot of people out there who really don’t like the mentally ill,” she said. “It’s wired into many species to be keenly aware of differences.”
Still, “An Unquiet Mind” resonated for 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 had been cleaning the building,” she said. “He came up to her, really quickly, and said: ‘I just want to tell you that your book changed my life.’”
She added, “It still gives me chills when I think about it, that sense that, beneath her fame and acclaim, there is this really powerful impulse towards human healing.”
An “Unquiet Mind” unlocked Kay Jamison’s life as a writer. Ever since, she has drawn explicitly from her own experience. In her book “Night Falls Fast,” for instance, she writes about her own suicide attempt during a particularly bad stretch of her 20s.
Now, in “Fires in the Dark,” her emphasis is on “psychotherapeutics,” which the English psychiatrist W.H. Rivers called “the oldest form of medicine.” “I wanted to get back into psychotherapy — into thinking about it, and being emotionally involved in it,” Jamison said.
Over lunch at her light-filled farmhouse in the countryside outside Baltimore, which she shares with her husband, the cardiologist Thomas A. Traill, and their basset hound Harriet (named for Robert Lowell’s daughter), the conversation turns to Rivers.
Born at the end of the 19th century, he trained and worked as an anthropologist before he served as an army doctor during World War I, treating the “shellshocked” soldiers. He didn’t like the term: The problem was psychological trauma, not concussive shock, he would later argue. In time, the diagnosis would be known as post-traumatic stress disorder. Rivers believed that “to be a healer was to make a patient’s ‘intolerable memories tolerable,’ to share in the darkness of the patient’s mind,” Jamison writes.
Rivers’s best-known patient was the poet Siegfried Sassoon, whose vivid account of their sessions together had been lodged in Jamison’s mind since her high school teacher gave her 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 sent to Craiglockhart War Hospital in Edinburgh to recover. He met Rivers five minutes after arriving.
“He made me feel safe at once, and seemed to know all about me,” Sassoon would write. “What he didn’t know he soon found out.” It was Rivers’s job, as an army doctor, to heal him — and send him back to fight.
Their sessions aimed at “autognosis” — “to know oneself,” as Rivers put it. Sassoon returned to the front that November. The following year, he was shot in the head but survived. Rivers came to see him in the hospital. “Quiet and alert, purposeful and unhesitating, he seemed to empty the room of everything that had needed exorcising,” Sassoon later wrote in his semi-autobiographical book “Sherston’s Progress.” “This was the beginning of the new life toward which he had shown me the way.”
Rivers is, for Jamison, an exemplar 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 residents at Hopkins to take the time to question their patients about particular symptoms, to understand the meaning behind them, not just to check a box. If the patient has racing thoughts, “What does it feel like? What do you experience?” 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 has included 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 reflects her own passionately varied intellectual life. But one through-line in her book is the constant nearness of loss, of pain, of suffering.
Jamison has known, and described, her own suffering and loss, but most of all, her work is replete with the kindnesses she has encountered in her long experience struggling with, and thinking about, mental illness. She still remembers a conversation she had with the chairman of her department at U.C.L.A. not long after the manic break that first started her life as a patient.
His advice, as she recalls it, would shape her notion of healing and the rest of her career: Learn from it. Teach from it. Write from it.
